The Impact of Affective Symptoms on Subjective Memory Complaints: Implications for Patient-Centered Cognitive Assessment and Gender-Sensitive Care

Introduction: The evolution of healthcare towards Patient-Centered Care (PCC) emphasizes the value of the patient's perspective, measured through Patient-Reported Outcomes (PROs). Subjective memory complaints (SMCs) represent a crucial PRO in the field of cognitive health. This study examines gender differences in the relationship between SMCs, affective symptoms, and objective cognitive performance, seeking to optimize care pathways by enhancing the interpretation of patient engagement and reported symptoms.

Methods: The sample included 58 participants aged 42 to 75 years (mean = 61), predominantly women (72.4%). Participants completed the Montreal Cognitive Assessment (MoCA), Subjective Memory Complaints Questionnaire (SMCQ), and measures of anxiety (GAD-7) and depression (PHQ-9). The inclusion of self-report measures supports the patient-centered approach by prioritizing the individual's perspective.

Results: Analysis revealed a clear dissociation between subjective memory complaints and objective cognitive performance, with no significant correlations between SMCQ and MoCA scores in the total sample or by gender. However, significant positive correlations emerged between SMCs and both anxiety (rho = 0.238, p = 0.036) and depression (rho = 0.271, p = 0.02). Gender-stratified analysis showed that these associations were significant only in women (anxiety: rho = 0.278, p = 0.037; depression: rho = 0.305, p = 0.025), with no significant correlations in men.

Conclusion: The findings highlight that, particularly in women, SMCs are more closely tied to affective symptoms than to objective cognitive performance. This proposes that in a PCC model, SMCs should not be solely interpreted as cognitive deficit markers but as valid indicators of affective distress that impair patient engagement and satisfaction. Incorporating gender-sensitive assessment of anxiety and depression is crucial to optimize care pathways in cognitive health, ensuring personalized interventions that address the root cause of the patient's concern, thereby improving overall patient outcomes.