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Relationships Between Cognitive Complaints and Quality of Life in Older Adults With Mild Cognitive Impairment, Mild Alzheimer Disease Dementia, and Normal Cognition

Stites, Shana D., PsyD, MS, MA*; Harkins, Kristin, MPH; Rubright, Jonathan D., PhD; Karlawish, Jason, MD§

Alzheimer Disease & Associated Disorders: October-December 2018 - Volume 32 - Issue 4 - p 276–283
doi: 10.1097/WAD.0000000000000262
Original Articles

Purpose: To examine in persons with varying degrees of cognitive impairment the relationship between self-reports of cognitive complaints and quality of life (QOL).

Methods: Older adults (n=259) with normal cognition, mild cognitive impairment (MCI), and mild stage Alzheimer disease (AD) dementia completed tests of cognition and self-report questionnaires about QOL and 3 kinds of cognitive complaints: cognitive difficulties, distress from cognitive difficulties, and believing you had more memory problems than most people. Bivariate, multivariable, and multivariate regression analyses assessed relationships between domains of QOL and each cognitive complaint.

Results: Bivariate and multivariable analyses controlling for severity of cognitive and functional impairment found that cognitive complaints were related to relatively lower quality of daily life (QOL-AD, Dementia Quality of Life Scale), greater depression (GDS), more anxiety (BAI), higher perceived stress (PSS), and lower general mental well-being (SF-12 MCS).

Discussion: Cognitive complaints have robust associations with QOL. These findings have implications for AD prevention trials and management of clinical populations.

*Department of Medical Ethics and Health Policy, Perlman School of Medicine

Departments of Medicine

§Medicine, Medical Ethics and Health Policy, and Neurology, Penn Memory Center, University of Pennsylvania

National Board of Medical Examiners, Philadelphia, PA

Supported by The Marian S. Ware Alzheimer Program, National Institute of Aging (P30-AG-010124), the Centers for Disease Control and Prevention Healthy Brain Research Center (U48-DP-005053), the Diane Eisen Memorial Neurodegenerative Disease Research Fund, and a grant from the Alzheimer’s Association (AARF-17-528934).

J.K. and K.H.: aided in the design and implementation of the study. S.D.S.: conceptualized the analyses and wrote the initial draft of the article.

The authors declare no conflicts of interest.

Reprints: Shana D. Stites, PsyD, MS, MA, Department of Medical Ethics and Health Policy, Perlman School of Medicine, University of Pennsylvania, 3615 Chestnut Street, Philadelphia, PA 19104 (e-mail:

Received April 9, 2018

Accepted May 18, 2018

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