Objective Cognitive Performance Research Articles

B - 31 Association of Hippocampal Volume with Subjective and Objective Cognitive Functioning in a Diverse Sample.

Individuals with subjective cognitive complaints (SCCs) and reduced hippocampal volumes (HV) may be at increased risk of future cognitive decline, though findings regarding the relationship between SCCs and HV have been mixed. The current study explores the association of HV with SCCs and objective cognitive performance in a diverse sample. Participants in a population-based cardiovascular risk study (N = 1754; MAge = 58.8, 59% Female, 50% Black, 10% Hispanic) responded to three subjective cognitive functioning questions prior to completing the Montreal Cognitive Assessment (MoCA): 1) Do you have consistent memory problems, 2) If YES, do they interfere with everyday activities, and 3) do you have trouble figuring things out/solving problems. HV were derived from a 3-tesla MRI and normalized using total intracranial volume. Partial correlations examined associations between HV, MoCA scores, and SCCs, while one-way ANCOVA compared HV by SCC endorsement pattern, controlling for demographics. Findings revealed smaller HV in those who endorsed all SCC questions (n = 27; MHV =0.34) compared to those without any SCC (n = 631, MHV = 0.36, p = 0.001), though effect size was small (η2 = 0.015). HV were not correlated with SCCs (r = -0.06, p = 0.10) or cognitive performance (r = 0.01, p = 0.75), and SCCs had a small correlation with MoCA scores (r = -0.18, p < 0.001). Subjective cognitive functioning was minimally associated with HV and cognitive performance in this sample, and as a result the clinical significance of these findings is unclear. Further research is needed to understand the possible neuroanatomical correlates of SCC, along with the predictive utility of SCCs in the early identification of cognitive decline.

A - 83 Associations between Subjective and Objective Cognition, Depression, and Quality of Life in Men Living with HIV.

In people living with HIV, subjective cognitive dysfunction is widely reported; however, few studies have examined the relationship between subjective cognitive functioning and performance-based measures of cognitive functioning, mood, and quality of life (QoL). Men living with HIV (MLWH) (n = 51, mean age = 54years, 67% Black) completed measures of subjective cognitive functioning (Cognitive Failures Questionnaire; CFQ), objective cognitive performance (HVLT-R, TMT, UFOV, WRAT-3 Reading), health-related QoL (Medical Outcomes Short-Form; SF-36), mood (CES-D), and overall QoL (Control, Autonomy, Self-Realization, and Pleasure Quality of Life Scale; CASP-19). Pearson and Spearman correlation analyses were conducted to examine significant associations between variables. Alpha was set at 0.01 for all analyses. The CFQ was not significantly correlated with performance on objective cognitive tests. However, significant associations were found between the CFQ and self-reported depression severity (CES-D; r = 0.655, p < 0.001), quality of life (CASP-19; r = -0.642, p < 0.001), and multiple subscales of the SF-36 (all p's < 0.003). Of note, correlations between the CFQ with SF-36 scales and CASP-19 were no longer significant after controlling for depressive symptoms. Consistent with prior work, we found that subjective cognitive functioning may inadequately capture the full range of a person's cognitive functioning status. We extend these findings to a sample of MLWH and further clarify the possible influence that depressive symptoms have on subjective cognitive functioning and self-reported QoL measures. Future studies with larger samples and a more comprehensive neuropsychological battery will be helpful in understanding the full nature of these relationships.

B - 33 Characterization of Subjective Cognitive Complaints in a Population-Based Sample.

Subjective cognitive complaints (SCCs) represent one's perception of cognitive change that may relate to cognitive decline. This study characterized SCC endorsement and objective cognitive performance in minority populations. Participants from a population-based, multiethnic cardiovascular risk study (N = 2653; Age = (18-85); Female = 58%; Black = 51%; Hispanic = 14%) responded to questions about their subjective cognitive functioning prior to completing the Montreal Cognitive Assessment (MoCA). Participants endorsed "Yes" or "No" to the following items: 1) Do you have consistent memory problems, 2) If YES, do they interfere with everyday activities, and 3) do you have trouble figuring things out/solving problems. Descriptive and chi-squared analyses characterized endorsement among ethnoracial groups. One-way ANCOVA controlling for age, race/ethnicity, and education compared MoCA scores by endorsement pattern. Nineteen percent (N = 520) of participants endorsed SCCs, in which blacks endorsed SCCs at a higher rate (22.4%; p < 0.008) than other ethnoracial groups (White = 16.3%; Hispanic = 17.8%). ANCOVA revealed significantly higher mean MoCA scores in those without cognitive complaints (MoCA = 23.4, N = 2122) than those who endorsed Item 3 (MoCA = 21.7, N = 42, p = 0.002, η2 = 0.001), Items 1&3 (MoCA = 21.8, N = 42, p = 0.004, η2 = 0.002), and Items 1,2, &3 (MoCA = 19.6, N = 100, p = <0.001, η2 = 0.024), respectively. Black individuals were more likely to endorse SCC's than other ethnoracial groups. Interestingly, memory complaints alone were not associated with cognitive performance, while those with problem solving concerns (with or without memory concerns) showed poorer cognitive performance. While a self-appraisal of executive functioning produced the strongest effect, future investigations are needed to characterize and distinguish the most sensitive SCCs to enhance clinical utility of brief screeners.

A - 30 Risk Factors for Poor Sleep Quality and Subjective Cognitive Decline during the COVID-19 Pandemic in an Ethnoracially Diverse US Sample.

Poor sleep quality is associated with subjective cognitive decline (SCD), a risk factor for developing Alzheimer's disease and Mild Cognitive Impairment. These relationships are understudied in ethnoracially diverse groups. We examined associations between sociodemographic characteristics, sleep changes during the COVID-19 pandemic (i.e., increased problems/poorer quality), and SCD in ethnoracially diverse older individuals in the US. 870 older adults (126 Latino, 74 Black, 33 Asian, and 637 White; Mage = 67.0 [7.6]) completed an online survey including sociodemographic information, the Everyday Cognition scale (ECog), which measures SCD, and a question inquiring about increased sleep problems/worsened sleep quality during the pandemic. Chi-square tests and analyses of variance assessed sociodemographic and SCD differences between groups. Regression and correlation analyses assessed relationships among sociodemographic factors, changes in sleep quality, and SCD. White participants were older (p < 0.001), and White and Asian groups had higher education levels (p = 0.009) than Latinos. There were more female (p = 0.016) and middle-income (p = 0.019) White respondents. There were no group differences in ECog ratings (p = 0.143) or the proportion of respondents endorsing changes in sleep during the pandemic (p = 0.197). Changes in sleep were associated with greater SCD (β= 0.214, p < 0.001). Younger age (p < 0.001), female sex (p = 0.001), and lower income (p = 0.016) were significant predictors of changes in sleep. Poorer sleep quality resulting from the COVID-19 pandemic was associated with SCD concerns. Notably, younger, female, and lower-income adults may have been at greater risk for increased sleep problems. Future work is needed to comprehensively examine sleep quality, SCD, and objective cognitive functioning in more representative samples.

A - 52 Self-Reports and Informant-Reports of Everyday Functioning as Predictors of Objective Cognition in Mild Cognitive Impairment and Dementia.

The objective of the current study was to investigate self- and informant-reports of everyday functioning and whether they predicted objective cognitive functioning. Participants included 65 persons with mild cognitive impairment (MCI), 18 individuals with dementia, and 58 healthy older controls. Self-reports and informant-reports were taken on the Everyday Cognition Scales (E-Cog), which included seven subscales: everyday language, memory, executive functioning (EF) planning, EF organization, EF divided attention, visual-spatial/perceptual abilities, and attention. Participants also completed a neuropsychological battery, and composite scores were calculated for each cognitive domain. Regression analyses revealed that in healthy older controls, self-reported EF organization significantly predicted objective executive functions. Additionally, informant-reported language significantly predicted objective language. In the MCI group, self- and informant-reports on the E-Cog did not predict objective cognition. For the dementia group, informant-reported EF planning, EF organization, and EF divided attention significantly predicted objective executive functions. Furthermore, informant-reported language significantly predicted objective language. Overall, informant-reports of everyday language predicted objective language in healthy aging and dementia. Self-reports were only predictive of objective cognition in healthy older controls, with self-reported everyday executive functions predicting objective executive functions. Interestingly, in MCI, self- and informant-reports were not predictive of any domain of objective cognitive skill. These results indicate that when the cognitive impairment is more subtle than in dementia, objective neuropsychological assessment will be even more important, as self- and informant-reports are not associated with actual cognitive functioning.

Different profiles of neurocognitive functioning in patients with brain metastases prior to brain radiotherapy.

Patients with brain metastases (BrMs) are a heterogeneous population, with almost 50% experiencing cognitive impairment before brain radiotherapy. Defining pre-radiotherapy cognitive profiles will aid in understanding of the cognitive vulnerabilities and offer valuable insight and guidance for tailoring interventions. The study population consisted of 58 adult patients with BrMs referred for radiotherapy. A semi-structured interview and comprehensive battery including 10 neuropsychological tests were used to assess subjective and objective cognitive performance prior to radiotherapy. A majority (69%) of patients report decline in cognitive performance compared to their premorbid level (i.e. pre-cancer). Objective testing revealed memory (52%), processing speed (33%) and emotion recognition (29%) deficits were most frequent. 21% of patients had no cognitive deficits while 55% had deficits (-1.5SD) in at least two cognitive domains. Hierarchical cluster analysis based on patient deficit profiles identified four clusters: (I) no or limited cognitive deficits selectively restricted to processing speed or executive function, (II) psychomotor speed deficits, (III) memory deficits and (IV) extensive cognitive deficits including memory. No patient or clinical-related (e.g. age, number of BrMs, previous treatment) differences were found between clusters. Patterns of cognitive performance in patients with BrMs are heterogeneous, with most experiencing at least some degree of neurocognitive dysfunction. We identified four meaningful cognitive clusters. Stability of these clusters over time and in different samples should be assessed to advance understanding of the cognitive vulnerability of this patient population.

Self- versus informant-report of cognitive decline in mild cognitive impairment: Concordance with cognitive and functional performance.

Debate continues regarding the use of self- versus informant-report to diagnose mild cognitive impairment (MCI) with studies reporting patients both overestimating and underestimating their abilities relative to informants. We assessed concordance of self- versus informant-report of cognitive decline with objective cognitive and functional performance in the participants of the preventing Alzheimer's dementia with cognitive remediation plus transcranial direct current stimulation in mild cognitive impairment and depression randomized controlled trial (PACt-MD). Three hundred six participants with MCI, and their informants, reported on cognitive decline; the participants also completed a comprehensive assessment of objective cognitive and functional performance. Based on the discrepancy between self- versus informant-report of cognitive decline, we grouped participants into categories of underestimators, congruent estimators, and overestimators. Informant- but not self-reported cognitive decline significantly correlated with objective cognitive performance. There were 68 underestimators, 94 congruent estimators, and 144 overestimators. Underestimators had significantly lower objective cognitive performance and functional performance than congruent estimators and overestimators. Cognitive performance significantly predicted functional performance in all three groups, and the relationship between cognitive and functional performance was moderated by the discrepancy between self- and informant-report. We showed a poor concordance among self-report of cognitive decline and both informant-report of cognitive decline and cognitive performance in patients with MCI. Our findings highlight clinical and research value in the assessment and consideration of degree of discrepancy between self- and informant-reports of cognitive decline in MCI. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Recent contributions to the field of subjective cognitive decline in aging: A literature review.

Subjective cognitive decline (SCD) is defined as self-experienced, persistent concerns of decline in cognitive capacity in the context of normal performance on objective cognitive measures. Although SCD was initially thought to represent the "worried well," these concerns can be linked to subtle brain changes prior to changes in objective cognitive performance and, therefore, in some individuals, SCD may represent the early stages of an underlying neurodegenerative disease process (e.g., Alzheimer's disease). The field of SCD research has expanded rapidly over the years, and this review aims to provide an update on new advances in, and contributions to, the field of SCD in key areas and themes identified by researchers in this field as particularly important and impactful. First, we highlight recent studies examining sociodemographic and genetic risk factors for SCD, including explorations of SCD across racial and ethnic minoritized groups, and examinations of sex and gender considerations. Next, we review new findings on relationships between SCD and in vivo markers of pathophysiology, utilizing neuroimaging and biofluid data, as well as associations between SCD and objective cognitive tests and neuropsychiatric measures. Finally, we summarize recent work on interventions for SCD and areas of future growth in the field of SCD.

Better than expected: the gap between self-reported and objective measures of cognitive performance in remitted bipolar disorder.

Studies comparing objective and self-reported cognitive functioning as well as influencing factors in individuals with remitted bipolar disorder are scarce and contradictory. The aim of this study was to compare executive functioning and other objective and self-reported cognitive impairment between 26 individuals with remitted bipolar disorder (15 BD I) and 24 healthy controls using a cross-sectional design. Executive functions were measured by the TAP Go/No-go subtest as well as the Stroop Task. Self-rated functioning was assessed using the Attention Deficit Experience Questionnaire. In addition, possible predictors of self-reported and objective cognitive functioning were examined to perform regression analyses. Individuals with remitted bipolar disorder did not differ significantly in executive functions or other objective cognitive domains from the healthy control group, but showed a significantly lower level of self-reported cognitive functioning and self-esteem. While self-esteem was the strongest predictor in healthy controls for self-reported cognitive functioning, severity of illness and subthreshold depressive mood were the most important predictors in individuals with remitted bipolar disorder. The results once again demonstrate the cognitive heterogeneity in bipolar disorder. In the treatment of cognitive deficits, factors such as subthreshold depressive symptomatology and self-esteem should be focused on in addition to cognitive training in remitted patients.

Cognitive, physical and emotional determinants of activities of daily living in nursing home residents—a cross-sectional study within the PROCARE-project

BackgroundInterdependencies of health, fitness, cognition, and emotion can promote or inhibit mobility. This study aimed to analyse pathways and interactions between individual subjective and objective physical performance, cognition, and emotions with activities of daily living (ADLs) as mobility indicators in multimorbid nursing home residents.MethodsThe study included n = 448 (77.1% females, age = 84.1 ± 7.8 years) nursing home residents. To describe the participant's demographics, frailty, number of falls, and participating institutions' socioeconomic status (SES) were assessed. ADLs were measured with the Barthel Index (BI; dependent variable). Independent variables included objective physical performance, subjective physical performance, cognition, and emotions. A structural equation model (SEM) with maximum likelihood estimation was conducted with AMOS. Direct and indirect effects were estimated using standardized coefficients (significance level of 0.05).ResultsIndices showed (Chi2(148) = 217, PCMIN/DF = 1.47; p < .001; Comparative Fit Index = .940; Tucker Lewes Index = .902, RMSEA = .033) that the model fitted the data adequately. While there was no direct association between emotions, subjective physical performance, and ADLs, objective physical performance and cognition predicted higher ADLs (p < .01). Emotions had a strong relationship with subjective physical performance, and cognition had a moderate relationship with objective physical performance.Discussion and conclusionObjective performance and cognition predicted higher functional status, as expressed by higher BI scores. ADLs, such as mobility, dressing, or handling tasks, require motor and cognitive performance. Subjective performance is an important predictor of ADLs and is only partly explained by objective performance, but to a large extent also by emotions. Therefore, future interventions for nursing home residents should take a holistic approach that focuses not only on promoting objective physical and cognitive performance but also on emotions and perceived physical performance.Trial registrationTrial registration number: DRKS00014957.

P01.06.B EVOLUTION OF NEUROCOGNITIVE FUNCTIONING AFTER RADIOTHERAPY IN PATIENTS WITH BRAIN METASTASES

Abstract BACKGROUND Brain metastases (BMs) occur in ten to thirty percent of the adult population. They present a heterogeneous population, with almost half already experiencing cognitive impairment prior to brain radiotherapy (RT). While RT aims to improve or stabilize the neurologic deficit(s), neurocognitive decline is often reported after treatment. To better understand cognitive performance after RT, we assessed the individual cognitive performance before, three months and at least eleven months after RT. METHODS The study population consisted of 32 adult patients with BMs that were referred for brain RT. An elaborate battery of neuropsychological tests was used to assess objective cognitive performance. Additionally, the Cognitive Failures Questionnaire (CFQ) and a semi-structured interview measured subjective cognitive performance and the EORTC QLQ-C30 and EQ-5D-3L were used to assess quality of life (QoL). The reliable change index (RCI) as formulated by Maassen et al. (2009) represented clinically significant change in cognitive performance at the follow-up time points, whereby RCI &amp;lt;-1.645 was denoted decline and RCI &amp;gt;1.645 improvement. This RCI takes into account test-retest reliability and practice effects. RESULTS Three months post-RT, 83% of the patients showed declines in at least one cognitive domain, with declines most frequent in memory (58%) and processing speed (36%). On the other hand, improvements were also found, especially for attention (92%) and fine motor coordination (46%). 50-60% of patients showed further decline in cognitive performance at task-level from three to eleven month follow-up, while 40% of patients showed further improvement. Multinomial logistic regressions indicated that a higher number of BMs was predictive of declined cognitive performance three months post-RT, specifically regarding executive functioning, processing speed and fine motor coordination. Additionally, patients without symptoms at the moment of BMs diagnosis more often showed declines in processing speed. BMs growth and age were not related to cognitive change. The change in cognitive performance was not related to either subjective cognitive performance or self-reported QoL. CONCLUSION Using a stringent RCI, we found patients who benefited from RT, but also patients who showed a clinical relevant cognitive decline three months post-RT. In most patients, this trend continued until at least eleven months after RT. Patients with multiple brain metastases may be particularly vulnerable to cognitive decline and death caused by tumour growth. However, life-extending RT also has its costs and thus requires careful consideration in shared decision-making regarding treatment options. GRANT INFORMATION The APRICOT study described in the current abstract as well as EG, were supported by funding from the Dutch Cancer Society “Koningin Wilhelmina Fonds (KWF)” (#11110).

Depression, Inflammation, and Intestinal Permeability: Associations with Subjective and Objective Cognitive Functioning throughout Breast Cancer Survivorship.

About one-in-three breast cancer survivors have lingering cognitive complaints and objective cognitive impairment. Chronic inflammation and intestinal permeability (i.e., leaky gut), two risk factors for cognitive decline, can also fuel depression-another vulnerability for cognitive decline. The current study tested whether depression accompanied by high levels of inflammation or intestinal permeability predicted lower subjective and objective cognitive function in breast cancer survivors. We combined data from four breast cancer survivor studies (n = 613); some had repeated measurements for a total of 1015 study visits. All participants had a blood draw to obtain baseline measures of lipopolysaccharide binding protein-a measure of intestinal permeability, as well as three inflammatory markers that were incorporated into an inflammatory index: C-reactive protein, interleukin-6, and tumor necrosis factor-α. They reported depressive symptoms on the Center for Epidemiological Studies depression scale (CES-D), and a binary variable indicated clinically significant depressive symptoms (CES-D ≥ 16). The Kohli (749 observations) and the Breast Cancer Prevention Trial (591 observations) scales assessed subjective cognitive function. Objective cognitive function tests included the trail-making test, Hopkins verbal learning test, Conners continuous performance test, n-back test, FAS test, and animal-naming test (239-246 observations). Adjusting for education, age, BMI, cancer treatment type, time since treatment, study visit, and fatigue, women who had clinically elevated depressive symptoms accompanied by heightened inflammation or intestinal permeability reported poorer focus and marginally poorer memory. However, poorer performance across objective cognitive measures was not specific to inflammation-associated depression. Rather, there was some evidence of lower verbal fluency; poorer attention, verbal learning and memory, and working memory; and difficulties with visuospatial search among depressed survivors, regardless of inflammation. By themselves, inflammation and intestinal permeability less consistently predicted subjective or objective cognitive function. Breast cancer survivors with clinically significant depressive symptoms accompanied by either elevated inflammation or intestinal permeability may perceive greater cognitive difficulty, even though depression-related objective cognitive deficits may not be specific to inflammation- or leaky-gut-associated depression.

Exploring the relationship between workplace bullying and objective cognitive performance

ABSTRACT In two studies, we investigated the effects of workplace bullying on objective measures of cognitive functioning. In Study 1, 47 university employees, self-identified as current targets of bullying (n = 24) or non-targets (n = 23), completed objectively scored cognitive tasks assessing general attention and three components of working memory (central executive, visuospatial sketchpad, and phonological loop). T-test analyses showed that self-identified targets performed more poorly on the suite of tests compared to non-bullied counterparts, primarily driven by deficits in central executive functioning. Study 2 recruited 70 retail and hospitality workers who completed the cognitive tasks plus measures of preoccupying cognitions and exposure to negative acts. As hypothesised, we found significant indirect effects demonstrating that preoccupying cognitions explained the negative relationship between bullying and the three aspects of working memory. The magnitude of the cognitive deficits observed here, and their potential significance for job performance, highlights the importance of primary bullying prevention within organisations. Secondary and tertiary prevention efforts should also consider cognitive impairments experienced by targets and look for opportunities to reduce preoccupying cognitions, which compete for limited cognitive resources, to mitigate the erosive effects of bullying.

Long-term resting EEG correlates of repetitive mild traumatic brain injury and loss of consciousness: alterations in alpha-beta power.

Long-term changes to EEG spectra after mild traumatic brain injury (mTBI, i.e., concussion) have been reported; however, the role of injury characteristics in long-term EEG changes is unclear. It is also unclear how any chronic EEG changes may underlie either subjective or objective cognitive difficulties, which might help explain the variability in recovery after mTBI. This study included resting-state high-density electroencephalography (EEG) and mTBI injury data from 340 service members and veterans collected on average 11 years after injury as well as measures of objective and subjective cognitive functioning. The average absolute power within standard bands was computed across 11 spatial regions of the scalp. To determine how variation in brain function was accounted for by injury characteristics and aspects of cognition, we used regression analyses to investigate how EEG power was predicted by mTBI history characteristics [number, number with post-traumatic amnesia and witnessed loss of consciousness (PTA + LOC), context of injury (combat or non-combat), potentially concussive blast exposures], subjective complaints (TBIQOL General Cognitive and Executive Function Concerns), and cognitive performance (NIH Toolbox Fluid Intelligence and premorbid IQ). Post-traumatic amnesia (PTA) and loss of consciousness (LOC), poorer cognitive performance, and combat experience were associated with reduced power in beta frequencies. Executive function complaints, lower premorbid IQ, poorer cognitive performance, and higher psychological distress symptoms were associated with greater power of delta frequencies. Multiple regression confirmed the relationship between PTA + LOC, poor cognitive performance, cognitive complaints, and reduced power in beta frequencies and revealed that repetitive mTBI was associated with a higher power in alpha and beta frequencies. By contrast, neither dichotomous classification of the presence and absence of mTBI history nor blast exposures showed a relationship with EEG power variables. Long-term alterations in resting EEG spectra measures of brain function do not appear to reflect any lasting effect of a history of mTBI or blast exposures. However, power in higher frequencies reflects both injury characteristics and subjective and objective cognitive difficulties, while power in lower frequencies is related to cognitive functions and psychological distress associated with poor long-term outcomes after mTBI.

Non-pharmacological randomized intervention trial for the management of neuropsychological symptoms in outpatients with progressive multiple sclerosis

Purpose Despite typically more pronounced cognitive and mental health issues in progressive disease courses of multiple sclerosis (PMS), rehabilitation research in this subgroup is rare. The efficacy of two non-pharmacological interventions with positive results from prior investigations was therefore examined in PMS specifically. Methods Persons with PMS (pwPMS) received either computerized cognitive training (BrainStim), standardized cognitive-behavioral group sessions (Metacognitive Training [MaTiMS]), or a combination of both in an ambulatory setting. Neuropsychological assessment was conducted before and after the four-week intervention. Results 37 participants (13 with primary/24 with secondary PMS, meanage = 52.87, SDage = 7.11, meanEDSS = 4.02, SDEDSS = 1.35) entered analyses. The BrainStim group improved in immediate and delayed verbal memory, recognition, verbal working memory, and perceived cognitive deficits while experiencing increased anxiety post-intervention. MaTiMS participants reported high program satisfaction and less cognitive difficulties at retest. The Combination group performed better in immediate and delayed verbal memory, and in information processing speed after training. Descriptive data further indicated positive effects on anxiety and depression in the MaTiMS and Combination group. Conclusions While objective cognitive performance improved when explicitly trained, psychoeducative sessions contributed to subjective mental health. The combination of both approaches is thus suggested, considering the specific needs of pwPMS treated in an ambulatory setting.

Differences in metacognition between multiple sclerosis phenotypes: cognitive impairment and fatigue are key factors.

Cognitive impairment is present in 40-65% of patients with multiple sclerosis (pwMS). Objectively measured cognitive performance often does not match patients' subjective perception of their own performance. We aimed to compare cognitive performance and subjective perception of cognitive deficits between pwMS and healthy controls (HCs), as well as the accuracy of subjective perception. In total, 54 HC and 112 pwMS (relapsing-remitting, RRMS, and progressive PMS) underwent neuropsychological evaluation and completed perceived deficit, fatigue, and anxiety-depression scales. Participants were classified according to their consistency between subjective self-evaluation of cognitive abilities and objective cognitive performance to assess accuracy. Regression models were used to compare cognitive performance between groups and explore factors explaining inaccuracy in the estimation of cognitive performance. PMS showed greater and more widespread cognitive differences with HC than RRMS. No differences were found between pwMS and HC in the perception of deficit. PMS had higher ratios of overestimators. In explaining inaccuracy, fatigue and cognitive preservation were found to be risk factors for underestimation, whereas physical disability and cognitive impairment were risk factors for overestimation. PwMS have metacognitive knowledge impairments. This study provides new information about metacognition, data on the prevalence of impairments over a relatively large sample of PwMS, and new insights into factors explaining it. Anosognosia, related to cognitive impairment, may be present in pwMS. Fatigue is a key factor in underestimating cognition.

Interaction effects of indoor environmental quality factors on cognitive performance and perceived comfort of young adults in open plan offices in North American Mediterranean climate

While Indoor Environmental Quality (IEQ) factors in an environment co-exist, the interaction effects of these factors and their impacts on cognitive functioning and perceived comfort have not been comprehensively examined. In this study, the interaction effects between temperature, lighting Correlated Color Temperature (CCT), and noise levels on selective attention, sustained attention, creativity, acoustics, thermal, visual, and overall IEQ comfort of young adults in open-plan offices in North American Mediterranean climate were presented. In a mixed-design controlled experimental setting, 52 young adults were recruited, and their objective cognitive performance and subjective comfort were assessed through statistical analysis. The experimental set points included [20 °C, 25 °C], [2700 K, 6500 K], and [50 dB, 65 dB] for temperature, lighting color, and noise, respectively. Additionally, the work took into consideration the gender and Body Mass Index (BMI) of participants. The results show that temperature moderated the effect of noise level and lighting CCT on selective attention, while no effect of IEQ factors on sustained attention was found. Creativity was influenced by gender and its interaction with the noise level. Concerning perceived comfort, acoustic comfort varied significantly with temperature. Thermal comfort was influenced by the combined moderating effect of lighting CCT and BMI on temperature, while visual comfort was driven by the moderation effect of gender on lighting CCT. Overall comfort was affected by the noise level and temperature. Finally, cognitive performance indicators were correlated with perceived IEQ comfort votes. Based on the findings of this study, considerations of interactions between noise, lighting CCT, temperature, gender, and BMI can shape occupant-centric priorities for enhanced cognitive functioning and comfort.

The Association Between Subjective Mental Impairment and Objective Cognitive Performance in Non-Demented, Very Mild and Mild Demented Individuals.

Explore associations between subjective mental impairment, objective cognitive performance, and subsequent decline in older individuals with different cognitive statuses in Taiwan. Use self-reported questionnaire and cognitive abilities screening instrument to assess subjective and objective cognitive function. Categorize participants as reporters or non-reporters based on subjective reports. Conduct t-tests and regression analysis. 206 participants were assessed: 99 cognitively intact (CI), 44 very mild dementia, and 63 mild dementia. In the CI group, reporters in memory, orientation, daily life, community affairs, and judgement domains performed worse than non-reporters. In very mild dementia group, reporters in memory and personality domains performed better than non-reporters. No association found between subjective reports and 1-year cognitive decline in dementia groups. Association between subjective impairment and objective performance differs in CI and very mild dementia groups. Subjective reports do not predict 1-year cognitive decline in dementia patients. Longer follow-up studies needed.

Objective cognitive functioning in patients with stress-related disorders: a cross-sectional study using remote digital cognitive testing

BackgroundPatients with stress-related mental disorders often report cognitive impairment, but studies investigating objective cognitive impairment in patients with stress-related disorders have produced inconsistent findings.AimThe primary aim of this study was to investigate objective cognitive functioning in patients diagnosed with the stress-related disorders adjustment disorder or exhaustion disorder, compared to a healthy normative group. Secondary aims were to conduct subgroup analyses of cognitive functioning between the diagnostic groups and explore associations between self-reported symptoms and cognitive functioning.MethodsCognitive test results on a digitally self-administered cognitive test battery from 266 patients (adjustment disorder, n = 131; exhaustion disorder, n = 135) were cross-sectionally compared with results from a healthy normative group (N = 184 to 692) using one-tailed t-tests. ANOVAs were conducted for subgroup analyses, and regression analyses for associations between self-reported symptoms and cognitive functioning. Effect sizes were calculated.ResultsPatients performed significantly worse than the normative group on all measures with small to moderate effect sizes ranging from d = -.13 to -.57. Those diagnosed with exhaustion disorder performed worse than norms on more measures than did patients with adjustment disorder, but no significant differences between diagnostic groups were found on any measure. Self-reported memory impairment was weakly associated with one of two memory measures. No clear associations between self-reported burnout symptoms and objective cognitive functioning were found.ConclusionsThis study adds to the literature indicative of small to moderate objective cognitive impairments in patients diagnosed with stress-related mental disorders. Further exploration into mechanisms of cognitive functioning in different populations is needed for development of theoretical models that may explain the weak correlation between self-reported symptoms and objective measures.Trial registrationClinicalTrial.gov: NCT04797273. Trial registration date 15 March 2021. This study was also pre-registered on Open Science Framework (osf.io) with https://doi.org/10.17605/OSF.IO/TQXZV.

Perceived cognitive impairment is related to internalizing psychopathology but unrelated to objective cognitive performance among nongeriatric adults presenting for outpatient neuropsychological evaluation

Objective: This study investigated the relationship between perceived cognitive impairment, objective cognitive performance, and intrapersonal variables thought to influence ratings of perceived cognitive impairment. Method : Study sample comprised 194 nongeriatric adults who were seen in a general outpatient neuropsychology clinic for a variety of referral questions. The cognition subscale score from the WHO Disability Assessment Schedule served as the measure of perceived cognitive impairment. Objective cognitive performance was indexed via a composite score derived from a comprehensive neuropsychological battery. Internalizing psychopathology was indexed via a composite score derived from anxiety and depression measures. Medical and neuropsychiatric comorbidities were indexed by the number of different ICD diagnostic categories documented in medical records. Demographics included age, sex, race, and years of education. Results: Objective cognitive performance was unrelated to subjective concerns, explaining <1% of the variance in perceived cognitive impairment ratings. Conversely, internalizing psychopathology was significantly predictive, explaining nearly one-third of the variance in perceived cognitive impairment ratings, even after accounting for test performance, demographics, and number of comorbidities. Internalizing psychopathology was also highly associated with a greater discrepancy between scores on perceived and objective cognitive measures among participants with greater cognitive concerns. Clinically significant somatic symptoms uniquely contributed to the explained variance in perceived cognitive impairment (by ∼13%) when analyzed in a model with internalizing symptoms. Conclusions: These findings suggest that perceived cognitive impairment may be more indicative of the extent of internalizing psychopathology and somatic concerns than cognitive ability.