Awareness of memory deficits is useful to distinguish between depression and mild cognitive impairment in the elderly

Gabriel Coutinho, Cláudia Drummond, Alina Teldeschi, Paulo Mattos

To investigate whether the level of awareness of memory deficits is useful for discriminating between major depressive disorder (MDD) and mild cognitive impairment (MCI) in the elderly. Sixty-three consecutively referred patients (38 women and 25 men) with memory concerns comprising three groups (clinical control, MDD and MCI) underwent a memory test (Rey Auditory Verbal Learning Test [RAVLT]) and completed the Memory Assessment Complaints-Questionnaire (MAC-Q). Level of awareness was estimated by the difference between the MAC-Q score and the score on the fifth presentation of the RAVLT. Memory performance, Mini-Mental State Examination (MMSE) and depressive symptoms (Geriatric Depression Scale [GDS]) were also assessed. The control (n=25), MDD (n=16), and MCI (n=22) groups were similar in age, educational level, and MMSE (p > 0.05). Among the groups, the MDD group had the most memory complaints, whereas the MCI group had the worst objective memory performance. Level of awareness was capable of discriminating between MDD and MCI (p < 0.05), but not between MDD and clinical controls (p > 0.05). MDD subjects tended to underestimate their memory functioning as compared to controls (p < 0.05). Level of awareness of memory deficits was significantly useful to discriminate between MCI and MDD, which is a common difficulty faced by clinicians. Future studies with larger samples are needed to confirm these findings.