Are subjective memory complaints indicative of objective cognitive decline or depressive symptoms? Findings from the English Longitudinal Study of Ageing

The complex relation between visual complaints and decline in visual, visuoperceptual and cognitive functions in people with multiple sclerosis

People with multiple sclerosis (pwMS) report many different visual complaints, but not all of them are well understood. Decline in visual, visuoperceptual and cognitive functions do occur in pwMS, but it is unclear to what extend those help us understand visual complaints. The purpose of this cross-sectional study was to explore the relation between visual complaints and decline in visual, visuoperceptual and cognitive functions, to optimize care for pwMS. Visual, visuoperceptual and cognitive functions of 68 pwMS with visual complaints and 37 pwMS with no or minimal visual complaints were assessed. The frequency of functional decline was compared between the two groups and correlations were calculated between visual complaints and the assessed functions. Decline in several functions occurred more frequently in pwMS with visual complaints. Visual complaints may be an indication of declined visual or cognitive functioning. However, as most correlations were not significant or weak, we cannot infer that visual complaints are directly related to functions. The relationship may be indirect and more complex. Future research could focus on the overarching cognitive capacity that may contribute to visual complaints. Further research into these and other explanations for visual complaints could help us to provide appropriate care for pwMS.

Association of mobile device proficiency and subjective cognitive complaints with financial management ability among community-dwelling older adults: a population-based cross-sectional study

BACKGROUND

Mobile devices have been used by many older adults and have the potential to assist individuals with subjective cognitive complaints (SCCs) in daily living tasks. Financial management is one of the most complex daily activity for older adults, as it is easily impaired in the prodromal stage of dementia and cognitive impairment.

AIM

To investigate financial management ability among older adults from SCCs and mobile device proficiency.

METHODS

A self-administered questionnaire was sent to 529 participants who were ≥ 65 years and regularly use mobile devices. Participants were divided into four groups based on SCC prevalence and scores of the Mobile Device Proficiency Questionnaire (MDPQ-16). Financial management abilities were compared between groups using the Process Analysis of Daily Activities for Dementia subscale. Regression model and crosstabulation table were used to investigate associations in detail.

RESULTS

A significant difference in financial management ability was observed among the four groups (p < 0.001), with the dual impairment group showed significantly lower than the robust and SCC groups (p < 0.001). Educational history, sex, and MDPQ-16 score were significantly associated with participants' financial management ability (p ≤ 0.01). The proportion of participants who could use ATMs and electronic money independently was significantly lower among those with low proficiency in mobile devices (LPM), regardless of SCC (p < 0.05).

CONCLUSION

The LPM group showed an impaired ability to manage their finances, particularly in situations where they would use information devices. Therefore, healthcare professionals should assess not only the SCC but also their proficiency with mobile devices to predict their impairment in activities of daily living.

Individual and dual trajectories of insomnia symptoms and body mass index before and after retirement and their associations with changes in subjective cognitive functioning

BACKGROUND

We examined individual and dual trajectories of insomnia symptoms and body mass index (BMI) before and after retirement, and their associations with changes in subjective cognitive functioning after retirement.

METHODS

We used the Helsinki Health Study's (n = 2360, 79% women, aged 40-60 at baseline, Finland) repeated surveys to identify the developmental patterns of insomnia symptoms and BMI (2000-2017) and changes in subjective cognitive functioning (2017-2022). We analysed the data using latent group-based dual trajectory modelling and logistic regression analysis.

RESULTS

Three latent groups were identified for insomnia symptoms (stable low, decreasing and increasing symptoms) and BMI (stable healthy weight, stable overweight and stable obesity). Insomnia symptoms were associated with declining subjective cognitive functioning and largely explained the effects in the dual models.

CONCLUSION

The association between dual trajectories of insomnia symptoms and BMI with subjective cognitive decline is dominated by insomnia symptoms.

Development of a Revised Version of Subjective Memory Complaints Questionnaire in Taiwan: A Preliminary Study

OBJECTIVES

Research has suggested that subjective memory complaints (SMC) are predictive of cognitive decline in cases of Alzheimer's disease; however, multidimensional characteristics of SMC make it difficult to formulate causal links. The Subjective Memory Complaints Questionnaire (SMCQ) has proven effective in capturing the nature of SMC. In this study, we developed a revised version of SMCQ (SMCQ-R) with corresponding normative data for application in Taiwan.

METHODS

This study recruited 100 cognitively normal participants (> 45 years) stratified according to demographic characteristics. Assessments were performed to evaluate test-retest reliability, criterion-related validity, and construct validity of SMCQ-R. SMCQ-R scores of 20 matched patients with mild cognitive impairment (MCI) were also compared with those of normal participants to test construct validity.

RESULTS

Reliability of SMCQ-R was satisfactory (0.81-0.95). Factor analysis revealed a three-factor structure: everyday memory problems (EMP), recent severe memory problems (RSMP), and long-term memory problems (LTMP). EMP and RSMP scores were negatively associated with objective cognitive function (r = -.20 to .39). Depressive symptoms were positively associated with all factors (r = .23-.33). Age was positively associated with total (b = 0.09, p < .05) and EMP scores (b = 0.06, p < .01). MCI patients obtained higher scores (p < .05) on all subscales. SMCQ-R scores discriminated between normal and MCI individuals (area under the curve = 0.77). This study established a norm based on scores adjusted to control for effects of age.

CONCLUSIONS

SMCQ-R has sound psychometric properties and could potentially be used as a tool to assess SMC in clinical settings.

Cognitive complaints in older adults: relationships between self and informant report, objective test performance, and symptoms of depression

This study explored the relationships between objective measures of cognitive functioning, self and informant reports of cognitive problems in daily life, and depression screening in older adults who had been referred because of reported or suspected cognitive changes. We used archival data from 100, predominantly White (97%), typically educated (M = 13.25 years), older adults (M = 70.38 years) who received an outpatient neuropsychological evaluation. We characterized the cognitive performance using the CVLT-II Total score. We characterized patient and collateral reports using the BRIEF-A MI index, a normed scale of cognitive problems in daily life. We also incorporated a depression screener (PHQ-9) into our analyses. Multiple linear regression analysis revealed that only the informant reported problems in daily life, using the BRIEF-A MI index, was a significant predictor of objective cognitive deficits, as defined by CVLT-II Total scores. Self BRIEF-A MI index scores were not significant predictors of CVLT-II Total performance after we accounted for depression using the patient's PHQ-9 score. Additionally, elevated depression widened the discrepancy between raters, with elevated depression associated with worsening sself-report scores compared to informant-reported scores. As informant-reported problems were the strongest predictor of cognitive deficits, we recommend routine collection of collateral informant reports in the neuropsychological evaluation of older adults referred for cognitive concerns. We also recommend incorporating self-ratings of daily life functioning and screening for depression to contextualize patient complaints and address their concerns, even in the absence of objective cognitive dysfunction.

Greater subjective cognitive decline severity is associated with worse memory performance and lower entorhinal cerebral blood flow in healthy older adults

OBJECTIVE

Subjective cognitive decline (SCD) is a potential early risk marker for Alzheimer's disease (AD), but its utility may vary across individuals. We investigated the relationship of SCD severity with memory function and cerebral blood flow (CBF) in areas of the middle temporal lobe (MTL) in a cognitively normal and overall healthy sample of older adults. Exploratory analyses examined if the association of SCD severity with memory and MTL CBF was different in those with lower and higher cardiovascular disease (CVD) risk status.

METHODS

Fifty-two community-dwelling older adults underwent magnetic resonance imaging, neuropsychological testing, and were administered the Everyday Cognition Scale (ECog) to measure SCD. Regression models investigated whether ECog scores were associated with memory performance and MTL CBF, followed by similar exploratory regressions stratified by CVD risk status (i.e., lower vs higher stroke risk).

RESULTS

Higher ECog scores were associated with lower objective memory performance and lower entorhinal cortex CBF after adjusting for demographics and mood. In exploratory stratified analyses, these associations remained significant in the higher stroke risk group only.

CONCLUSIONS

Our preliminary findings suggest that SCD severity is associated with cognition and brain markers of preclinical AD in otherwise healthy older adults with overall low CVD burden and that this relationship may be stronger for individuals with higher stroke risk, although larger studies with more diverse samples are needed to confirm these findings. Our results shed light on individual characteristics that may increase the utility of SCD as an early risk marker of cognitive decline.

Subjective memory complaints: Prevalence, associated factors and sex differences in the ELSI-Brazil study

BACKGROUND

Subjective memory complaints (SMCs) are a possible prodrome of cognitive decline but are understudied in low- and middle-income countries (LMIC). We aimed to estimate the prevalence of SMCs in a large, nationally representative sample of older adults from Brazil and to identify sociodemographic and health-related factors that are associated with SMCs independently of objective memory.

METHODS

Baseline data (n = 7831) from the ELSI-Brazil study, a national representative sample of adults aged 50 and over. They were asked to rate their memory and then divided into two groups - having or not having SMCs. Logistic regression models were used to estimate the association of demographic characteristics, health related factors, objective memory performance and disability in basic (b-ADL), instrumental (i-ADL), and advanced (a-ADL) activities of daily living associated with SMCs. Whether sex was an effect modifier of the association between age and objective memory performance and SMCs was also tested.

RESULTS

Of the sample, 42% (95% CI; 39.9-43.9) had SMCs, and it was higher among women (46.9%) than men (35.9%). SMC prevalence decreased with age among women and increased among men, and for both it decreased with better cognitive performance. Fully adjusted logistic regression model showed that older age, higher education, higher b-ADL scores, and better cognitive performance were associated with decreased SMCs, while being female, with higher number of chronic conditions, higher i-ADL scores, worst self-rated health, and an increased number of depressive symptoms were associated with increased SMCs. However, the interaction test (p < 0.001) confirmed that increased age was associated with decreased SMCs only among women, and that better objective memory performance was associated with decreased SMCs only among men.

CONCLUSIONS

SMCs are common in the Brazilian older population and are associated with health and sociodemographic factors, with different patterns between men and women. There is a need for future studies looking at the cognitive trajectory and dementia risk in older adults with subjective cognitive complaints.

Cost-benefit and discriminant validity of a stepwise dementia case-finding approach in an Asian older adult community

Background

Case-finding is a recommended approach for dementia early detection in the community.

Aims

To investigate the discriminant validity and cost-effectiveness of a stepwise dementia case-finding approach in a Singaporean older adult community.

Methods

The two-phase study was conducted in the community from 2009 to 2015 in Singapore. A total of 3780 participants (age ≥60 years) completed phase I (a brief cognitive screening); 918 completed phase II and were included in the final analysis. In phase I, all participants were administered the Abbreviated Mental Test (AMT) and the Progressive Forgetfulness Question (PFQ). Those who screened positive on either test were invited to phase II, whereby the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA) and a formal neuropsychological battery were administered, followed by the research diagnosis of no cognitive impairment, cognitive impairment no dementia (CIND)-Mild (≤2 impaired cognitive domains), CIND-Moderate (>2 impaired domains) or dementia. Receiver operating characteristic curve analyses were conducted for the different cognitive instruments. All discriminant indices were calculated, including sensitivity, specificity, positive and negative predictive values (NPV) and accuracy. Cost-effectiveness analysis was conducted by estimating the amount of screening time needed and the number of older adults requiring re-evaluation in two case-finding scenarios, ie, with or without preselection by the PFQ.

Results

The stepwise case-finding approach (preselection by the PFQ, then MMSE or MoCA or AMT) showed an excellent NPV (>99%) and accuracy (>86%) for excluding dementia-free cases. Without preselection by the PFQ, screening time for the three cognitive tools were 317.5, 317.5 and 254 hours, with 159, 302 and 175 screen-positive older adults involved in further evaluation. By adopting the stepwise case-finding approach, total screening time were 156.5, 156.5 and 126.2 hours, which decreased by 50.7%, 50.7% and 50.3% as compared with those without preselection. Furthermore, after preselection, only 98, 167 and 145 screen-positive older adults required further evaluation, corresponding to a reduction of 38.4%, 44.7% and 17.1% in the numbers compared with those without preselection.

Conclusions

A stepwise approach for dementia case-finding should be implemented in the community to minimise the time and resources needed for large-scale early detection of dementia.

Predictors and prognosis of population-based subjective cognitive decline: longitudinal evidence from the Caerphilly Prospective Study (CaPS)

OBJECTIVES

To understand associations between the subjective experience of cognitive decline and objective cognition. This subjective experience is often conceptualised as an early step towards neurodegeneration, but this has not been scrutinised at the population level. An alternative explanation is poor meta-cognition, the extreme of which is seen in functional cognitive disorder (FCD).

DESIGN

Prospective cohort (Caerphilly Prospective Study).

SETTING

Population-based, South Wales, UK.

PARTICIPANTS

This men-only study began in 1979; 1225 men participated at an average age of 73 in 2002-2004, including assessments of simple subjective cognitive decline (sSCD, defined as a subjective report of worsening memory or concentration). Dementia outcomes were followed up to 2012-2014. Data on non-completers was additionally obtained from death certificates and local health records.

PRIMARY AND SECONDARY OUTCOME MEASURES

The primary outcome measure was incident dementia over 10 years. Secondary outcome measures included prospective change in objective cognition and cross-sectional cognitive internal inconsistency (the existence of a cognitive ability at some times, and its absence at other times, with no intervening explanatory factors except for focus of attention).

RESULTS

sSCD was common (30%) and only weakly associated with prior objective cognitive decline (sensitivity 36% (95% CI 30 to 42) and specificity 72% (95% CI 68 to 75)). Independent predictors of sSCD were older age, poor sleep quality and higher trait anxiety. Those with sSCD did not have excess cognitive internal inconsistency, but results suggested a mild attentional deficit. sSCD did not predict objective cognitive change (linear regression coefficient -0.01 (95% CI -0.13 to 0.15)) nor dementia (odds ratio 1.35 (0.61 to 2.99)) 10 years later.

CONCLUSIONS

sSCD is weakly associated with prior objective cognitive decline and does not predict future cognition. Prior sleep difficulties and anxiety were the most robust predictors of sSCD. sSCD in the absence of objective decline appears to be a highly prevalent example of poor meta-cognition (ie, poor self-awareness of cognitive performance), which could be a driver for later FCD.

Five-Factor Model Personality Domains and Facets Associated with Markers of Cognitive Health

Using a diverse, age-stratified sample (N=3,478; age range 18-90) this study examines the cross-sectional association between five-factor model personality traits - domains and facets - and three measures of cognitive health - processing speed, visuospatial ability, subjective memory - and whether these associations vary by age, race, and ethnicity. Consistent with the literature on personality and cognitive health, higher openness and conscientiousness were associated with better cognitive performance and subjective memory, whereas higher neuroticism was associated with slower processing speed and worse subjective memory but was unrelated to visuospatial ability. Moderation analyses suggested some associations were stronger in midlife compared to younger and older adulthood but were generally similar across race and ethnicity. The facet-level analyses indicated the components of each domain most strongly associated with cognitive function (e.g., the responsibility facet of conscientiousness) and suggested some differences across facets within the same domain (e.g., depression was associated with worse performance, whereas anxiety was unrelated to performance; sociability was the only facet of extraversion associated with worse performance). The present research is consistent with the larger literature on personality and cognition and extends it by documenting similarities and differences across facets and demographic groups.

The association between subjective cognitive decline and trajectories of objective cognitive decline: Do social relationships matter?

OBJECTIVES

We examine the association between subjective cognitive decline (SCD) and the trajectories of objective cognitive decline (OCD); and the extent to which this association is moderated by social relationships.

METHODS

Data come from waves 10 (2010) through 14 (2018) of the Health and Retirement Study, a nationally representative panel survey of individuals aged 50 and above in the United States. OCD is measured using episodic memory, and overall cognition. SCD is assessed using a baseline measure of self-rated memory. Social relationships are measured by social network size and perceived positive and negative social support. Growth curve models estimate the longitudinal link between SCD and subsequent OCD trajectories and the interactions between SCD and social relationship variables on OCD.

RESULTS

SCD is associated with subsequent OCD. A wider social network and lower perceived negative support are linked to slower decline in memory, and overall cognition. None of the social relationship variables, however, moderate the link between SCD and future OCD.

CONCLUSION

Knowing that SCD is linked to subsequent OCD is useful because at SCD stage, deficits are more manageable relative to those at subsequent stages of OCD. Future work on SCD and OCD should consider additional dimensions of social relationships.

Longitudinal association between subjective and objective memory in older adults: a study with the Virginia Cognitive Aging Project sample

Using the bivariate dual change score approach, the present study investigated the directionality of the SMC-OMP association in a sample of healthy older adults (N = 2,057) from the Virginia Cognitive Aging Project. The sample was assessed throughout 10 years, five time points, and the impact of education, depressive symptoms, and low-memory functioning was tested. The Memory Functioning Questionnaire was used to assess SMC. There was a lack of longitudinal association with no significant coupling effects found between subjective and objective memory. After including depressive symptoms as a covariate, Frequency of Forgetting significantly predicted subsequent negative changes in OMP . A similar result was found for the low-memory functioning group after the inclusion of depression, with the frequency of memory complaints predicting subsequent memory decline . Our results do not support a predictive value of SMC without accounting for the influence of depressive symptoms and low-memory functioning.

Prevalence and Factors Associated with Subjective Memory Complaint in a Semi-Rural Community in Chile

BACKGROUND

Subjective memory complaints (SMC) are commonly studied in older adults and have been identified as potentially prodromal to dementia and Alzheimer's disease. Studies among younger adults from South America are lacking.

OBJECTIVE

To estimate the prevalence of SMC and the factors associated with it among Maule Cohort (MAUCO) participants.

METHODS

We performed a cross-sectional analysis to estimate the prevalence of SMC and investigated its associated factors from MAUCO baseline data (N = 6,687). Within groups defined by age (38-59, 60-74) and global cognition (Mini-Mental State Examination: ≥26, 25-22, ≤21), multinomial logistic regression models evaluated risk factors for SMC (Yes, Sometimes, No).

RESULTS

Overall, SMC prevalence was 16.4%; 15.9% (95% CI 14.9-16.9%) among younger and 17.6% (15.8-19.4%) among older participants. Female sex, comorbidities, and bad/fair self-reported health status (SRHS) were generally associated with higher odds of SMC.

CONCLUSION

Overall prevalence of SMC was 16%. Different factors were associated with the odds of SMC depending on age and global cognitive status. Future SMC studies should include sex-specific assessments, evaluate SRHS as a moderator of SMC reporting, and the influence of the SARS-CoV-2 pandemic on SMC reporting.

Neurological Complications of Conventional and Novel Anticancer Treatments

Various neurological complications, affecting both the central and peripheral nervous system, can frequently be experienced by cancer survivors after exposure to conventional chemotherapy, but also to modern immunotherapy. In this review, we provide an overview of the most well-known adverse events related to chemotherapy, with a focus on chemotherapy induced peripheral neurotoxicity, but we also address some emerging novel clinical entities related to cancer treatment, including chemotherapy-related cognitive impairment and immune-mediated adverse events. Unfortunately, efficacious curative or preventive treatment for all these neurological complications is still lacking. We provide a description of the possible mechanisms involved to drive future drug discovery in this field, both for symptomatic treatment and neuroprotection.

The Use of Executive Fluency Tasks to Detect Cognitive Impairment in Individuals with Subjective Cognitive Decline

OBJECTIVE

Although evidence has indicated that subjective cognitive decline (SCD) may be an early sign of Alzheimer's disease (AD), the objectification of cognitive impairment in SCD is challenging, mainly due to the lack of sensitivity in assessment tools. The present study investigated the potential contribution of two verbal fluency tasks with high executive processing loads to the identification of cognitive impairment in SCD.

METHODS

A total of 60 adults with SCD and 60 healthy controls (HCs) performed one free action (verb) fluency task and two fluency tasks with more executive processing load-an alternating fluency task and an orthographic constraint fluency task-and the results were compared.

RESULT

In the free action fluency task, the performance of the participants with SCD and the HCs was similar. However, HCs performed significantly better than SCD in the alternating fluency task, which required mental flexibility, and the orthographic constraint fluency task, which required inhibition.

DISCUSSION

The study findings suggest that verbal fluency tasks with high executive processing load could be useful in detecting cognitive deficits at the preclinical stage of AD. The inclusion of such tests in assessment batteries should be considered in order to improve the detection of subtle cognitive impairment in preclinical major neurocognitive disorder populations.

Disentangling the relationship of subjective cognitive decline and depressive symptoms in the development of cognitive decline and dementia

INTRODUCTION

Subjective cognitive decline (SCD) and depressive symptoms (DS) frequently co-occur prior to dementia. However, the temporal sequence of their emergence and their combined prognostic value for cognitive decline and dementia is unclear.

METHODS

Temporal relationships of SCD, DS and memory decline were examined by latent difference score modeling in a high-aged, population-based cohort (N = 3217) and validated using Cox-regression of dementia-conversion. In 334 cognitively unimpaired SCD-patients from memory-clinics, we examined the association of DS with cognitive decline and with cerebrospinal fluid (CSF) Alzheimer's disease (AD) biomarkers.

RESULTS

In the population-based cohort, SCD preceded DS. High DS were associated with increased risk of dementia conversion in individuals with SCD. In SCD-patients from memory-clinics, high DS were associated with greater cognitive decline. CSF Aß42 predicted increasing DS.

DISCUSSION

SCD typically precedes DS in the evolution to dementia. SCD-patients from memory-clinics with DS may constitute a high-risk group for cognitive decline.

HIGHLIGHTS

Subjective cognitive decline (SCD) precedes depressive symptoms (DS) as memory declines. Emerging or persistent DS after SCD reports predict dementia. In SCD patients, more amyloid pathology relates to increasing DS. SCD patients with DS are at high risk for symptomatic progression.

Socio-cognitive mindfulness predicts memory complaint and cognitive performance of older adults with different years of education

BACKGROUND

Even though the effect of education on cognitive performance has been widely reported, the relationship between socio-cognitive mindfulness, cognitive performance, and memory complaint among the elderly with heterogeneous educational levels has not yet been investigated.

AIM

This study aimed to analyze the potential relationship between cognitive performance, memory complaint, and socio-cognitive mindfulness in a sample of healthy older adults with different years of education.

METHODS

In this quantitative, cross-sectional, observational, and analytical study, participants (n = 68) were assessed with a sociodemographic questionnaire, cognitive performance test (ACE-III), levels of socio-cognitive mindfulness (LSM-21), and memory complaint (Memory Complaint Scale). Descriptive statistics, as well as Pearson's correlation, and linear regression analysis were performed, and significance was assumed if p < .05.

RESULTS

Years of education correlated with cognitive performance and socio-cognitive mindfulness, but not with memory complaint. Socio-cognitive mindfulness had a positive correlation with cognitive performance and a negative correlation with memory complaint. Also, socio-cognitive mindfulness predicted cognitive performance and memory complaint both in bivariate analysis and when controlling for years of education.

CONCLUSION

Our findings suggested that older adults with higher levels of socio-cognitive mindfulness showed better cognitive performance and less memory complaint.

The discriminant validity of single-question assessments of subjective cognitive complaints in an Asian older adult population

Objective

To compare the discriminant validity of three different single-question assessments of subjective cognitive complaints (SCC) for dementia in a community-based older adult population in Singapore.

Methods

Eligible older adults aged ≥60 were recruited into phase I for identifying those who require further assessment using the Abbreviated Mental Test (AMT) and progressive forgetfulness question (PFQ). Participants who failed either tests entered phase II and were administered various single-question assessments of SCC, such as the 8th question on the patient Ascertain Dementia 8 (AD8-8_pt), informant AD8 (AD8-8_info), and the 10th item on the Geriatric Depression Scale (GDS-10), followed by the Montreal Cognitive Assessment (MoCA) and a formal neuropsychological battery to identify the participant’s cognitive status by a research diagnosis and DSM-IV criteria. Differences in characteristics among diagnostic groups were compared. All discriminatory indices (sensitivity, specificity, positive, and negative predictive values, overall accuracy) for these single-question assessments and their combinations with the MoCA were calculated and reported to confirm their discriminant validity in identifying the existence of subjective complaints and objective impairment.

Results

A total of 3,780 participants were assessed at phase I, of which 957 entered and completed phase II. Of whom, 911 were dementia-free and 46 had dementia. The MoCA (13/14) displayed good sensitivity (95.6%), specificity (81.5%), and overall accuracy (82.1%) for dementia detection. The GDS-10 and AD8-8_pt showed poor discriminant validity, while the AD8-8_info had the highest specificity (83.2%) and the greatest overall accuracy (82.5%) for dementia. Compensatory combination of the AD8-8_info with MoCA, the sensitivity and positive predictive values were optimized (100%), while the conjunctive combination of two tools achieved excellent specificity (96.3%) and overall accuracy (94.8%) in discriminating dementia patients.

Conclusion and implications

Combining a reliable single-question SCC assessment with an objective tool can efficiently discriminate dementia patients from healthy older adults in the community.

A systematic review of subjective cognitive characteristics predictive of longitudinal outcomes in older adults

BACKGROUND AND OBJECTIVES

Subjective cognitive decline (SCD) is a common experience of self-perceived decline without objective cognitive impairment among older adults. SCD has been conceptualized as very early Alzheimer's disease (AD), but the specific SCD features predictive of clinical or cognitive decline remain unclear. This systematic review is the first to characterize specific SCD features and their relation to longitudinal outcomes.

RESEARCH DESIGN AND METHODS

Multiple electronic databases were searched from inception until August 2021 for longitudinal studies of adults aged >50 (mean>60) and free of dementia, with baseline SCD measurement and clinical or cognitive follow-up. Studies were screened for inclusion criteria and assessed for risk of bias using weight-of-evidence ratings.

RESULTS

570 potentially relevant studies were identified, and 52 studies evaluated for eligibility after initial screening. Thirty-three studies with medium to high weight-of-evidence ratings were included and results narratively synthesized. Measurement methods varied substantially across studies: the majority (n=27) assessed SCD symptom types and intensity, and consistently reported that higher symptom burden increased the risk for MCI and dementia. The evidence was less compelling for cognitive outcomes. A handful of studies (n=5) suggested a predictive role for SCD symptom consistency and informant corroboration.

DISCUSSION AND IMPLICATIONS

SCD symptom intensity emerged from our review as the most reliable predictor of future clinical outcomes. Combinations of SCD-Plus symptoms also had predictive utility. No single symptom was uniquely prognostic. Our findings support the quantitative evaluation of SCD symptoms in the assessment of risk for progression to MCI or dementia.

The Role of Cognitive Self-Report Measure Type in Predicting Cognitive Decline Among Older Adults: A Systematic Review

Many types of items are used to measure self-reported cognition, resulting in heterogeneity across studies. Certain cognitive self-report measure types may be more predictive of future decline. Therefore, the purpose of this systematic review was to compare whether specific types of cognitive self-report measures better predict risk for cognitive decline over time when measures are directly compared within the same study. The PRISMA criteria guided the review. Eligibility criteria included: longitudinal studies, outcome of cognitive decline, at least 2 different cognitive self-report measures, and no cognitive impairment at baseline. Nineteen studies were included in the final review. A narrative synthesis of results was completed, resulting in 3 thematic groups of comparisons across self-reported measure types. Self-reported memory decline with worry and peer perceptions of memory were associated with the highest risk for cognitive decline. Future longitudinal investigations of self-reported cognitive problems should focus on using measures that may be most sensitive to predicting cognitive decline risk.

Diagnostic accuracy of CompCog: reaction time as a screening measure for mild cognitive impairment

BACKGROUND

Reaction time is affected under different neurological conditions but has not been much investigated considering all types of mild cognitive impairment (MCI).

OBJECTIVE

This study investigated the diagnostic accuracy of CompCog, a computerized cognitive screening battery focusing on reaction time measurements.

METHODS

A sample of 52 older adults underwent neuropsychological assessments, including CompCog, and medical appointments, to be classified as a control group or be diagnosed with MCI. The accuracy of CompCog for distinguishing between the two groups was calculated.

RESULTS

The results from diagnostic accuracy analyses showed that the AUCs of ROC curves were as high as 0.915 (CI 0.837-0.993). The subtest with the highest sensitivity and specificity (choice reaction time subtest) had 91.7% sensitivity and 89.3% specificity. The logistic regression final model correctly classified 92.3% of individuals, with 92.9% specificity and 91.7% sensitivity, and included only four variables from different subtests.

CONCLUSIONS

In summary, the study showed that reaction time assessed through CompCog is a good screening measure to differentiate between normal aging and MCI. Reaction time measurements in milliseconds were more accurate than correct answers. This test can form part of routine clinical tests to achieve the objectives of screening for MCI, indicating further procedures for investigation and diagnosis and planning interventions.

Paradoxical relationship between subjective and objective cognition: the role of sleep

STUDY OBJECTIVES

Subjective memory complaints and objective cognitive dysfunction are common in aging populations, however research investigating the associations between them is inconclusive. Given the high prevalence of sleep complaints in middle-aged/older adults, this research tested whether objective cognition interacted with sleep parameters in its associations with subjective cognition.

METHODS

Cognitively healthy adults aged 50+ completed the Pittsburgh Sleep Quality Index, Cognitive Failures Questionnaire (CFQ) and cognitive tasks: Stroop, Sternberg, and Posner cueing. Multiple regression and simple slope analyses examined whether objective cognition interacted with sleep parameters in its associations with subjective memory.

RESULTS

Stroop performance and sleep (efficiency and disturbances) had interactive associations with CFQ-memory. Specifically, better Stroop performance (faster reaction time, RT-control trials) was associated with more memory complaints at worst and average, but not best sleep efficiency. Additionally, faster RT was associated with more memory complaints only for worst sleep disturbance. Similarly, Sternberg performance and sleep (efficiency and disturbances) had interactive associations with CFQ-memory. Specifically, higher proportion correct was associated with more memory complaints only at worst sleep efficiency and sleep disturbance. Finally, Posner performance and sleep disturbance had an interactive association with CFQ-memory. Faster exogenous orienting was associated with more memory complaints only for worst sleep disturbance.

CONCLUSIONS

Objective cognition interacts with sleep efficiency and sleep disturbances in its associations with subjective memory in mid-to-late life. Findings suggest sleep fragmentation plays a role in the discrepant relationship between objective and subjective cognition. Future studies should investigate this relationship in aging populations with sleep disorders and/or cognitive impairments.

Cross-sectional relationship between pain intensity and subjective cognitive decline among middle-aged and older adults with arthritis or joint conditions: Results from a population-based study

Introduction

We investigated cross-sectional relationships between arthritis or joint-related pain intensity and subjective cognitive decline in middle-aged and older adults.

Methods

The sample consisted of 30,150 adults ⩾age 45 years with self-reported arthritis or joint conditions who completed key variables in the 2015 wave of the Behavioral Risk Factor Surveillance System.

Results

Using weighted data, 94.2% of the sample reported experiencing joint pain in the last month (35.9% reported moderate pain and 30.6% reported severe pain) and 17.3% reported subjective cognitive decline. In logistic regression models, pain intensity was associated with significantly higher odds of reporting subjective cognitive decline, after controlling for age, race/ethnicity, sex, education, household income, cardiovascular health, mental health, and history of stroke. Those with moderate pain were two times as likely to report subjective cognitive decline and those with severe pain were more than three times as likely to report subjective cognitive decline relative to those without pain, adjusting for covariates.

Conclusion

The results of this study highlight a significant relationship between pain intensity and subjective cognitive decline in middle-aged and older adults with arthritis or joint conditions typically associated with joint pain. Moderate and severe joint pain is significantly associated with higher risk of subjective cognitive decline, after controlling for personal and health characteristics. Future studies with more comprehensive assessments of pain and cognition are warranted to further elucidate these relationships and their underlying mechanisms.

Subjective memory in adults over 50 years of age: associations with affective and physiological markers of emotion regulation

OBJECTIVES

To examine associations among subjective memory reports, psychophysiological markers of emotion regulation, and cognitive performance in healthy adults over 50 years of age.

METHOD

A cross-sectional laboratory study was conducted with healthy, community-dwelling, non-depressed adults (M age = 60.4 years, SD = 8.4). The Metamemory in Adulthood (MIA) questionnaire provided reports of subjective memory capacity and stability (versus decline) and anxiety about memory. Poorer emotion regulation was marked by greater negative affect (NA) and lower high frequency heart rate variability (HF-HRV) responses to a challenging working memory task. Regression models were used to identify associations between subjective memory and emotion regulation markers, and structural equation modeling was used to explore whether emotion regulation mediated associations between subjective memory and objective task performance.

RESULTS

A total of 115 participants were included in the final sample. Subjective memory decline (indicated by lower scores on memory stability) was associated with lower HF-HRV response and worse working memory performance. Poorer subjective memory capacity and more anxiety about memory were both associated with greater negative affect in response to the working memory task. There was an indirect effect of subjective memory capacity on working memory performance through negative affect response.

CONCLUSIONS

The findings here suggest that worse subjective memory may signal reduced capacity for emotion regulation. Along with known cognitive risks of depression and anxiety, more subtle emotion regulation difficulties may be involved in pathways of poor cognitive aging.

The Challenge of Subjective Cognitive Complaints and Executive Functions in Middle-Aged Adults as a Preclinical Stage of Dementia: A Systematic Review

Subjective cognitive complaints correspond to a heterogeneous construct that frequently occurs in the early stages of older adult life. Despite being a common source of worry for middle-aged people, it can be underestimated when clinical and neuropsychological assessments discard any underlying pathological processes. Negative age stereotyping but also self-stereotyping can contribute to doing so. Although its diagnosis is a challenge, its implication as a possible predictor of mild cognitive impairment or dementia increases the interest in its early diagnosis and intervention. The present systematic review analyzes the empirical data on the relationship between these complaints and early executive dysfunction with possible predictive value for preclinical stages of dementia. The sixteen papers obtained from the PubMed and Embase databases were exploratory, cross-sectional and prospective in scope. The studies corroborated the relationship between subjective cognitive complaints and some executive processes, which is noteworthy since many people with subjective executive complaints progress to dementia. The relational studies confirmed that impaired executive performance is associated with CSF biomarkers and reduced cortical volume in specific brain regions. However, the heterogeneity of reports in these studies demands stronger efforts in future research with specific tools applied in clinical and neuropsychological assessments and analyzed under a gender perspective.

Effects of smartphone application-based cognitive training at home on cognition in community-dwelling non-demented elderly individuals: A randomized controlled trial

INTRODUCTION

We investigated whether cognitive function improves in elderly individuals after Application-based Cognitive Training at Home (ACTH) for 12 months.

METHODS

A total of 389 non-demented elderly volunteers aged over 60 years were recruited and randomly assigned to the intervention or control group. The intervention group underwent daily ACTH (with regular feedback from the administrator) and monthly offline cognitive training in groups for 12 months. All participants received a computerized cognitive test battery called Inbrain Cognitive Screening Test (Inbrain-CST) at baseline and 6 and 12 months. The primary outcome was the change in the total composite score of Inbrain-CST, and secondary outcomes included changes in composite scores in five cognitive domains of Inbrain-CST.

RESULTS

The intervention group outperformed the control group in terms of the total score (P = .001) and subscores of language (P < .001) and memory (P < .001) domains at 12 months.

DISCUSSION

ACTH improved global cognition in community-dwelling non-demented elderly individuals.

Spousal bereavement and the cognitive health of older adults in the US: New insights on channels, single items, and subjective evidence

This study provides novel insights into older adults' cognitive functioning before and after widowhood onset and possible effect channels. It further examines gender heterogeneity in the adaptation to (anticipated or actual) spousal bereavement, comparing objective evidence with subjective evidence of cognitive abilities. We used longitudinal data of up to 26,584 participants of the Health and Retirement Study, aged over 50 at recruitment, assessed biennially between 1998 and 2016. Two-way fixed effects with dynamic treatment effects were estimated for various cognitive measures, including six aggregated indices and six single item scales. After adjusting for effect channels including depression, social vulnerability, and stress, there remained significant widowhood effects on older adults' cognitive health. Using single item scales, we established the adverse contemporaneous and adaptation effects on bereaved older females' short-term memory, semantic memory, and numeracy. For bereaved older males, working memory and focus-of-attention deteriorated after widowhood onset. Meanwhile, subjective memory rating remained intact, contrary to objective evidence. We conclude that cognitive transitions to and from widowhood can exhibit distinctive patterns across objective and subjective cognitive domains. With the effect channels in mind, cognitive intervention for widowed older adults should be tailored to the temporal distance to spousal loss, gender, and task.

Longitudinal Relationships Between Subjective Cognitive Decline and Objective Memory: Depressive Symptoms Mediate Between-Person Associations

BACKGROUND

Subjective cognitive decline (SCD) may be an early indicator of cognitive impairment, but depressive symptoms can confound this relationship. Associations may be influenced by differences between individuals (i.e., between-persons) or how each individual changes in their experiences over time (i.e., within-persons).

OBJECTIVE

We examined depressive symptoms as a mediator of the between- and within-person associations of SCD and objective memory in older adults.

METHODS

Coordinated analyses were conducted across four datasets drawn from large longitudinal studies. Samples (range: n = 1,889 to n = 15,841) included participants 65 years of age or older with no dementia at baseline. We used multilevel structural equation modeling to examine the mediation of SCD and objective memory through depressive symptoms, as well as direct relationships among SCD, objective memory, and depressive symptoms.

RESULTS

Older adults who were more likely to report SCD had lower objective memory on average (between-person associations), and depressive symptoms partially mediated this relationship in three of four datasets. However, changes in depressive symptoms did not mediate the relationship between reports of SCD and declines in objective memory in three of four datasets (within-person associations).

CONCLUSION

Individual differences in depressive symptoms, and not changes in an individual's depressive symptoms over time, partially explain the link between SCD and objective memory. Older adults with SCD and depressive symptoms may be at greater risk for poor cognitive outcomes. Future research should explore how perceived changes in memory affect other aspects of psychological well-being, and how these relationships influence cognitive decline and Alzheimer's disease risk.

Subjective memory, objective memory, and race over a 10-year period: Findings from the ACTIVE study

The longitudinal associations between subjective and objective memory functioning in later life remain unclear. This may be due, in part, to sociodemographic differences across studies, given the hypothesis that these associations differ across racial groups. Using data from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE; N = 2,694; 26% African American), multiple-group, parallel-process latent growth curve models were used to explore relationships between subjective and objective memory over 10 years and assess racial differences in these associations. Across African Americans and whites, we found bidirectional associations between subjective and objective memory such that greater self-reported forgetting at baseline predicted faster subsequent verbal episodic memory declines, and higher baseline objective memory scores predicted less increase in self-reported forgetting over time. However, rates of change in self-reported frequency of forgetting were correlated with rates of change in verbal episodic memory in whites, but not in African Americans. Subjective memory complaints may be a harbinger of future memory declines across African Americans and whites but may not track with objective memory in the same way across these racial groups. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Depression, health comorbidities, cognitive symptoms and their functional impact: Not just a geriatric problem

OBJECTIVE

To compare the prevalence of cognitive symptoms and their functional impact by age group accounting for depression and number of other health conditions.

METHODS

We analyzed data from the 2011 Behavioral Risk Factor Surveillance System, a population-based, cross-sectional telephone survey of US adults. Twenty-one US states asked participants (n = 131, 273) about cognitive symptoms (worsening confusion or memory loss in the past year) and their functional impact (interference with activities and need for assistance). We analyzed the association between age, depression history and cognitive symptoms and their functional impact using logistic regression and adjusted for demographic characteristics and other health condition count.

RESULTS

There was a significant interaction between age and depression (p < 0.0001). In adults reporting depression, the adjusted odds of cognitive symptoms in younger age groups (<75 years) were comparable or greater to those in the oldest age group (≥75 years) with a peak in the middle age (45-54 years) group (OR 1.9 (95% Confidence Interval: 1.4-2.5). In adults without depression, adults <75 years had a significantly lower adjusted odds of cognitive symptoms compared to the oldest age group with the exception of the middle-aged group where the difference was not statistically significant. Over half of adults under age 65 with depression reported that cognitive symptoms interfered with life activities compared to 35.7% of adults ≥65 years.

CONCLUSIONS

Cognitive symptoms are not universally higher in older adults; middle-aged adults are also particularly vulnerable. Given the adverse functional impact associated with cognitive symptoms in younger adults, clinicians should assess cognitive symptoms and their functional impact in adults of all ages and consider treatments that impact both cognition and functional domains.

The relationship of functional hippocampal activity, amyloid deposition, and longitudinal memory decline to memory complaints in cognitively healthy older adults

We evaluated whether self-reports of worse cognition in older adults with normal cognitive function reflected actual memory decline, amyloid pathology, and subtle vulnerabilities in hippocampal function. We measured subjective cognitive decline (SCD) in 156 older participants from the Dallas Lifespan Brain Study. Functional hippocampal activation during encoding, measured with fMRI, and longitudinal memory change that was measured in the four years preceding the SCD measures were used to predict the magnitude of SCD. A subsample (N=105) also underwent ¹⁸F-Florbetapir PET imaging that measured amyloid burden. Results showed that increased SCD were associated with greater prior memory decline and amyloid deposition. Importantly, decreased hippocampal activation during encoding was a significant predictor of SCD, particularly in young-old adults below 69 years old, above and beyond prior memory change and amyloid deposition. These results indicate that multiple measures of neural and cognitive dysfunction are simultaneously associated with SCD. Moreover, SCD in younger seniors appears to reflect deficient hippocampal activity that increases their reports of poorer memory, independent of amyloid. This manuscript is part of the Special Issue entitled "Cognitive Neuroscience of Healthy and Pathological Aging" edited by Drs. M. N. Rajah, S. Belleville, and R. Cabeza. This article is part of the Virtual Special Issue titled COGNITIVE NEU-ROSCIENCE OF HEALTHY AND PATHOLOGICAL AGING. The full issue can be found on ScienceDirect at https://www.sciencedirect.com/journal/neurobiology-of-aging/special-issue/105379XPWJP.

Cognitive Effects and Depression Associated With Taxane-Based Chemotherapy in Breast Cancer Survivors: A Meta-Analysis

Purpose: This meta-analysis provides a longitudinal assessment of depression and cognitive impairment induced by taxane-based chemotherapy in women with breast cancer after 6 months of treatment. We highlighted the incidence and prevalence, the cognitive pattern in neuropsychological studies, and the relationship between chemotherapy-induced cognitive impairment and different risk factors. We estimated the effect sizes on each cognitive domain and differentiated effect sizes by each method of comparison of effects (i.e., baseline data, or control groups). Methods: The databases MEDLINE and Embase were searched for publications about taxane-related cognitive changes in patients with breast cancer published from 1980 to 2019. Cross-sectional and self-reported outcomes studies were excluded except for the depression item. Included studies were assessed for risk of bias with the Newcastle-Ottawa Scale. We estimated effect sizes for each cognitive domain and differentiated effect sizes by each method of comparison of effects. The review is reported in compliance with the PRISMA Statement; it was registered prospectively in PROSPERO as CRD42020163255. Results: Eleven studies meeting the criteria were analyzed, which resulted in a sample of 1,057 patients with breast cancer who received chemotherapy including 820 patients (77%) who received taxane-based chemotherapy. Attention and concentration, depression, and executive function domains had significant chemotherapy-induced impairment across all comparison types. Statistically significant improvement was found in language and verbal memory when comparing chemotherapy patients' test scores with baseline or matched controls. Taxane-based chemotherapy had a non-significant effect on processing speed, visual memory, visuospatial, and motor function domains. Conclusions: The occurrence of chemotherapy-induced cognitive impairment 6 months or more after the course of treatment in people with breast cancer is frequent in the domains of attention, executive function, and depression. Other domains appear stable or improve with time after treatment cessation.

Altered mismatch response precedes gray matter atrophy in subjective cognitive decline

The cross-sectional identification of subjective cognitive decline (SCD) in cognitively normal adults is particularly important for the early effective prevention or intervention of the future development of mild cognitive impairments (MCI) or Alzheimer's disease (AD). A pre-attentive neurophysiological signal that reflects the brain's ability to detect the changes of the environment is called mismatch negativity (MMN) or its magnetic counterpart (MMNm). It has been shown that patients with MCI or AD demonstrate reduced MMN/MMNm responses, while the exact profile of MMN/MMNm in SCD is substantially unknown. We applied magnetoencephalographic recordings to interrogate MMNm activities in healthy controls (HC, n = 29) and individuals with SCD (n = 26). Furthermore, we analyzed gray matter (GM) volumes in the MMNm-related regions through voxel-based morphometry and performed apolipoprotein E4 (APOE4) genotyping for all the participants. Our results showed that there were no significant differences in GM volume and proportions of APOE4 carriers between HC and SCD groups. However, individuals with SCD exhibited weakened z-corrected MMNm responses in the left inferior parietal lobule and right inferior frontal gyrus (IFG) as compared to HC. Based on the regions showing significant between-group differences, z-corrected MMNm amplitudes of the right IFG significantly correlated with the memory performance among the SCD participants. Our data suggest that neurophysiological changes of the brain, as indexed by MMNm, precede structural atrophy in the individuals with SCD compared to those without SCD.

Interaction between Subjective Memory Decline and Depression Symptom Intensity in Older People. Results of the Second Wave of Cognition of Older People, Education, Recreational Activities, Nutrition, Comorbidities, and Functional Capacity Studies (COPERNICUS)

Background: Prevalence of subjective memory impairment (SMC), with or without objective memory impairment, and the mediating role of depression symptom intensity was examined in older people. Methods: n = 205 subjects (60 years old and older) were examined and followed up at two years. Cognitive function was examined using the Montreal Cognitive Assessment (MoCA) Delayed Recall (DR) subtest. Geriatric Depression Scale (GDS) was used as a screening tool for depression. Statistical analysis was performed using linear mixed models. Results: A total of 144 subjects (70.24%) had SMC. MoCA Delayed Recall scores were not significantly changed in relation to time and SMC. Dynamics of SMC significantly influenced changes in GDS score (p = 0.008). Conclusions: SMC and objective memory impairment do not fully overlap each other. Subjects without SMC for longer than two years noted less intensity of depression symptoms in comparison to subgroup with SMC. However, occurrence of SMC in subjects who were previously free of SMC, was not related to increase in depression symptom intensity.

How Well Does Subjective Cognitive Decline Correspond to Objectively Measured Cognitive Decline? Assessment of 10-12 Year Change

BACKGROUND

Although not strongly correlated with current objective cognitive ability, subjective cognitive decline (SCD) is a risk factor for Alzheimer's disease. Most studies focus on SCD in relation to future decline rather than objective prior decline that it purportedly measures.

OBJECTIVE

We evaluated whether self-report of cognitive decline-as a continuous measure-corresponds to objectively-assessed episodic memory and executive function decline across the same period.

METHODS

1,170 men completed the Everyday Cognition Questionnaire (ECog) at mean age 68 assessing subjective changes in cognitive ability relative to 10 years prior. A subset had mild cognitive impairment (MCI), but MCI was diagnosed without regard to subjective decline. Participants completed up to 3 objective assessments of memory and executive function (M = 56, 62, and 68 years). Informant-reported ECogs were completed for 1,045 individuals. Analyses controlled for depression and anxiety symptoms assessed at mean age 68.

RESULTS

Participant-reported ECog scores were modestly associated with objective decline for memory (β= -0.23, 95%CI [-0.37, -0.10]) and executive function (β= -0.19, 95%CI [-0.33, -0.05]) over the same time period. However, these associations were nonsignificant after excluding MCI cases. Results were similar for informant ratings. Participant-rated ECog scores were more strongly associated with concurrent depression and anxiety symptoms, (β= 0.44, 95%CI [0.36, 0.53]).

CONCLUSION

Continuous SCD scores are correlated with prior objective cognitive changes in non-demented individuals, though this association appears driven by individuals with current MCI. However, participants' current depression and anxiety ratings tend to be strongly associated with their SCD ratings. Thus, what primarily drives SCD ratings remains unclear.

Schizophrenia polygenic risk predicts general cognitive deficit but not cognitive decline in healthy older adults

There has been a long argument over whether schizophrenia is a neurodegenerative disorder associated with progressive cognitive impairment. Given high heritability of schizophrenia, ascertaning if genetic susceptibility to schizophrenia is also associated with cognitive decline in healthy people would support the view that schizophrenia leads to an accelerated cognitive decline. Using the population representative sample of 6817 adults aged >50 years from the English Longitudinal Study of Ageing, we investigated associations between the biennial rate of decline in cognitive ability and the schizophrenia polygenic score (SZ-PGS) during the 10-year follow-up period. SZ-PGS was calculated based on summary statistics from the Schizophrenia Working Group of the Psychiatric Genomics Consortium. Cognition was measured sequentially across four time points using verbal memory and semantic fluency tests. The average baseline verbal memory was 10.4 (SD = 3.4) and semantic fluency was 20.7 (SD = 6.3). One standard deviation (1-SD) increase in SZ-PGS was associated with lower baseline semantic fluency (β = -0.25, 95%CI = -0.40 to -0.10, p = 0.002); this association was significant in men (β = -0.36, 95%CI = -0.59 to -0.12, p = 0.003) and in those who were aged 60-69 years old (β = -0.32, 95%CI = -0.58 to -0.05, p = 0.019). Similarly, 1-SD increase in SZ-PGS was associated with lower verbal memory score at baseline in men only (β = -0.12, 95%CI = -0.23 to -0.01, p = 0.040). However, SZ-PGS was not associated with a greater rate of decline in these cognitive domains during the 10-year follow-up. Our findings highlight that while genetic susceptibility to schizophrenia conveys developmental cognitive deficit, it is not associated with an ongoing cognitive decline, at least in later life. These results do not support the neo-Kraepelinian notion of schizophrenia as a genetically determined progressively deteriorating brain disease.

The Interpersonal Context of Memory Complaints

This mixed-methods study was designed to investigate the interpersonal experience of having memory problems using a community-dwelling sample of 94 adults over the age of 50 (M age = 72.35, SD = 10.51). Participants were asked a series of open-ended questions about their reactions to memory problems and completed questionnaires about memory, personality, and health. Qualitative findings suggest a few clear patterns of response (e.g., admitting the problem, ignoring the problem) to memory failures. In addition, endorsing avoidance of talking to certain people was related to worry and memory anxiety. Correlations showed subjective memory related to conscientiousness, neuroticism, depression, and worry which replicates previous studies about memory complaints. This study adds to the subjective memory literature by enhancing what we know about what people do when they are confronted with a memory challenge as well as to whom they will or will not speak about their complaints.

Structural Model for Estimating the Influence of Healthy Lifestyle on Episodic Memory in Adults with Subjective Memory Complaints

The aim of this study is to examine the relationships between a healthy lifestyle and episodic memory among adults with subjective memory complaints (SMCs). We proposed a structure equation model to study the association between a healthy lifestyle and episodic memory with an investigation covering 309 participants over 50 years old with SMCs. The model showed a good fit after being adjusted (p = 0.054, goodness of fit index = 0.981, adjusted goodness of fit index = 0.956, comparative fit index = 0.981, and root mean square error of approximation = 0.049): a healthy lifestyle has a direct positive effect on episodic memory among adults with SMCs (β = 0.60). The research model provides possible guidelines for medical staff to prevent the cognitive function decline in the risk population of Alzheimer's disease.

Functional cognitive disorders: a systematic review

Cognitive symptoms are common, and yet many who seek help for cognitive symptoms neither have, nor go on to develop, dementia. A proportion of these people are likely to have functional cognitive disorders, a subtype of functional neurological disorders, in which cognitive symptoms are present, associated with distress or disability, but caused by functional alterations rather than degenerative brain disease or another structural lesion. In this Review, we have systematically examined the prevalence and clinical associations of functional cognitive disorders, and related phenotypes, within the wider cognitive disorder literature. Around a quarter of patients presenting to memory clinics received diagnoses that might indicate the presence of functional cognitive disorders, which were associated with affective symptoms, negative self-evaluation, negative illness perceptions, non-progressive symptom trajectories, and linguistic and behavioural differences during clinical interactions. Those with functional cognitive disorder phenotypes are at risk of iatrogenic harm because of misdiagnosis or inaccurate prediction of future decline. Further research is imperative to improve diagnosis and identify effective treatments for functional cognitive disorders, and better understanding these phenotypes will also improve the specificity of diagnoses of prodromal degenerative brain disease.

May Subjective Language Complaints Predict Future Language Decline in Community-Dwelling Subjects?

Subjective cognitive complaints are rather prevalent in the elderly population and are associated with an increased risk of cognitive impairment and dementia. However, the predictive role of specific types of cognitive complaints has been less systematically assessed. The aim of the present study is to examine the predictive value of language complaints for cognitive and language decline in a cohort of community-dwelling healthy older adults, followed longitudinally over a 5-year period. A total of 402 subjects were enrolled in a prospective longitudinal study on aging and cognition. Participants answered a cognitive complaints questionnaire including two questions directed to language and were classified at baseline as having “Language Complaints” (LC) or “No Language Complaints” (NLC). They also performed a neuropsychological assessment tackling attention/processing speed, memory, executive functioning, and language at baseline. From these, 275 (68.4%) participated in a follow-up evaluation 4.9 (±0.6) years later. At re-evaluation, subjects had a mean age of 70.4 (±8.3) years, 7.5 (±4.4) years of education, and 63.3% were female. Multivariate linear regression analysis was used to investigate whether language complaints at baseline predicted poorer language performance at follow-up or increased the risk of cognitive decline, with correction for sex, depressive symptoms, living status, baseline performance, and composite memory and executive performance. Results indicated that LC subjects had significantly worse performances than NLC subjects on semantic fluency 5 years later, but with a similar rate of decline overtime that was not associated with a follow-up outcome of cognitive decline/dementia. Language difficulties may represent a specific type of age-related cognitive complaints. Longer follow-ups are necessary to understand if they are associated with an increased risk of language or cognitive decline.