Sex Influences the Accuracy of Subjective Memory Complaint Reporting in Older Adults

Article type: Research Article

Authors: Sundermann, Erin E.^{a; *} | Edmonds, Emily C.^{a; b} | Delano-Wood, Lisa^{a; b} | Galasko, Douglas R.^{b; c} | Salmon, David P.^c | Rubin, Leah H.^d | Bondi, Mark W.^{a; b} | for the Alzheimer’s Disease Neuroimaging Initiative¹

Affiliations: [a] Department of Psychiatry, University of California, La Jolla, CA, USA | [b] VA San Diego Healthcare System, San Diego, CA, USA | [c] Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA | [d] Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA

Correspondence: [*] Correspondence to: Erin E. Sundermann, PhD, UCSD School of Medicine, 3350 La Jolla Village Dr. (151A), Building 13, Room 322, La Jolla, CA 92161, USA. Tel.: +1 858 552 8585/Ext. 7286; E-mail: esundermann@ucsd.edu.

Note: [1] Data used in preparation of this article were obtained from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) database (http://adni.loni.usc.edu). As such, the investigators within the ADNI contributed to the design and implementation of ADNI and/or provided data but did not participate in analysis or writing of this report. A complete listing of ADNI investigators can be found at: http://adni.loni.usc.edu/wp-content/uploads/how_to_apply/ADNI_Acknowledgement_List.pdf

Abstract: Subjective memory complaints (SMC) are required when diagnosing amnestic mild cognitive impairment (aMCI), although their relationship with objective memory performance and Alzheimer’s disease (AD) pathology remains unclear. We investigated whether the sex of the patient/participant moderates these associations. Participants were 940 normal control (NC) and aMCI participants from the Alzheimer’s Disease Neuroimaging Initiative. SMC were assessed via the memory scale of the Everyday Cognition questionnaire. Discrepancy scores were calculated between self- and informant-reports and categorized into “overestimates,” “comparable estimates”, and “underestimates” of SMC. We conducted linear and logistic regressions to examine the interaction of sex with self- and informant-reported SMC and discrepancy group on the Rey Auditory Verbal Learning Test (RAVLT) Immediate and Delayed Recall and on PET measures of amyloid-β (Aβ) positivity. Diagnosis-stratified analyses were also conducted. Overall, there were sex by self- and informant-reported SMC interactions for Immediate and Delayed Recall. Despite a higher proportion of “overestimates” in women, greater self- and informant-reported SMC showed a stronger relationship to poorer RAVLT scores in women versus men. Diagnosis-stratified analyses revealed that results were driven by aMCI participants. Conversely, overall, greater self- and informant-reported SMC related to greater odds of Aβ positivity regardless of sex. In diagnosis-stratified analyses, only informant-reported SMC related to Aβ positivity in aMCI. Relative to “comparable estimates,” “underestimates” of SMC were associated with poorer RAVLT scores across sexes in the overall sample and in aMCI. The predictive utility of self-report SMC may be limited to women in aMCI. Sex differences should be considered when evaluating SMC.

Keywords: Alzheimer’s disease, amyloid, awareness, cognitive reserve, mild cognitive impairment, sex differences memory

DOI: 10.3233/JAD-170425

Journal: Journal of Alzheimer's Disease, vol. 61, no. 3, pp. 1163-1178, 2018