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Characterizing spontaneously reported cognitive complaints: the development and reliability of a classification instrument

Published online by Cambridge University Press:  04 September 2012

Daniel Apolinario ,
Rafaela Branco Miranda ,
Claudia Kimie Suemoto ,
Regina Miksian Magaldi ,
Alexandre Leopold Busse ,
Aline Thomaz Soares ,
Leonardo da Costa Lopes ,
Juliana Yumi Tizon Kasai ,
Erika Satomi  and
Elina Lika Kikuchi
...Show all authors
Daniel Apolinario*
Affiliation:
Geriatrics Division, Department of Internal Medicine, University of São Paulo Medical School, São Paulo, Brazil
Rafaela Branco Miranda
Affiliation:
Geriatrics Division, Department of Internal Medicine, University of São Paulo Medical School, São Paulo, Brazil
Claudia Kimie Suemoto
Affiliation:
Geriatrics Division, Department of Internal Medicine, University of São Paulo Medical School, São Paulo, Brazil
Regina Miksian Magaldi
Affiliation:
Geriatrics Division, Department of Internal Medicine, University of São Paulo Medical School, São Paulo, Brazil
Alexandre Leopold Busse
Affiliation:
Geriatrics Division, Department of Internal Medicine, University of São Paulo Medical School, São Paulo, Brazil
Aline Thomaz Soares
Affiliation:
Geriatrics Division, Department of Internal Medicine, University of São Paulo Medical School, São Paulo, Brazil
Leonardo da Costa Lopes
Affiliation:
Geriatrics Division, Department of Internal Medicine, University of São Paulo Medical School, São Paulo, Brazil
Juliana Yumi Tizon Kasai
Affiliation:
Geriatrics Division, Department of Internal Medicine, University of São Paulo Medical School, São Paulo, Brazil
Erika Satomi
Affiliation:
Geriatrics Division, Department of Internal Medicine, University of São Paulo Medical School, São Paulo, Brazil
Elina Lika Kikuchi
Affiliation:
Geriatrics Division, Department of Internal Medicine, University of São Paulo Medical School, São Paulo, Brazil
Wilson Jacob-Filho
Affiliation:
Geriatrics Division, Department of Internal Medicine, University of São Paulo Medical School, São Paulo, Brazil
*
Correspondence should be addressed to: Daniel Apolinario, MD, Geriatrics Division, University of São Paulo Medical School, Av. Dr. Enéas de Carvalho Aguiar, 155, 8° Andar, Bloco 8 São Paulo, CEP 05403-900, Brazil. Phone: +55-11-30696639; Fax: +55-11-30696236. Email: daniel.apolinario@usp.br.
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Abstract

Background: The characteristics and associated risks of spontaneously reported cognitive complaints have not been investigated due to the lack of a classification instrument.

Methods: In phase 1, a classification system with descriptive categories and cognitive domains was developed by experts through a modified Delphi technique. In phase 2, 180 elderly patients seeking medical attention for cognitive complaints provided free reports of their cognitive difficulties and each complaint was recorded verbatim. Three observers were asked to classify each complaint into a descriptive category. Perceived cognitive function was further characterized using the Memory Complaint Questionnaire (MAC-Q).

Results: The patients reported 493 spontaneous complaints, with a range of 1–6 complaints per patient and a mean of 2.7 (±1.3). The proportion of complaints that could be classified into a category by each of the three observers varied from 91.9% to 95.7%. Inter-observer agreement assessed using the κ statistic varied from 0.79 to 1 for descriptive categories and 0.83 to 0.97 for domains. Compared with the MAC-Q, spontaneously reported complaints provided complementary information by avoiding the cueing effect provoked by the questionnaire. The total number of complaints and their occurrences in specific domains were associated with important sociodemographic and clinical factors, indicating that their meaning and associated risks need to be further investigated.

Conclusion: The instrument developed in this study proved to be a practical tool for classifying the majority of spontaneously reported cognitive complaints with high reliability. Further studies are needed to investigate clinical usefulness of this approach.

Keywords

subjective cognitive complaintsspontaneouslymemorymild cognitive impairmentelderly
Type
Research Article
Information
International Psychogeriatrics , Volume 25 , Issue 1 , January 2013 , pp. 157 - 166
Copyright
Copyright © International Psychogeriatric Association 2012

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