Higher perceived age‐related gains and losses relate to lower objective cognitive scores

Abstract

AbstractBackgroundAwareness of age‐related changes (AARC), including perceived losses (e.g., memory decline) and gains (e.g., wisdom), comprise an important component of the aging process. Indeed, subjective perceptions of aging and health can reveal critical information not captured by objective measures. In particular, growing biomarker evidence suggests that subjective cognitive decline (SCD) may be a risk state for dementia. However, whether perceived age‐related gains confer cognitive protection is not known. We examine the extent to which perceived age‐related gains and losses explain variability in cognitive performance across three stages of older adulthood.MethodWe used cross‐sectional data from the PROTECT cohort (assessment in 2019); 6,377 UK residents (age range= 51‐95 years, mean age= 66.1 years, 75.9% women) without dementia completed measures of depression, AARC gains and losses, and undertook cognitive tasks. Structural equation modeling (SEM) was used to test whether AARC gains and losses predict scores on objective cognitive tasks. In the model, we included depressive symptoms as a mediator of the associations of AARC losses with scores on cognitive tasks. We also controlled for potential confounders. We tested the same model among three sub‐samples of individuals aged 50 to 60 (N= 1,628), 61 to 70 (N= 3,076), and 71 and over (N= 1,673).ResultThe model fit the data well among all three groups. The correlation between AARC gains and losses was negligible, yet higher levels of both predicted poorer cognitive scores among all groups. Associations of gains and losses with verbal reasoning were small to moderate, whereas associations with remaining cognitive tasks were of negligible size. Depressive symptoms mediated the effect of AARC losses on verbal reasoning in the two older groups.ConclusionAs hypothesized, individuals with higher perceived losses demonstrated poorer cognition. In contrast, higher perceived gains did not confer protection; rather, perceived gains were also associated with lower cognitive performance. This unexpected pattern of results, seen across all age groups, underscores the complexity of mapping perceived experiences onto objective outcomes, and emphasizes the importance of considering subjective aging more broadly when refining the clinical construct of SCD as a reliable marker of cognitive decline.