The association between subjective memory complaints and objective memory performance in older adults with mood disorders

Abstract

<h3>Introduction</h3> The relationship between subjective memory complaints (SMCs) and objective memory performance is not always clear-cut, which in turn can complicate the assessment of potential memory decline in older adults. Although previous research suggests that the presence of certain state-related factors, including mood and anxiety symptoms, are associated with higher SMCs, whether these factors play a mediating or moderating role in the relationship between SMCs and objective memory performance isn't as clear. In addition, scant research has explored this relationship in older adults with mood disorders. This is an important target of investigation, as accounting for mood state is critical when interpreting the clinical significance of one's SMCs and objective test performance. Thus, the current study aimed to (1) investigate the relationship between SMCs and concurrent performance on memory testing in older adults with mood disorders compared to healthy controls (HCs), and (2) determine if the relationship between SMCs and objective memory performance varies as a function of depression and/or anxiety symptom severity within the mood disorder group. <h3>Methods</h3> We conducted multilevel regression analyses of cross-sectional data from a total of 36 older adults (aged 56-89) who were enrolled in the Geriatric Mood Disorders Database study at McLean Hospital. Our sample included 21 older adults with major mood disorders (depressive and bipolar spectrum disorders) and 15 older adults without any psychiatric diagnoses (HCs). All participants completed self-report scales that assessed current mood/anxiety symptom severity (Geriatric Depression Scale, GDS; Geriatric Anxiety Scale, GAS-2) and subjective memory concerns (Multifactorial Memory Questionnaire, MMQ), as well as objective memory testing using the California Verbal Learning Test (CVLT-II). Aim 1 analyses used group (HCs vs mood), SMCs (total MMQ score), and their interaction term (group x SMCs) as predictors, with three CVLT-II metrics representing memory encoding/registration, retrieval, and storage/retention as outcome variables. Aim 2 analyses were performed within the mood group only and used SMCs (total scores from the MMQ), GDS/GAS-2, and their interaction term (SMCs x GDS and SMCs x GAS-2, respectively) as predictors, with the same CVLT-II scores as outcome variables. All analyses included age and sex as covariates. <h3>Results</h3> Mood group and control group did not significantly differ (p > 0.05) in participant's age, sex, race/ethnicity, SMCs, and three categories of objective memory testing (memory encoding/registration, retrieval, and storage/retention). As expected, the groups did differ significantly in mean severity of depressive and anxiety symptoms. For aim 1, the results from regression analyses indicated that SMCs did not significantly predict memory encoding/registration (Β = .332, <i>p</i> = .16), memory retrieval (Β = .063, <i>p</i> = .40), and memory storage/retention (Β = .189, <i>p</i> = .231). Moreover, being in a mood vs. control group did not significantly moderate any of the association between SMCs and objective memory performances (i.e., memory encoding/registration (Β = -.32, <i>p</i> = .231); retrieval (Β = -.055, <i>p</i> =.514); and storage/retention (Β =-.187, <i>p</i> = .295). For aim 2, results suggested that, within the mood disorder group, the severity of depressive symptoms did not significantly moderate the association between SMCs and each of the objective memory performance variables: encoding/registration (Β = .022, <i>p</i> =.272); retrieval (Β = .007, <i>p</i> =.336); and storage/retention (Β = .02, <i>p=</i>.212). Additionally, results demonstrated that severity of anxiety symptoms was not a significant moderator for the association between SMCs and memory performance within older adults with mood disorders (i.e., Β =.003, <i>p</i> =.583 for encoding/registration; Β = .002, <i>p</i> =.454 for retrieval; and Β = .007, <i>p=</i>.261 for storage/retention). <h3>Conclusions</h3> The current results indicate that the association between SMCs and concurrent objective memory performance did not differ between healthy older adults and those with major mood disorders. In addition, the strength of this association did not vary as a function of current depression or anxiety symptom severity within the mood disorder group. Collectively, these findings suggest that, amongst older adults, neither the presence of an endogenous mood disorder nor the severity of active depression/anxiety symptoms impacts the subjective appraisal of memory functioning in relation to objective performance on concurrent memory testing. Further, those with mood disorders did not differ significantly from HCs in their subjective appraisal of memory concerns. These findings are surprising, as prior literature suggests that those with more severe mood symptoms also have higher SMCs. Our analysis is limited by a small sample size, and further investigations should be conducted with larger samples to confirm the strength of these findings. <h3>This research was funded by</h3> This study is funded by the Rogers Family Foundation.