• Lennard L van Wanrooij, Edo Richard, Susan Jongstra, Eric P Moll van Charante, and Willem A van Gool.
• Amsterdam UMC, University of Amsterdam, Department of Neurology, Amsterdam, The Netherlands l.l.vanwanrooij@amc.uva.nl.
• Ann Fam Med. 2019 Sep 1; 17 (5): 412-418.

PurposeFamily physicians need simple yet comprehensive algorithms to discriminate between community-dwelling older persons who are at increased risk of dementia and those who are not. We aimed to investigate associations between incident dementia and responses to a single question regarding subjective memory complaints (SMC) combined with scores on 2 simple memory tests that are easy to use in the primary care setting.MethodsAnalyses were based on data from 3,454 community-dwelling older persons who participated in the 6- to 8-year Prevention of Dementia by Intensive Vascular Care (preDIVA) trial, yielding 21,341 person-years of observation. Participants were considered a single cohort. We used Cox models to assess separate and combined associations of SMC, an imperfect score on the Mini-Mental State Examination delayed recall item (MMSE-5), and an imperfect score on the Visual Association Test (VAT) with future dementia.ResultsSubjective memory complaints alone were associated with future dementia (hazard ratio [HR] = 3.01; 95% CI, 2.31-3.94; P <.001), as were the MMSE-5 (HR = 2.14; 95% CI, 1.59-2.87; P <.001) and VAT (HR = 3.19; 95% CI, 2.46-4.13; P <.001) scores. After a median follow-up of 6.7 years, the occurrence of dementia ranged from 4% to 30% among persons with SMC, depending on the MMSE-5 and VAT scores. These test scores did not substantially alter the association with future dementia for persons without SMC.ConclusionsIn persons with SMC, the strength of the association between future dementia and an imperfect MMSE-5 score depends substantially on the VAT score.© 2019 Annals of Family Medicine, Inc.

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