Subjective memory complaints. Relations to objective memory function, gender, personality, affective status and stress

Sammanfattning: The overall aim of this thesis was to enhance the understanding of patients with subjective memory complaints. The thesis is based on three empirical studies examining middle-aged and young old (< 70 years) non-demented patients assessed at a memory clinic. In the first study the personality characteristics of the patients were compared with a Swedish normative sample. The patients scored higher on neuroticism and agreeableness and lower on extraversion. The female patients were in the majority and scored higher than the males on a scale assessing symptoms of anxiety and depression. Approximately half of the patients had objectively verified memory impairment (OMI) according to the neuropsychological assessment while the remaining patients were classified as having subjective memory impairment (SMI). No differences were revealed regarding personality characteristics or affective status between the OMI and SMI groups. In the second study about half of the patients reported significant stressors in their private life and a majority of the patients reported significant change at work related to strain. No gender differences were revealed regarding the presence or intensity of stressors. However, the female patients reported a higher level of affective stress response than the males. A large number, above all the women, were on sick leave. Furthermore, both a lower affective stress response and a better performance on a test of executive function were related to a higher basal morning cortisol level. The third study investigated potential changes regarding clinical characteristics and neuro¬psychological test results after one year. A reduction of depressive symptoms and an improved performance on a test of executive function were found in the OMI patients at the follow-up. None of the patients had converted to dementia. In conclusion, subjective memory complaints, even in younger populations should not be neglected. Our studies emphasise the complexity of subjective memory complaints. The results imply the need for a comprehensive assessment of cognitive functions, psychiatric and psychosocial variables as well as a gender perspective.