Older Adults With Subjective Cognitive Decline Worry About the Emotional Impact of Cognitive Test Results

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.

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Differences in quantitative methods for measuring subjective cognitive decline – results from a prospective memory clinic study

International Psychogeriatrics ◽

10.1017/s1041610216000272 ◽

2016 ◽

Vol 28 (9) ◽

pp. 1513-1520 ◽

Cited By ~ 16

Author(s):

Asmus Vogel ◽

Lise Cronberg Salem ◽

Birgitte Bo Andersen ◽

Gunhild Waldemar

Keyword(s):

Depressive Symptoms ◽

Cognitive Decline ◽

Quantitative Methods ◽

Cognitive Status ◽

Cognitive Test ◽

Subjective Cognitive Decline ◽

Linear Regression Models ◽

Memory Clinic ◽

Subjective Memory ◽

Wide Range

ABSTRACTBackground:Cognitive complaints occur frequently in elderly people and may be a risk factor for dementia and cognitive decline. Results from studies on subjective cognitive decline are difficult to compare due to variability in assessment methods, and little is known about how different methods influence reports of cognitive decline.Methods:The Subjective Memory Complaints Scale (SMC) and The Memory Complaint Questionnaire (MAC-Q) were applied in 121 mixed memory clinic patients with mild cognitive symptoms (mean MMSE = 26.8, SD 2.7). The scales were applied independently and raters were blinded to results from the other scale. Scales were not used for diagnostic classification. Cognitive performances and depressive symptoms were also rated. We studied the association between the two measures and investigated the scales’ relation to depressive symptoms, age, and cognitive status.Results:SMC and MAC-Q were significantly associated (r = 0.44, N = 121, p = 0.015) and both scales had a wide range of scores. In this mixed cohort of patients, younger age was associated with higher SMC scores. There were no significant correlations between cognitive test performances and scales measuring subjective decline. Depression scores were significantly correlated to both scales measuring subjective decline. Linear regression models showed that age did not have a significant contribution to the variance in subjective memory beyond that of depressive symptoms.Conclusions:Measures for subjective cognitive decline are not interchangeable when used in memory clinics and the application of different scales in previous studies is an important factor as to why studies show variability in the association between subjective cognitive decline and background data and/or clinical results. Careful consideration should be taken as to which questions are relevant and have validity when operationalizing subjective cognitive decline.

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Perceptual-Cognitive Training Can Improve Cognition in Older Adults with Subjective Cognitive Decline

10.31038/asmhs.2019361 ◽

2019 ◽

Vol 3 (6) ◽

Keyword(s):

Older Adults ◽

Cognitive Decline ◽

Cognitive Training ◽

Subjective Cognitive Decline

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

Journal of Alzheimer s Disease ◽

10.3233/jad-210230 ◽

2021 ◽

pp. 1-14

Author(s):

Nikki L. Hill ◽

Sakshi Bhargava ◽

Emily Bratlee-Whitaker ◽

Jennifer R. Turner ◽

Monique J. Brown ◽

...

Keyword(s):

Older Adults ◽

Depressive Symptoms ◽

Cognitive Decline ◽

Structural Equation ◽

Disease Risk ◽

Well Being ◽

Equation Modeling ◽

Subjective Cognitive Decline ◽

Future Research ◽

Over Time

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.

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Efficacy of tablet-based applications for mental training in preserving cognitive abilities of older adults

ABOUTOPEN ◽

10.33393/abtpn.2019.282 ◽

2019 ◽

Vol 6 (1) ◽

pp. 24-30

Author(s):

Marcello Maria Turconi ◽

Filomena Vella ◽

Francesco Mosetti

Keyword(s):

Older Adults ◽

Cognitive Decline ◽

Cognitive Performance ◽

Cognitive Abilities ◽

Cognitive Test ◽

Mental Training ◽

Versus Group ◽

Group 3 ◽

Group 2 ◽

Group 1

Background and aims: Nonpathological, age-related cognitive decline is among the most feared consequences of aging. Evidence suggests that the continued use of mental abilities can slow down cognitive decline. We developed two tablet-based applications for the mental training (ElasticaMente) and social interaction/entertainment (iNonni) of older adults. The aim of this study was to evaluate their effect on cognitive performance.Materials and methods: This was an exploratory study of 8 months duration. Sixty healthy residents of a senior community center aged ≥60 years were recruited and divided into three groups: participants in Groups 1 and 2 received a tablet with ElasticaMente and iNonni (Group 1, n = 20) or with iNonni only (Group 2, n = 20); participants in Group 3 (n = 20) did not receive any tablet. Participants in Groups 1 and 2 were instructed to use the applications three times a week (each session ~45 minutes). Cognitive performance was assessed at baseline (T0) and after 8 months (T1) using a battery of six validated tests.Results: In Group 1, cognitive test scores remained consistently stable from T0 to T1, suggesting maintenance of cognitive abilities. In contrast, in Groups 2 and 3, scores worsened from T0 to T1 across all tests. Comparison of the changes from T0 to T1 revealed statistical significance for Group 1 versus Group 3, but not for Group 1 versus Group 2 and Group 2 versus Group 3.Conclusion: The 8 months use of the applications ElasticaMente and iNonni was associated with a significant benefit in terms of preserved cognitive performance compared with no tablet-based activity. The potential contribution of ElasticaMente to the attenuation of cognitive decline should be further investigated.

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Abstract 22: Visit-to-Visit Variability in Blood Pressure is Related to Late-Life Cognitive Decline

Circulation ◽

10.1161/circ.131.suppl_1.22 ◽

2015 ◽

Vol 131 (suppl_1) ◽

Author(s):

Bo Qin ◽

Anthony J Viera ◽

Linda S Adair ◽

Brenda L Plassman ◽

Lloyd J Edwards ◽

...

Keyword(s):

Blood Pressure ◽

Older Adults ◽

Cognitive Function ◽

Cognitive Decline ◽

Verbal Memory ◽

Repeated Measures ◽

Community Dwelling ◽

Cognitive Testing ◽

Cognitive Test ◽

Nutrition Survey

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.

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Is the Discrimination of Subjective Cognitive Decline from Cognitively Healthy Adulthood and Mild Cognitive Impairment Possible? A Pilot Study Utilizing the R4Alz Battery

Journal of Alzheimer s Disease ◽

10.3233/jad-200562 ◽

2020 ◽

Vol 77 (2) ◽

pp. 715-732

Author(s):

Eleni Poptsi ◽

Despina Moraitou ◽

Emmanouil Tsardoulias ◽

Andreas L. Symeonidisd ◽

Magda Tsolaki

Keyword(s):

Older Adults ◽

Working Memory ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Cognitive Control ◽

Cognitive Decline ◽

Neurocognitive Disorders ◽

Community Dwelling ◽

Subjective Cognitive Decline ◽

Working Memory Updating

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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