This study investigated the characteristics of subjective memory complaints (SMCs) and their association with current and future cognitive functions.

A cohort of 209 community-dwelling individuals without dementia aged 47–90 years old was recruited for this 3-year study. Participants underwent neuropsychological and clinical assessments annually. Participants were divided into SMCs and non-memory complainers (NMCs) using a single question at baseline and a memory complaints questionnaire following baseline, to evaluate differential patterns of complaints. In addition, comprehensive assessment of memory complaints was undertaken to evaluate whether severity and consistency of complaints differentially predicted cognitive function.

SMC and NMC individuals were significantly different on various features of SMCs. Greater overall severity (but not consistency) of complaints was significantly associated with current and future cognitive functioning.

SMC individuals present distinctive features of memory complaints as compared to NMCs. Further, the severity of complaints was a significant predictor of future cognition. However, SMC did not significantly predict change over time in this sample. These findings warrant further research into the specific features of SMCs that may portend subsequent neuropathological and cognitive changes when screening individuals at increased future risk of dementia.

To define the predictive value of clinical diagnosis of chronic obstructive pulmonary disease (COPD) or suspected COPD in primary care patients with spirometric criteria for diagnosis.

The diagnosis of COPD is usually made clinically but often not confirmed by diagnostic testing. Recent initiatives have called for universal spirometry testing in primary care to diagnose and monitor such patients the implications of this policy on diagnostic accuracy are not as yet known.

Retrospective comparative analysis of 677 consecutive primary care referrals to a district general hospital lung function laboratory for spirometry, March 1998 to December 2006.

Five hundred and three of 677 patients referred for open access spirometry had a primary care clinical diagnosis or suspected diagnosis of COPD. When compared with NICE spirometric criteria for diagnosis of COPD, 141 patients (28%) had normal spirometry, 46 (9%) had reversible airflow obstruction and 14 (3%) a restrictive pattern of spirometry. The positive predictive value of a primary care clinical diagnosis of COPD was 0.62 for patients referred for assessment of severity and 0.56 for those referred for diagnostic testing. Clinical suspicion of COPD in this sample was not confirmed by spirometry in a high proportion of referred patients. The introduction of the widespread use of spirometry for confirmation of primary care clinician made COPD diagnosis have important implications for both individual patients and primary care service planning.