Memory Complaints and Impairment Among Middle-Aged and Older Brazilians: ELSI-Brazil Study

Objective To measure awareness of memory impairment (MI) among individuals with MI, the prevalence of MI among those with memory complaints (MC), and to identify associated factors to both in a nationally representative sample of Brazilians aged ≥50. Methods MI was defined as a z-score ≤ −1.5 derived from immediate and delayed recall tests, adjusted for demographics. MC were identified by self-report. Logistic regression models examined sociodemographic and health-related factors associated with awareness of MI and with MI among individuals reporting MC. Results Of 7831 participants, 739 (9.3%) had MI, of whom 52% were aware of their impairment. Greater awareness was associated with a higher number of chronic illnesses, disability in instrumental activities of daily living (i-ADL), and more depressive symptoms. Among 3402 (41.7%) participants with MC, 11.5% had objective MI. In this group, higher education, lower income, fewer chronic illnesses, disability in i-ADL and advanced ADL (a-ADL), and more depressive symptoms were associated with MI. Conclusion Half of individuals with objective MI demonstrated awareness of their impairment, and one in ten individuals with MC showed objective cognitive decline. These findings emphasize the need for cognitive screening in middle aged and older adults and for clinical evaluation of other causes of memory complaints, particularly mood and functional factors.