Asking Family About Memory Loss

Objective: To compare a family informant's report of memory loss in an older family member to standardized clinical diagnoses of cognitive impairment. Setting: Duke Established Populations for Epidemiologic Studies of the Elderly (EPESE), a 10‐year longitudinal study of community dwellers aged 65 and greater in five counties of North Carolina. Participants: A stratified random sample of potentially demented participants was selected from the second wave of the Duke EPESE using responses to a brief cognitive screen. A neuropsychological battery was administered to these participants, and their family informants were asked whether they recognized memory loss in the participant. One hundred fifty‐seven participants completed the full evaluation and also had an available family informant. Main Outcome Measures: Family informant's report of memory loss (yes, no, sometimes) compared to expert consensus diagnosis of cognitive impairment or dementia. Results: There was poor concordance between the clinical diagnoses of cognitive impairment or dementia and the family informant's recognition of memory loss (κ=−0.05; P =.74). When informants reported memory loss, 30% of participants were found not to have a cognitive loss. Among participants in whom family informants reported no memory loss, 75% were diagnosed with dementia or cognitive impairment (sensitivity, 0.70, 95% confidence interval [CI], 0.61 to 0.78; specificity, 0.24, 95% CI, 0.13 to 0.40; positive predictive value, 70%; negative predictive value, 25%). Conclusions: Asking family members about memory loss in a patient may be an unreliable strategy to detect dementia.