Evaluation of cognitive complaints and neuropsychological performance in early-onset cognitive impairment and dementia

Thesis event information

Date and time of the thesis defence

Place of the thesis defence

Ls 8, Oulu University Hospital

Topic of the dissertation

Evaluation of cognitive complaints and neuropsychological performance in early-onset cognitive impairment and dementia

Doctoral candidate

Master of Philosophy and Psychology Anna-Leena Heikkinen

Faculty and unit

University of Oulu Graduate School, Faculty of Medicine, Research Unit of Clinical Medicine, Neurology

Subject of study

Doctor of Philosophy


Docent Tiia Saunamäki, University of Jyväskylä


Professor Anne Portaankorva, University of Helsinki

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It is estimated that more than 400 000 working-age Finns suffer from memory and other cognitive problems, and an increasing number of people are seeking medical help due to cognitive problems. Identifying early-onset dementia (EOD) can be challenging, as many stressors, such as sleep problems or depression, can also cause cognitive symptoms. The aim of this dissertation was to provide new knowledge and new methods for assessing cognitive symptoms in working-age people.
It was found that patients referred to a specialised memory clinic reported significantly more work-related cognitive symptoms in the Cognitive Function at Work Questionnaire than working people in general. Patients diagnosed with EOD reported relatively high levels of symptoms, and partly even higher amounts of symptoms than other patient groups. Given the difficulties in symptom awareness often associated with EOD, this is a significant finding.
A comparison of two cognitive screening tests, the Ineco Frontal Screening (IFS) and the Frontal Assessment Battery (FAB), showed that patients with EOD performed worse on both tests than other memory clinic patients. However, the IFS was slightly better at identifying executive dysfunction and it correlated slightly higher with global cognitive impairment than the FAB.
Patients with EOD were found to have particularly high impairments in memory and executive functions on the basis of a comprehensive neuropsychological assessment. Compared to patients with other causes of cognitive impairment, differences were found in several domains of cognition and in symptom awareness. It was also found that patients with Alzheimer's disease (AD) had poorer memory retention ability than patients with frontotemporal dementia (FTD), but they had less behavioural and mood symptoms. AD and FTD patients had more difficulties than depressed patients in symptom awareness, immediate memory and general cognition.
Reliable, easy-to-use and accessible assessment methods are needed for the initial assessment of cognitive symptoms. EOD patients who are still active in working life seem to identify their cognitive symptoms generally quite well, and the Cognitive Function at Work Questionnaire is helpful in identifying subjective memory symptoms. The IFS appears to be a promising method for assessing executive functions in working age patients. Comprehensive neuropsychological assessment can provide important differential diagnostic information on the cognitive deficits of working age people.
Last updated: 4.3.2024