scholarly journals A-025 Subjective Cognitive Decline and Likelihood of Participation Across Home-Based Cognitive Assessment Modalities

2020 ◽  
Vol 35 (6) ◽  
pp. 815-815
Author(s):  
Splonskowski M ◽  
Smith S ◽  
Jacova C

Abstract Objective Individuals with subjective cognitive decline (SCD) are approximately twice as likely to develop dementia and less likely to seek cognitive assessment. Home-based cognitive assessment (HBCA) could reduce many practical and emotional barriers associated with in-person cognitive testing. We aimed to explore the relationship between SCD and likelihood of HBCA participation across various modalities. Method A nation-wide sample of 483 community-dwelling adults age 50 years and older (M = 63.61 ± 5.47) were recruited via Amazon Mechanical Turk, an online crowdsourcing website, to complete a survey. SCD was measured using the SCD-MyCog Questionnaire. A score of 7/24 endorsed symptoms classified respondents into SCD and non-SCD. Likelihood of participation in HBCA was measured using 4 likert-scale items (e.g., “How likely would you be to participate in HBCA via computer?”). Total likelihood was calculated by summing items. Results Regression revealed SCD symptom burden predicted likelihood of participation in HBCA [F(1, 481) = 12.42, B = .097, [.043–.150], p < .001, r^2 = .025]. Likelihood was higher in SCD (15.25 ± 3.3) than non-SCD (14.23 ± 3.5). When looking at specific HBCA modalities, SCD were more likely than non-SCD to participate in computer and videoconferencing modalities (1.36 ± 0.6 vs1.68 ± 0.87, p < .001; 2.26 ± 1.11 vs 2.58 ± 1.16, p < .001). There was no relationship with iPad or smartphone modalities. Conclusion SCD endorsement was associated with increased likelihood of engagement in HBCA. It is possible that HBCA can help overcome barriers to help-seeking in this group. SCD may prefer videoconferencing and computer modalities.

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 293-294
Author(s):  
Moriah Splonskowski ◽  
Holly Cooke ◽  
Claudia Jacova

Abstract Home-based cognitive assessment (HBCA) services are emerging as a convenient alternative to in-clinic cognitive assessment and may aid in mitigating barriers to detecting cognitive impairment (CI). It is unknown which older adults would be likely to participate in HBCA. Here we investigated the role of age and Subjective Cognitive Decline (SCD). SCD has demonstrated an increased risk for progression to CI/dementia. A nation-wide community-dwelling sample of 494 adults age 50+ were recruited via Amazon Mechanical Turk to complete an online survey assessing perceptions around HBCA and SCD. Our sample was 91.9% White and 66.8% female. It consisted of 174 respondents aged 50-60, 265 aged 61- 70, and 55 aged 71-79. Age groups were comparable with respect to their acceptance of cognitive assessment (Range 4-20, higher score=higher acceptance, 7.9±3.3, 8.15±3.2, 8.05±3.43) and SCD-Q total (43.1±5.8, 43.2±5.7, 43.3±5.7). Correlation analysis revealed a relationship between SCD-QSCD total and perceived likelihood of participation in HBCA for those ages 61-70 (r(263) = .222 p = .000), but not for ages 50-60 or 71-79 (r(172) = .102 p = .152; r(53) = -.102 p = .458). Our findings suggest that SCD influences the likelihood of participation in HBCA for older adults’ transitioning to old age (61-70). Findings show that for adults transitioning into old age (61-70), perceived cognitive state influences their likelihood of participation in HBCA. Importantly, concerns about CI/dementia may generate more favorable perceptions of HBCA for this group.


Healthcare ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 567
Author(s):  
Akio Goda ◽  
Shin Murata ◽  
Hideki Nakano ◽  
Koji Nonaka ◽  
Hiroaki Iwase ◽  
...  

Few studies have examined the effects of health literacy on people at risk of developing dementia; its effects on the pathogenesis of subjective cognitive decline (SCD) are particularly unclear. This study aimed to clarify the relationship between health literacy and SCD in a population of healthy community-dwelling older adults. SCD status was assessed using the Cognitive Function domain of the Kihon Checklist (KCL-CF). Health literacy, in turn, was evaluated using the Communicative and Critical Health Literacy (CCHL) scale. Global cognitive function and depressive symptoms were evaluated using the Mini-Mental State Examination (MMSE) and a five-item version of the Geriatric Depression Scale (GDS-5), respectively. Participants who were suspected of having SCD were significantly older than their non-SCD peers, and scored significantly worse on the CCHL, MMSE, and GDS-5. In addition, SCD status was found to be associated with CCHL and GDS-5 scores, as well as age, according to a logistic regression analysis. These findings suggest that low health literacy is linked to SCD morbidity in healthy community-dwelling older adults and should prove useful in the planning of dementia prevention and intervention programs for this population.


2020 ◽  
Vol 35 (6) ◽  
pp. 823-823
Author(s):  
Splonskowski M ◽  
Jacova C

Abstract Objective Individuals endorsing subjective cognitive decline (SCD) are at risk for dementia, likely to endorse depression and anxiety but often don’t seek cognitive assessment. Here we examined the relationship between SCD and acceptance of cognitive assessment. Method A nation-wide sample of 483 adults age 50 and older completed an online survey via the crowdsourcing website, Amazon Mechanical Turk. The SCD-MyCog Questionnaire was used to calculate total SCD score and determine SCD and non-SCD groups (>7/24 = SCD). Items from The Perceptions Regarding Investigational Screening for Memory in Primary Care were summed to create total Assessment Acceptance. Anxiety and depressive symptoms were measured using Patient-Reported Outcome Measurement Information System scales. Results A hierarchical regression showed SCD total score adding to the prediction of assessment acceptance (R2 change = 8.5%). Once age (R2 change = 0.2%), and depression and anxiety (R2 change = 0.5%) were entered in steps 1 and 2. Step 3 coefficients were − .016, −.047, .019, and .18. The SCD group had an overall acceptance score > 1 SD higher than non-SCD (17.4 ± 2.32 and 15.46 ± 3.46). Conclusion SCD endorsed more acceptance even when anxiety and depression symptoms were accounted for. This finding is at odds with reduced help-seeking behavior among SCD. Further research is warranted to understand the specific barriers to seeking assessment among SCD.


2020 ◽  
Vol 35 (6) ◽  
pp. 816-816
Author(s):  
Splonskowski M ◽  
Binng D ◽  
Cooke H ◽  
Jacova C

Abstract Objective Recent implementations of teleneuropsychological services allow cognitive assessment to take place within the individual’s home. Geographic location and financial resources may influence older adults’ decision to access these services. Additionally, the likelihood of older adults’ participation in home-based cognitive assessment (HBCA) is unknown. We aimed to examine the relationship between age, geographic location, income, and likelihood of participation in HBCA. Method A nation-wide sample of 483 adults ages 50–79 completed an online survey via the crowdsourcing website Amazon Mechanical Turk. Respondents were asked about age, income and geographic location (e.g. rural, urban, suburban). Income was categorically measured in $20,000 increments. Likelihood of participation in HBCA was measured using 4 likert-scale items. Total likelihood was calculated by summing items. Results Perceived likelihood of participating in HBCA increased with greater household income, B = .087, p = .001 (0-20 K: M = 13.08 ± 4.19; 20-40 K: M = 14.76 ± 3.39; 40-60 K: M = 14.55 ± 3.49; 60–80 K: M = 14.55 ± 3.38; 80-100 K: M = 15.11 ± 2.83 and > 100 K: M = 15.48 ± 2.55). Likelihood decreased with age, B = −.061 p = .025 (50–59: M = 15.03 ± 3.56; 60–69: M = 14.31 ± 3.52, 70–79 M = 14.29 ± 3.27). Likelihood was not related to geographic location B = −.005, p = .933 (rural: M = 14.52 ± 3.84; suburban: M = 14.48 ± 3.31; urban: M = 14.48 ± 3.56). Conclusion Adults aged 50–59 with high income were the group most likely to participate in HBCA. Geographic location does not appear to play a role in acceptance of HBCA. However, this survey was conducted with online respondents. Different results may be obtained with in-person samples.


Author(s):  
Hai-Xin Jiang ◽  
Xin Xie ◽  
Yang Xu ◽  
Rui Wang ◽  
Xu Lei ◽  
...  

This study examined the relationship between older adults’ subjective versus objective sleep and subjective cognitive decline (SCD), and explored the role of depression on this association. One hundred and four community-dwelling older adults underwent a week of actigraphic sleep monitoring, and completed a series of neuropsychological screeners. Older adults’SCD score was positively correlated with subjective insomnia, but not with objective sleep parameters. Further mediation modeling revealed that older adults’depression mediated the association between subjective insomnia and SCD. Subjective sleep, rather than objective sleep, may be a more sensitive indicator for older adults’ SCD, with depression symptoms appearing to account for most of the variance. These findings extend our perspective on the relationship between sleep disruption and cognitive decline, and highlight the necessity of early targeted interventions on sleep to reduce the risk of cognitive impairment in the elderly with SCD.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 361-361
Author(s):  
Claudia Jacova ◽  
Samantha Smith ◽  
Frank Robertson

Abstract Subjective cognitive decline (SCD) is a construct of high interest in aging and dementia because individuals endorsing it are at higher risk of developing cognitive problems. It is unclear how individuals arrive at the judgement that they have SCD. Here we aimed to understand which SCD symptoms give rise to the perception of decline as older adults age. Community-dwelling adults (N=494, mean age=63.6, SD=5.44), completed the Subjective Cognitive Decline Questionnaire (SCD-Q) online, using an online crowdsourcing site. The SCD-Q consists of one global question regarding self-perceived decline (yes/no) and 24 questions about everyday functioning which we utilized to form a memory, language, and executive functioning domain score, higher for greater perceived decline. Logistic regression revealed that memory and language domains predicted the likelihood of endorsing SCD for adults aged >64 (Memory: OR=1.76, CI=1.47-2.05; Language: OR=1.66, CI=1.30-2.02). Only the memory domain predicted the likelihood of endorsing SCD for adults <63 (OR=2.69, CI=2.35-3.02). Executive functioning domain scores did not play a role in the relationship between SCD likelihood in either age group. The higher the self-perceived memory or language decline, the more likely older adults are to conclude they have SCD. Our results suggest there is an age-related trajectory in how people evaluate their cognition, with younger people only considering memory and older people considering both memory and language. Clinicians should be aware of this trajectory when examining patients with SCD. Executive functions should be specifically queried because they may not emerge from older adults’ self-reported cognitive problems.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 752-752
Author(s):  
Moriah Splonskowski ◽  
Samantha Smith ◽  
Claudia Jacova

Abstract Older adults often find it difficult to use everyday technology proficiently. We hypothesized that these difficulties would be exacerbated in those with subjective cognitive decline (SCD), that is, self-perceived worsening of cognitive functions that has been associated with increased risk of future dementia. Here we investigated the relationship between SCD symptom burden and technology proficiency. A nation-wide sample of adults (N=483) ages 50-79 (66.5% female; 14.5% age >70) completed an online survey via a crowdsourcing website, Amazon Mechanical Turk. The survey included the Subjective Cognitive Decline Questionnaire (SCD-Q MyCog) (0-25, M=4.71, SD=5.77), questions about respondents’ proficiency with computer, smartphone, and tablet (4-12, M=9.72, SD=1.97), and the PROMIS depression (M=13.18, SD=6.32) and anxiety (M=13.04, SD=5.68) scales. Linear regression was used to examine the ability of technology proficiency to predict SCD score. We also probed the interaction of technology proficiency with age (<70 vs. >70 years), and adjusted for covariates. We found that the age/technology interaction (B=-0.80), older age (B=7.49), lower education (B=-1.08), higher depression (B=0.20) and anxiety (B=0.16) symptoms predicted higher SCD burden (R-squared=.16). For respondents >70 years low technology proficiency predicted high SCD burden (B=-.79) whereas for those <70 years no relationship was found. Our study draws attention to older adults’ self-experienced cognitive function in the digital era. The association between low technology proficiency and SCD may signal the adverse impact of the digital era on those who experienced technology only later in life. It is equally possible that declining technology proficiency is an indicator of emerging neurodegenerative disease.


Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Bo Qin ◽  
Anthony J Viera ◽  
Linda S Adair ◽  
Brenda L Plassman ◽  
Lloyd J Edwards ◽  
...  

Introduction: Recent studies suggest higher visit-to-visit variability of blood pressure (BP) is associated with worse cognitive function, but evidence based on longitudinal cognitive testing has not been reported. Hypothesis: We assessed the hypothesis that higher visit-to-visit variability in BP, but not mean BP, would be associated with faster decline in cognitive function among community-dwelling older adults. Methods: This prospective cohort study comprised 1213 adults who had two or more waves of BP measurements as part of the China Health and Nutrition Survey from 1991, up to their first cognitive tests, and completed a cognitive screening test at two or more waves in 1997, 2000 or 2004. Mean (SD) age at first cognitive test was 64 (6) y. Outcomes were repeated measures of global cognitive scores (baseline mean ± SD: 19 ± 6 points), standardized composite cognitive and verbal memory scores (standardized units [SU]). Visit-to visit BP variability was expressed as the standard deviation [SD] or as the variation independent of mean (SD/mean^x, with x derived from curve fitting) in BP measures obtained at a mean interval of 3.6 years. Multivariable-adjusted linear mixed-effects models were used to determine the association of changes in cognitive scores with visit-to visit BP variability. Results: Higher visit-to-visit variability in systolic BP, but not mean systolic BP, was associated with a faster decline of cognitive function (adjusted mean difference [95% CI] for high vs. low tertile of SD in variability (Figure): global score -0.23 points/y [-0.41 to -0.04], composite scores -0.029 SU/y [-0.056 to -0.002] and verbal memory -0.044 SU/y [-0.075 to -0.012]). Higher visit-to-visit variability in diastolic BP was associated with a faster decline of global cognitive function only among adults 55-64 years, independent of mean diastolic BP. Conclusion: Higher long-term BP visit-to-visit variability predicted a faster rate of cognitive decline among older adults.


2020 ◽  
Vol 77 (2) ◽  
pp. 715-732
Author(s):  
Eleni Poptsi ◽  
Despina Moraitou ◽  
Emmanouil Tsardoulias ◽  
Andreas L. Symeonidisd ◽  
Magda Tsolaki

Background: The early diagnosis of neurocognitive disorders before the symptoms’ onset is the ultimate goal of the scientific community. REMEDES for Alzheimer (R4Alz) is a battery, designed for assessing cognitive control abilities in people with minor and major neurocognitive disorders. Objective: To investigate whether the R4Alz battery’s tasks differentiate subjective cognitive decline (SCD) from cognitively healthy adults (CHA) and mild cognitive impairment (MCI). Methods: The R4Alz battery was administered to 175 Greek adults, categorized in five groups a) healthy young adults (HYA; n = 42), b) healthy middle-aged adults (HMaA; n = 33), c) healthy older adults (HOA; n = 14), d) community-dwelling older adults with SCD (n = 34), and e) people with MCI (n = 52). Results: Between the seven R4Alz subtasks, four showcased the best results for differentiating HOA from SCD: the working memory updating (WMCUT-S3), the inhibition and switching subtask (ICT/RST-S1&S2), the failure sets (FS) of the ICT/RST-S1&S2, and the cognitive flexibility subtask (ICT/RST-S3). The total score of the four R4Alz subtasks (R4AlzTot4) leads to an excellent discrimination among SCD and healthy adulthood, and to fare discrimination among SCD and MCI. Conclusion: The R4Alz battery is a novel approach regarding the neuropsychological assessment of people with SCD, since it can very well assist toward discriminating SCD from HOA. The R4Alz is able to measure decline of specific cognitive control abilities - namely of working memory updating, and complex executive functions - which seem to be the neuropsychological substrate of cognitive complaints in community dwelling adults of advancing age.


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