BACKGROUND Early consultation is important to delay the onset of dementia. The present study aimed to explore the reasons for delaying a consultation of dementia while focusing on the differences in the perception of cognitive decline between older adults and their family members. METHODS A group of 663 older adults aged ≥65 years and living with family members in Toyama Prefecture was surveyed. The questionnaires included items that measured changes in cognitive function noticed by older adults and their family members, and the Revised Hasegawa Dementia Scale (HDS-R). The degrees of consistency on the perception of mental changes that accompanied cognitive decline were measured using the Kappa statistic. RESULTS Both older adults and their family members were well aware of "forgetfulness" as a symptom of cognitive decline. Only the perception of "loss of appetite" at the late stage of cognitive decline was consistent between older adults and their family (κ = 0.707). When older adults often noticed their own forgetfulness, their mean HDS-R score was 22.7, whereas that of the family members was 14.7. The combinations of perception of forgetfulness by older adults and their family members, and the mean HDS-R scores were unaware/unaware (mean HDS-R score = 27.0), aware/unaware (mean HDS-R score = 24.9), aware/aware (mean HDS-R score = 15.5), and unaware/aware (mean HDS-R score = 13.0). CONCLUSIONS There were discrepancies in the perception of cognitive decline between older adults and their family members. Cognitive decline had progressed by the time that family members had noticed the symptom of forgetfulness in their older adult relatives. The perception gap regarding cognitive decline deters consultation of dementia.

中文翻译：

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老年人与其家庭成员之间认知能力下降症状的感知差异：富山痴呆症调查的结果。

背景技术尽早咨询对于延迟痴呆的发作是重要的。本研究旨在探讨延误痴呆症咨询的原因，同时关注老年人及其家人之间认知能力下降的差异。方法对富山县663例年龄≥65岁并与家人同住的老年人进行调查。问卷包括测量老年人及其家人注意到的认知功能变化的项目，以及修订后的长谷川痴呆量表（HDS-R）。使用Kappa统计量来衡量对伴随认知能力下降的心理变化的感知的一致性程度。结果老年人和他们的家庭成员都充分意识到“健忘”是认知能力下降的症状。在老年人及其家人之间，只有认知能力减退后期对“食欲不振”的感觉是一致的（κ= 0.707）。当老年人经常注意到自己的健忘时，他们的HDS-R平均值为22.7，而家庭成员的平均值为14.7。老年人及其家人对健忘的感知与HDS-R平均得分的组合是：无意识/无意识（平均HDS-R得分= 27.0），有意识/无意识（平均HDS-R得分= 24.9），有意识/意识（平均HDS-R得分= 15.5）和不知道/意识（平均HDS-R得分= 13.0）。结论老年人及其家庭成员对认知能力下降的认识存在差异。当家庭成员注意到年长的亲戚中有健忘的症状时，认知能力的下降就开始了。