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Subjective Memory Complaints, White-Matter Lesions, Depressive Symptoms, and Cognition in Elderly Patients

Received January 15, 2004; revised April 26, June 10, 2004; accepted June 27, 2004. From the Institute for Ageing and Health, Wolfson Research Centre, Newcastle General Hospital, Newcastle, UK (TSCM, JLD, MF, JTO); the Sector of Behavioural Neurology, Department of Neurology and Neurosurgery, São Paulo Federal University, São Paulo, Brazil (TSCM); and the Department of Neuroradiology, Newcastle General Hospital, Newcastle, UK (PE). Send correspondence and reprint requests to Dr. Thaís Soares Cianciarullo Minett, Sector of Behavioural Neurology, UNIFESP-EPM – São Paulo Federal University, Rua Rio Grande 551-24A, São Paulo 04018-001, Brazil. e-mail: thaisminett{at}hotmail.com
© 2005 American Association for Geriatric Psychiatry

Objectives: Subjective memory complaints (SMC) and cerebral white-matter lesions (WML) are very prevalent among elderly subjects, but their clinical significance is controversial. The authors sought to determine whether SMCs are related to WML, independently of the presence of depressive symptoms, which are known to be associated with both. The relationship between SMC and cognition was also examined. Methods: This is a cross-sectional study on 60 elderly subjects without dementia. All subjects underwent FLAIR and T₂-weighted axial MRI scans, a memory-complaint questionnaire, a geriatric depression scale, and a comprehensive cognitive assessment. Results: Multiple linear regression showed that although the best correlate of SMC was the severity of depressive symptoms, SMC and WML were strongly correlated. Objective cognitive performance was not significantly associated with SMC after adjusting for WML and mood. The presence of a history of late-onset depression was a strong correlate of WML severity, even after adjusting for age, gender, and education. Conclusions: Complaints of cognitive decline are significantly associated with the severity of WML, independently of level of cognition and depression.

Key Words: Memory Complaints • Cognitive Status • Age-Associated Memory Impairment (AAMI) • White-Matter Lesions • Depression

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