`I forgot everything` The Frequency of Subjective Cognitive Decline in a Secondary Care Neurology Clinic in Izmir, Turkey

Introduction and Aim Forgetfulness is one of the most common complaints of admissions to general neurology clinics. Some of these admissions are classified as subjective cognitive decline (SCD). However how many of the forgetfulness admissions are diagnosed with SCD in Turkey is still unknown. We aimed to determine the frequency of SCD, neurological disease (ND) and psychiatric disorder (PD) diagnosis among patients who admitted with forgetfulness complaint to a secondary care neurology clinic and compare their demographic, family history characteristics and referral status. This is a cross-sectional analysis of forgetfulness admissions to a secondary care physician between April 2017 and September 2018 in Izmir, Turkey. Materials and Methods This cross-sectional study is based on data collected from a single neurology secondary care outpatient clinic Izmir between April 2017 and September 2018 . All patients admitted with forgetfulness complaint were included in the study. The diagnosis of the patients were categorized under three main groups such as SCD, PD, and ND. The independent variables are age, gender, family history of dementia and referral from a physician. The frequency of each diagnostic group is shown. Multinomial regression model is fitted with age and gender to predict the major diagnostic group. Dokuz Eylul University Non-invasive Research Ethical Board approved study design. Results There were 464 admissions with forgetfulness during the target period. Less than a half of the applicants were diagnosed with an ND (44.4%) in total. In the younger group (< 65), frequency of the ND group was quite low (ND = 8.8%, SCD = 37.6%, PD = 53.6%). Family history of dementia was significantly higher among ND and SCD groups than PD group (p < 0,001). In multinomial logistic regression one-year increase in age decreased the chance of having SCD by 14.5% (OR = 0.855, 95% CI: 0.828-0.882) and having ND 14.8% (OR = 0.852, 95% CI: 0.826-0.879) compared to having an ND. Women had 2.618 (95% CI: 1.359- 5.044) times higher SCD diagnosis compared to men relative to having an ND diagnosis. Conclusions and Recommendations This cross sectional study shows that more than a half of the admissions are not associated with an ND and, mostly young, women population admits neurology clinics with forgetfulness complaint without objective deficits for cognitive decline. In our opinion, the high frequency rates of this group should be considered carefully by policy makers. Key words: cognitive decline, subjective cognitive decline, dementia, referral, secondary care.