Abstract
The diagnostic value of subjective cognitive complaints for cognitive functioning in a clinical setting remains unresolved today. However, consensus exists on the relation between subjective cognitive complaints (SCC) and mood variables such as anxiety and depression. Hence, SCC have also been discussed as potential proxies of psychopathology rather than representing cognitive functioning. In order to shed more light on yet still unexplained variance in subjective cognitive complaints, the relation between lifestyle variables (such as nutrition habits, exercise, alcohol consumption, smoking, quality of sleep, and Body Mass Index) and subjective complaints of selective attention as well as subjective memory performance were assessed, additionally to the influence of objective memory performance, measures of anxiety, and depression. A sample of 877 (554 women) healthy, middle-aged individuals (51 years on average, age range 35–65) was assessed in the present study. In a logistic regression framework results revealed that the effect of lifestyle variables on subjective complaints of selective attention as well as subjective memory performance was rendered non-significant. Instead, subjective complaints of selective attention and subjective memory performance were significantly determined by measures of both, anxiety and depression. One unit increase in anxiety or depression led to an increase of 6 or 15% in subjective memory performance complaints, respectively. For subjective complaints of selective attention, a one unit increase in anxiety or depression led to an increase of 11 or 26%, respectively. The strong relation between SCC and measures of depression and anxiety corroborates the notion of SCC being indicative of mental health and general well-being.
Highlights
The diagnostic value of subjective cognitive complaints (SCC) for the evaluation of cognitive functioning remains unsatisfactory to date
The authors assessed SCC targeting different domains and related them cross-sectionally to objective cognitive measures. While they found that on the one hand the number of SCC was negatively related to task performance, they found that the relation between SCC-items and cognitive performance varied in strength depending on SCC-item
Numbers in bold represent p < 0.05, 95% CI = 95% Confidence interval; mem = model parameter for subjective complaints on memory performance, con = model parameter for subjective complaints on selective attention. memory = objective memory performance assessed as delayed word-list recall from the Auditory Verbal Learning Test; Depression = assessed with the Patient Health Questionnaire (PHQ)-9; Anxiety = assessed as five items from the German Version of the Penn State Worry Questionnaire (PSW); Smoking = cigarettes per day; alcohol = Alcohol consumption according to Alcohol Use Disorder Identification Test; Craving = Desire to consume alcohol; Fat and Carbohydrate = Attention paid to intake each; Fruits and Vegetables, Meat, and Fish = Consumption of each; BMI = Body Mass Index
Summary
The diagnostic value of subjective cognitive complaints (SCC) for the evaluation of cognitive functioning remains unsatisfactory to date. Existing studies report brain atrophy resembling Alzheimer dementia (AD)-disease in mood-disorder-free, older individuals with SCC but (yet) without objective cognitive deficits (Saykin et al, 2006; Chao et al, 2010; Jessen et al, 2010). These studies support the notion of SCC being of diagnostic value for (early) cognitive deficits (Jessen et al, 2014). The authors assessed SCC targeting different domains (e.g. getting lost in familiar streets, change in ability to remember things, trouble following a conversation) and related them cross-sectionally to objective cognitive measures. A meta-analysis by Mitchell et al (2014) came to the conciliatory conclusion that SCC do not necessarily need to be related to objective memory performance at the time of assessment; they are justifiably in a diagnostic process as the conversion rate to dementia or MCI is twice as high in older individuals with SCC prior to onset
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