Objective Cognitive Performance Research Articles

Associations Between Self and Study Partner Report of Cognitive Decline With Regional Tau in a Multicohort Study.

Self-reported cognitive decline is an early behavioral manifestation of Alzheimer disease (AD) at the preclinical stage, often believed to precede concerns reported by a study partner. Previous work shows cross-sectional associations with β-amyloid (Aβ) status and self-reported and study partner-reported cognitive decline, but less is known about their associations with tau deposition, particularly among those with preclinical AD. This cross-sectional study included participants from the Anti-Amyloid Treatment in Asymptomatic AD/Longitudinal Evaluation of Amyloid Risk and Neurodegeneration studies (N = 444) and the Harvard Aging Brain Study and affiliated studies (N = 231), which resulted in a cognitively unimpaired (CU) sample of individuals with both nonelevated (Aβ-) and elevated Aβ (Aβ+). All participants and study partners completed the Cognitive Function Index (CFI). Two regional tau composites were derived by averaging flortaucipir PET uptake in the medial temporal lobe (MTL) and neocortex (NEO). Global Aβ PET was measured in Centiloids (CLs) with Aβ+ >26 CL. We conducted multiple linear regression analyses to test associations between tau PET and CFI, covarying for amyloid, age, sex, education, and cohort. We also controlled for objective cognitive performance, measured using the Preclinical Alzheimer Cognitive Composite (PACC). Across 675 CU participants (age = 72.3 ± 6.6 years, female = 59%, Aβ+ = 60%), greater tau was associated with greater self-CFI (MTL: β = 0.28 [0.12, 0.44], p < 0.001, and NEO: β = 0.26 [0.09, 0.42], p = 0.002) and study partner CFI (MTL: β = 0.28 [0.14, 0.41], p < 0.001, and NEO: β = 0.31 [0.17, 0.44], p < 0.001). Significant associations between both CFI measures and MTL/NEO tau PET were driven by Aβ+. Continuous Aβ showed an independent effect on CFI in addition to MTL and NEO tau for both self-CFI and study partner CFI. Self-CFI (β = 0.01 [0.001, 0.02], p = 0.03), study partner CFI (β = 0.01 [0.003, 0.02], p = 0.01), and the PACC (β = -0.02 [-0.03, -0.01], p < 0.001) were independently associated with MTL tau, but for NEO tau, PACC (β = -0.02 [-0.03, -0.01], p < 0.001) and study partner report (β = 0.01 [0.004, 0.02], p = 0.002) were associated, but not self-CFI (β = 0.01 [-0.001, 0.02], p = 0.10). Both self-report and study partner report showed associations with tau in addition to Aβ. Additionally, self-report and study partner report were associated with tau above and beyond performance on a neuropsychological composite. Stratification analyses by Aβ status indicate that associations between self-reported and study partner-reported cognitive concerns with regional tau are driven by those at the preclinical stage of AD, suggesting that both are useful to collect on the early AD continuum.

Investigating the Effects of Discrimination Experiences on Everyday Metamemory Accuracy.

Lifetime and daily experiences of discrimination contribute to impaired performance on cognitive assessments. However, the underlying mechanism by which discrimination negatively impacts cognition is unclear. Recent research investigating stress-induced impairment of metamemory may address the relationship between discrimination experiences and cognitive impairment. The aim of this study was to determine the relationship of lifetime and daily experiences of discrimination, daily affect balance, baseline objective cognitive performance, and sociodemographic variables (age, race, ethnicity, and sex) with metamemory accuracy across the lifespan (ages 20-75). Impaired metamemory accuracy was defined by the number of subjective cognitive complaints. Diary data from the Midlife in the United States (MIDUS Refresher 1) Daily Diary Project (N = 782) was used for these analyses. Results from linear mixed model analyses showed significant within-person effects of daily discrimination, where people who reported more daily discrimination also reported lower metamemory accuracy, and daily affect balance, where people who reported very negative affect also reported lower metamemory accuracy. Additionally, linear mixed model analyses revealed significant between-person effects of race on metamemory accuracy, with individuals from minoritized racial groups generally reporting poorer metamemory accuracy. Daily discrimination experiences also interacted with other variables in predicting day-to-day metamemory accuracy. These findings add to our understanding of how psychosocial stress in the form of daily discrimination experiences may impair metamemory processes contributing to increased subjective cognitive complaints. Future research should consider the contribution of daily experiences of discrimination across the lifespan to poor cognitive outcomes in later life.

Firearm ownership factors and cognitive functioning: A preliminary study

Recent studies have suggested that owning a firearm for the purpose of protection and intending to acquire a firearm within the next year are associated with disrupted cognitive-affective processes that may increase firearm suicide risk. Prior studies were limited by self-report measures and would benefit from the utilization of objective indicators of cognitive functioning to clarify associations between firearm ownership and cognitive-affective states. The present study examined objective cognitive performance in a sample of U.S. adults in relation to firearm ownership variables. Based on prior studies, we hypothesized that protective owners and individuals with the intention to acquire a firearm within the next year would demonstrate reduced performance on decision-making, mental flexibility, and emotional bias tasks. A total of 112 participants (61% female, 79% white) completed objective cognitive tasks following completion of a larger survey study through ResearchMatch. Results indicated that intention to purchase a firearm within the next year was not associated with cognitive functioning but was associated with an array of heightened psychiatric symptoms. Owning a firearm for the purpose of protection was associated with decreased mental flexibility relative to non-owners, but no differences were seen for decision-making or emotional bias. These findings represent the first attempt to examine underlying objective cognitive processes related to firearm ownership, and implications for future research are discussed.

Self-reported cognitive function mediates the relationship between employment status and cognitive functioning in persons with multiple sclerosis

BackgroundCognitive impairment (CI) is common in people with MS (PwMS). Evidence is lacking for the self-reported CI's mediation effect on employment status and objective cognitive performance. Self-reported CI was found to be unreliable and seemed to be more associated with depression rather than formal cognitive performance. We hypothesized that the link between subjective and objective assessments of cognitive functions, mood, and employment status may be more complex in PwMS than previously reported. ObjectiveThe aims of this study are the following: (Romero-Pinel et al., 2022) to determine whether employment status could affect performance in cognitive function testing and (Rao et al., 1991) whether their relationship may be mediated by self-reported CI; and (Deluca et al., 2013) to determine whether self-reported depression interacts with self-reported CI in influencing performance in various cognitive domains in PwMS. MethodologyA retrospective study was performed involving PwMS who completed the self-report Multiple Sclerosis Neuropsychological Questionnaire (MSNQ), Hospital Anxiety and Depression Scale-depression scale (HADS-D), Minimal Assessment of Cognitive Function in MS (MACFIMS) and had data regarding employment status. Included PwMS were classified as employed or unemployed. A structural equation modeling (SEM) approach was taken due to the advantage of examining multiple cognitive outcomes simultaneously while accounting for shared associations. First, a latent factor of memory and executive functioning modeled the error-free associations between both factors and a processing speed task (SDMT). Next, the model tested for the indirect effect of self-reported cognition (MSNQ) on employment status differences in each outcome (memory, speed, and executive functioning). Finally, we tested interactions between MSNQ and HADS-D on each of the outcomes. ResultsWe included 590 PwMS: 72.5% female, mean age 44.2 years (SD = 10.5), mean disease duration 8.6 years (SD 9.0). The majority (n = 455, 77.1%) had relapsing MS; 357 (60.5%) were employed. About half (n = 301, 51%) did not report CI on the MSNQ; of those, 213 (70.8%) were employed. The mean MSNQ for employed PwMS was 24.5 (SD = 10.7) and 29.8 (SD = 11.2) for unemployed PwMS. Employed PwMS had significantly better memory (β = .16, p < .05), executive functioning (β = .25, p < .05), and processing speed (β = .22, p < .05). MSNQ partially indirectly mediated the effect of employment status on memory (Δβ = .03, p < .05) and executive functioning (Δβ = .03, p < .05) and processing speed (Δβ = .04, p < .05), indicating that self-report CI partially explains the influence of employment status on these cognitive domains. The association between MSNQ with both memory and executive functioning was moderated by depression, meaning that in PwMS with high HADS-D scores, MSNQ was more strongly related to worse memory and executive functioning. The final model was an acceptable fit to the data (χ2(87) = 465.07, p < .05; CFI = .90, RMSEA = .08, 90% CI [.06, .09], SRMR = .05) explaining 41.20%, 38.50% and 33.40% of the variability in memory, executive functioning, and processing speed, respectively. ConclusionSelf-reported CI partially explains the associations between employment status and objective cognitive assessment in PwMS. Depression may moderate the relationship between self-reported cognitive assessment and objective cognitive performance. Thus, employment status and mood may guide the interpretation of self-reported CI.

Subjective and objective cognitive functioning in untreated late-life depression: An exploration centered on comorbid generalized anxiety disorder

BackgroundLate-Life Depression (LLD) is a prevalent mental health disorder that is often accompanied by cognitive impairments. The objective of this study is to investigate the influence of coexisting Generalized Anxiety Disorder (GAD) on both subjective and objective cognitive abilities in untreated LLD individuals. MethodsA total of 77 participants aged 60 years and above were recruited for this study, comprising 31 individuals with Major Depressive Disorder (LLD group), 46 with MDD and coexisting Generalized Anxiety Disorder (LLDA group), and 54 healthy controls (HC). Prior to the study, all patients had abstained from psychotropic medication for a minimum of two weeks. Comprehensive neuropsychological assessments were administered to all participants. ResultsThe LLDA group exhibited substantial disparities in memory, attention, processing speed,executive function,overall cognitive functioning, and subjective cognitive functioning when compared to the HC group. The LLD group displayed deficits in memory, SCWT-W in attention, SCWT-C in processing speed,overall cognitive functioning, and subjective cognitive functioning in comparison to the healthy controls. Although the LLD group achieved lower average scores in executive function, TMTA in processing speed, and DSST in attention than the HC group, no significant distinctions were identified between these groups in these domains. Linear regression analysis unveiled that anxiety symptoms had a significant impact on subjective cognitive deficits among MDD patients, but exhibited a milder influence on objective cognitive performance. After adjusting for the severity of depression, anxiety symptoms were found to affect TMTA in processing speed and subjective cognitive functioning in LLD patients. ConclusionLate-Life Depression (LLD) exhibits pervasive cognitive impairments, particularly in individuals with generalized anxiety disorder, presenting a crucial target for future therapeutic interventions. Among elderly individuals with depression, anxiety symptoms significantly impact subjective cognitive functioning, suggesting its potential utility in distinguishing between depression-associated cognitive decline and pre-dementia conditions.

The Ultra-Long-Term Sleep study: Design, rationale, data stability and user perspective.

Sleep deprivation and poor sleep quality are significant societal challenges that negatively impact individuals' health. The interaction between subjective sleep quality, objective sleep measures, physical and cognitive performance, and their day-to-day variations remains poorly understood. Our year-long study of 20 healthy individuals, using subcutaneous electroencephalography, aimed to elucidate these interactions, assessing data stability and participant satisfaction, usability, well-being and adherence. In the study, 25 participants were fitted with a minimally invasive subcutaneous electroencephalography lead, with 20 completing the year of subcutaneous electroencephalography recording. Signal stability was measured using covariance of variation. Participant satisfaction, usability and well-being were measured with questionnaires: Perceived Ease of Use questionnaire, System Usability Scale, Headache questionnaire, Major Depression Inventory, World Health Organization 5-item Well-Being Index, and interviews. The subcutaneous electroencephalography signals remained stable for the entire year, with an average participant adherence rate of 91%. Participants rated their satisfaction with the subcutaneous electroencephalography device as easy to use with minimal or no discomfort. The System Usability Scale score was high at 86.3 ± 10.1, and interviews highlighted that participants understood how to use the subcutaneous electroencephalography device and described a period of acclimatization to sleeping with the device. This study provides compelling evidence for the feasibility of longitudinal sleep monitoring during everyday life utilizing subcutaneous electroencephalography in healthy subjects, showcasing excellent signal stability, adherence and user experience. The amassed subcutaneous electroencephalography data constitutes the largest dataset of its kind, and is poised to significantly advance our understanding of day-to-day variations in normal sleep and provide key insights into subjective and objective sleep quality.

Subjective memory complaints in young people; their relationship with objective cognitive performance and the role of neuroticism

Subjective memory complaints in young people; their relationship with objective cognitive performance and the role of neuroticism

Subjective and Objective Cognitive Functioning and Associations with Post-Stroke Social Participation: Mediating Role of Depression

Subjective and Objective Cognitive Functioning and Associations with Post-Stroke Social Participation: Mediating Role of Depression

Individualized trajectories in post-radiotherapy neurocognitive functioning of patients with brain metastases

Abstract Background The increasing incidence of brain metastases (BMs) and improved survival rates underscore the necessity to investigate the effects of treatments on individuals. The aim of this study was to evaluate the individual trajectories of subjective and objective cognitive performance after radiotherapy in patients with BMs. Methods The study population consisted of adult patients with BMs referred for radiotherapy. A semi-structured interview and comprehensive neurocognitive assessment (NCA) were used to assess both subjective and objective cognitive performance before, 3 months and ≥11 months after radiotherapy. Reliable change indices were used to identify individual, clinically meaningful changes. Results Thirty-six patients completed the 3-month follow-up, and 14 patients completed the ≥11-months follow-up. Depending on the domain, subjective cognitive decline was reported by 11-22% of patients. In total, 50% of patients reported subjective decline on at least one cognitive domain. Intracranial progression 3 months post-radiotherapy was a risk-factor for self-reported deterioration (p=.031). Objective changes were observed across all domains, with a particular vulnerability for decline in memory at 3 months post-radiotherapy. The majority of patients (81%) experienced both a deterioration as well as improvement (e.g. mixed response) in objective cognitive functioning. Results were similar for the long-term follow-up (3-≥11 months). No risk factors for objective cognitive change 3 months post-radiotherapy were identified. Conclusions Our study revealed that the majority of patients with BMs will show a mixed cognitive response following radiotherapy, reflecting the complex impact. This underscores the importance of patient-tailored NCAs three months post-radiotherapy to guide optimal rehabilitation strategies.

Investigating the Impact of Polypharmacy and Anticholinergic Medication Burden on Objective Cognitive Performance in Adults With Multiple Sclerosis.

Polypharmacy, or the use of 5 or more daily medications, is common in adults with multiple sclerosis (MS), and is often due to various physical, cognitive, and emotional symptoms. However, research regarding the association between polypharmacy and cognitive outcomes in MS is sparse. Furthermore, individuals with MS often use medications with anticholinergic properties, which are commonly associated with cognitive impairment and other central nervous system adverse effects. Currently, the utility of scales measuring anticholinergic burden in MS is unknown. This study aims to investigate the relationship between polypharmacy, anticholinergic burden, and objective cognitive performance in MS. We recruited 90 individuals with MS during routine visits at an MS specialty clinic in Kansas City. Participants completed a brief, virtual cognitive assessment and answered questions about their health. Participants provided their medication lists from which we determined polypharmacy and scores on several anticholinergic burden scales. Statistical analyses included Spearman correlations and linear regression models. Approximately 44% of the individuals surveyed met the criteria for polypharmacy. The number of daily medications was negatively correlated with cognitive performance (rs = -0.45, P < .001). Further, the Drug Burden Index accounted for additional variance in cognitive performance beyond that explained by age, education, MS disease duration, and comorbidities [ΔR2 = .12, F(5, 84) = 7.84, P < .001.]. Clinicians should consider the possible negative consequences of polypharmacy when addressing cognitive concerns in MS. Anticholinergic burden scales may be valuable in this regard. Future investigations could explore behavioral and pharmacological interventions aimed at reducing polypharmacy in MS.

Genetic Risk for Alzheimer's Disease Alters Perceived Executive Dysfunction in Cognitively Healthy Middle-Aged and Older Adults.

Subjective cognitive complaints (SCC) may be an early indicator of future cognitive decline. However, findings comparing SCC and objective cognitive performance have varied, particularly in the memory domain. Even less well established is the relationship between subjective and objective complaints in non-amnestic domains, such as in executive functioning, despite evidence indicating very early changes in these domains. Moreover, particularly early changes in both amnestic and non-amnestic domains are apparent in those carrying the Apolipoprotein-E ɛ4 allele, a primary genetic risk for Alzheimer's disease (AD). This study investigated the role of the ɛ4 allele in the consistency between subjective and objective executive functioning in 54 healthy, cognitively intact, middle-aged and older adults. Participants (Mage = 64.07, SD = 9.27, range = 48-84; ɛ4+ = 18) completed the Frontal Systems Behavior Scale (FrSBe) Executive Dysfunction Scale (EXECDYS) to measure subjective executive functioning (SEF) and multiple executive functioning tasks, which were condensed into a single factor. After accounting for age, depression, and anxiety, objective executive functioning performance significantly predicted SEF. Importantly, ɛ4 moderated this effect. Specifically, those carrying the ɛ4 allele had significantly less accurate self-awareness of their executive functioning compared to ɛ4 non-carriers. Utilizing an approach that integrates self-evaluation of executive functioning with objective neurocognitive assessment may help identify the earliest signs of impending cognitive decline, particularly in those with genetic risk for AD. Such an approach could sensitively determine those most prone to future cognitive decline prior to symptom onset, when interventions could be most effective.

Influence of psychological factors on the relationship between subjective and objective memory in adults with pharmacoresistant temporal lobe epilepsy

PurposeMany adults with temporal lobe epilepsy (TLE) report subjective cognitive impairment; however, prior studies have shown a discrepancy between these subjective complaints and objective cognitive deficits on neuropsychological measures. Mood disorders/symptoms are also common in TLE and have been linked to greater subjective cognitive difficulties. To further understand these relationships, this retrospective study sought to determine if symptoms of depression and anxiety moderate or mediate the relationship between subjective cognitive impairment and objective cognitive performance in adults with TLE. MethodParticipants were 345 adults (mean age = 40.7; 55 % female) with pharmacoresistant TLE who completed self-report screening measures of depression, anxiety, and subjective cognitive function along with objective memory measures as part of a pre-surgical clinical neuropsychological evaluation. A series of linear regression analyses was conducted to examine the potential moderating and mediating effects of mood on the relationship between subjective and objective memory function after adjusting for relevant covariates. ResultsConsistent with existing literature, self-reported depression and anxiety symptoms were significantly correlated with subjective memory difficulties across all scales (all p < .001). Subjective memory impairment was also significantly correlated with objective memory performance on neuropsychological measures, albeit with small effect sizes (estimate range 0.04-0.20). Contrary to our hypothesis, depression and anxiety did not moderate or mediate the relationship between subjective memory complaints and objective memory performance. ConclusionsWhile symptoms of depression and anxiety were associated with subjective memory ability in this cohort of adults with TLE, this study suggests that mood symptoms do not fully explain the relationship between subjective and objective memory function, likely reflecting the complex and multifactorial relationships among these variables. Nevertheless, our results highlight the importance of screening for depression and anxiety symptoms and assessing patients' subjective memory complaints as part of a neuropsychological evaluation as each of these factors tap into a different aspect of the patient functioning.

THE ROLE OF PSYCHOSOCIAL AND LIFESTYLE FACTORS IN PROMOTING COGNITIVE HEALTH

Abstract This symposium will highlight the role of psychosocial and lifestyle factors in cognitive health. Across four talks, we consider a wide range of psychosocial and lifestyle factors including personality, stress, physical activity, and nutrition, and a wide range of cognitive health outcomes including subjective and objective cognitive performance, clinical diagnoses of cognitive status, and cognitive healthspan. First, Dr. Patrick Hill will share findings on links between Big Five personality traits and the degree of concordance between subjective and objective cognitive functioning. Second, Dr. Tomiko Yoneda uses longitudinal data to investigate personality trait predictors of transitions between cognitive states (no cognitive impairment, mild cognitive impairment, dementia) and death, as well as personality effects on cognitive healthspan (i.e., years without cognitive impairment) and total longevity. Third, Nicole Stuart used ecological momentary assessment and activity trackers to investigate links among daily stress, daily physical activity, and daily cognitive performance. Finally, Dr. Julia Sheffler will discuss how we can apply our knowledge of psychosocial and lifestyle factors in cognitive health to inform the development of interventions. She will share quantitative and qualitative findings from proof-of-concept (N=9) and pilot (N=58) studies of a nutrition intervention in older adults at risk for dementia, and she will discuss implications for lifestyle intervention development more broadly. Together, this symposium showcases how a wide range of methods can be employed to reveal the importance of psychosocial and lifestyle factors for promoting healthy cognitive aging.

MINDFULNESS-BASED STRESS REDUCTION (MBSR): TREATMENT FOR COGNITIVE IMPAIRMENT POST CHEMOTHERAPY (CT)

Abstract The purpose of this R01 trial was to evaluate the efficacy of MBSR(BC) compared to the Breast Cancer Education Support program(BCES) or Usual Care(UC) regimens for improvement in cognitive functioning among breast cancer survivors(BCS) who received (CT), or CT and radiation. Methods: BCS (212) were randomized to MBSR(BC) (n=91) or BCES(90) or UC (n = 31) with MBSR(BC) and BCES participants attending a 6-week program. Measures of neuropsychological and perceived cognitive performance, psychological and physical symptoms were collected at baseline, 6, 12, and 26 weeks. Linear mixed models assessed the MBSR(BC) effects over time. Characteristics at baseline were tested as moderators of MBSR(BC) program effects. Results: 212 BCS had a mean age of 57, 73% were White, non-Hispanic, 78% received CT and radiation; and 22% CT alone. All BCS improved across the study on all measures. For most measures, cognitive and symptom improvement effects followed the hypothesized pattern favoring MBSR(BC), followed by BCES and UC groups. Effect sizes were generally small, particularly for measures of cognition. The largest week 26 effect sizes were observed in the physical symptom fatigue, where the MBSR(BC) group improved with a 0.45 Cohen’s d effect over BCES and 0.65 over UC. Type of CT, radiation treatment, time since treatment, and informal and formal practice techniques of MBSR(BC) moderated the effects of MBSR(BC). Conclusions: Although effects were modest, BCS receiving the MBSR(BC) and BCES groups improved in objective and subjective cognitive functioning and symptoms compared to UC. Longer follow-up studies are needed to determine sustained effects.

CONTEXTUALIZING HOW DAILY DISCRIMINATION EXPERIENCES IMPACT EVERYDAY METAMEMORY

Abstract Examining day-to-day responses to everyday stressors, such as discrimination, contextualizes how cognitive aging trajectories may vary across the lifespan. Furthermore, recent research investigating stress-induced impairment of metamemory may address the relationship between discrimination experiences and cognitive impairment. This study sought to articulate the association between daily experiences of discrimination and impaired metamemory across the lifespan, as defined by the number of subjective cognitive complaints, using data collected from the Midlife in the United States Refresher Study Daily Diary Project (N = 782; ages 20-75; M = 47.91 years, SD = 12.67 years). A two-level linear mixed model was conducted to examine the within and between-persons relationships concerning lifetime and daily experiences of discrimination, daily affect balance, baseline objective cognitive performance, and sociodemographic variables (age, race, ethnicity, and sex) on impaired everyday metamemory. Results from linear mixed model analyses showed significant within-person fixed effects of daily discrimination and daily affect balance on metamemory accuracy, as well as significant between-persons fixed effects of race and ethnicity on metamemory accuracy. Furthermore, significant interactions were found between race and daily discrimination experiences, ethnicity and daily discrimination experiences, daily affect balance and daily discrimination experiences, daily affect balance and age, and endorsement of lifetime experiences of discrimination and daily discrimination experiences on day-to-day metamemory accuracy. These findings extend our understanding of how discrimination experiences may impair metacognitive processes and demonstrate the need for more research into understanding metamemory accuracy as an underlying mechanism by which the psychosocial stressor of discrimination impacts cognition across the lifespan.

S16: Post-Acute Covid-19 Cognitive Sequelae in an Aging Population

S16: Post-Acute Covid-19 Cognitive Sequelae in an Aging Population

Association of subjective and objective cognitive performance to self‐rated driving ability in older adults

AbstractBackgroundOlder drivers often self‐regulate their driving behaviours to avoid more challenging situations that may lead to increased driving risk. However, other research also indicates that many older adults overestimate their driving ability, and therefore may be at risk of road traffic incidents due to not self‐regulating accurately. Understanding how self‐rated driving relates with cognitive performance can uncover markers for at‐risk driving behaviours. The present study therefore aimed to establish how self‐rated driving ability within a healthy older adult cohort relates to subjective and objective cognitive performance.Method925 cognitively healthy individuals were recruited to take part in an online cohort study (age: 71.07, % female = 55.56). Participants completed questionnaires examining driving behaviour and subjective cognitive performance. Subjective cognition was measured by a questionnaire examining spatial ability and memory performance across the lifespan and within the past 3 months. A subjective cognitive change measure was established by subtracting lifetime cognition ratings from recent cognition ratings. Participants then completed a cognitive battery in domains associated with driving performance. Hierarchical regression modelling was conducted to establish how self‐rated driving ability was associated with subjective and objective cognitive performance after controlling for age and gender effects.ResultWithin subjective cognition, individuals who rated their spatial ability and memory performance higher also rated their driving ability higher, and greater subjective cognitive change within both memory and spatial ability was predictive of lower self‐rated driving ability. Within objective cognitive performance, individuals with faster reaction speeds and faster Trail Making Test‐B completion time rated their driving abilities higher. Interestingly, when included in the same regression model, only subjective cognitive measures were predictive of self‐rated driving ability.ConclusionPrevious studies have found that self‐perceived driving ability is a more accurate indicator of self‐regulation behaviour than actual driving ability. Here, we show that subjective cognitive measures were more predictive of self‐rated driving ability than objective cognitive measures within a healthy older adult cohort. These findings add to the understanding in how cognition interacts with self‐regulation behaviour and provides an opportunity for comparison in self‐regulation driving behaviour within prodromal and clinical dementia.

P46: Subjective cognitive decline and frailty status: results from the Compostela Ageing Study.

Objective:The relationship between objective cognitive performance and physical frailty has been explored in the recent literature and cognitive frailty has emerged as a strong field of study in psychogerontology. However, less is known about the relationship between subjective cognitive status and physical frailty. The aim of this communication is to present the relationships found between subjective cognitive decline and physical frailty in the third wave of the Compostela Aging Study, the first in which frailty status has been studied.Methods:Cognitive and neuropsychological, functional, and affective assessment was conducted with persons over 50 years of age with subjective memory complaints in the health area of Santiago de Compostela. 149 participants who completed the third wave of the study and who did not present dementia or other serious pathologies were selected. Mild Cognitive Impairment (MCI) was diagnosed according to the current criteria in a special meeting of the research team. In the participants without MCI, the intensity and severity of their complaints were assessed according to the Subjective Cognitive Decline (SCD) criteria. Physical frailty was assessed following the frailty phenotype as described by Fried et al.Results:Only 4 participants (2.7%) presented physical frailty (3, 4 or 5 criteria in the frailty phenotype). Of those presenting physical pre-frailty (1 or 2 criteria), 36 were MCI (23.8%), 33 SCD (21.9%) and 36 controls. Finally, 40 participants (26.5%) presented no frailty criteria (8 with MCI, 13 with SCD and 19 controls). Participants with SCD and pre-frailty were of intermediate age and they had more years of education than the group with MCI and pre-frailty, although these differences were not significant. They have significantly more symptoms of depression (GDS) and worse mental health status (GHQ-12) than participants without frailty and pre-frailty controls, and more symptoms of anxiety (GAD-7) than participants without frailty.Conclusion:The relationship between subjective memory complaints and frailty could help to establish groups at special risk of cognitive impairment in phases prior to objective cognitive decline, being these groups particularly optimal targets for preventive intervention. However, a detailed characterization of these subgroups is still required.

Discrepancies Between Informant vs. Patient Ratings of Functional Abilities: Association with Objective Cognitive Performance in Mild Cognitive Impairment and mild dementia

AbstractBackgroundSelf‐ and informant‐ratings of functional abilities are used to diagnose mild cognitive impairment (MCI) versus dementia and are a common outcome measure in clinical trials. These ratings are assumed to be accurate, yet they are subject to biases. Biases in patient ratings of daily function have been found in individuals with dementia who are older and more depressed (Martyr et al., 2012, 2019, 2022). Biases in informant ratings have been found in caregivers with higher distress and burden (Mangone et al., 1993; Martyr et al., 2014, 2022) and higher education (Hackett et al., 2020). The current study examined discrepancies in informants’ ratings of daily functioning in individuals with MCI/mild dementia.MethodParticipants were 118 patients clinically diagnosed with MCI or mild dementia and their care partners/informants who were referred to the Emory Cognitive Empowerment Program. Table 1 shows details regarding all measured constructs and variables. The discrepancy between informant rating of daily function and patients’ cognition (i.e., informant daily function rating and patient cognition discrepancy) and the informant‐ and patient discrepancy in ratings of daily function (i.e., informant/patient daily function rating discrepancy) served as dependent variables. Two forward linear regression models were run.ResultTable 2 shows demographic information. For the informant daily function rating and patient cognition discrepancy, informants with higher perceived stress reported worse patient functioning. For the informant/patient daily function discrepancy score, worse ratings of daily function by the informant than the patient were found for informants with higher caregiver burden, worse communicative effectiveness, and patients with higher self‐efficacy.ConclusionThis study highlights the potential for biases in patient and informant ratings of functional abilities in MCI/mild dementia. The risk for underreporting functional abilities in informants with higher burden and stress levels and lower communicative effectiveness aligns with previous research indicating that ratings can be biased by individual factors. Worse ratings by informants than patients for patients with higher self‐efficacy may also be due to individual factors in patients such as presence of anosognosia. These findings have implications for the use of perceived functional ratings for diagnostic purposes and as outcome measures in clinical trials.

Predictors of subjective and objective cognitive performance examined in an online sample of adults with and without prior COVID‐19 infection

AbstractBackgroundCOVID‐19 is still a major public health concern. COVID‐19 is known to affect the central nervous system (CNS), however, the extent of the cognitive effects of infection are unknown. We developed an online battery for community testing, to learn more about the cognitive effects of infection.MethodParticipants were recruited between October 2020 and December 2021 from social media, and completed objective cognitive‐tasks and online health questionnaires using Psytoolkit (Stoet, 2017). Subjective questionnaire measures included fatigue, sleepiness, mood, and cognitive complaints. Objective cognitive tests measured sustained attention; spatial span; and visual short‐term memory. Participants self‐reported their comorbidities. Prior COVID‐19 infection was identified by self‐reported positive PCR or lateral flow test. Data was split into age/infection status groups of i) 18‐34y positive infection (n = 69, mean‐age: 21.4 [3.6]); ii) 18‐34y negative infection (n = 189, mean‐age: 22.65 [4.3]); iii) positive infection (n = 26, mean‐age: 46.9 [7.1]); and iv) 35y+ negative infection (n = 68, mean‐age: 45.44 [7.56]).ResultOf 359 participants recruited, 95 (26.4%) reported a prior positive COVID‐19 test. We found no differences in demographic variables and any variables of interest between Covid‐positive and Covid‐negative groups overall. However, within the age/infection status groups, we found: The 35+ Covid positive group reported higher fatigue (d = 0.69) and performed poorer (d = 0.66) on a visual short‐memory task relative to the 35+ Covid‐negative individuals. Within the overall Covid‐positive sample, younger age ß = ‐0.18, p = 0.04); higher fatigue (ß&lt;0.001) and poorer mood (ß = ‐0.18, p = 0.05), were associated with greater perceived cognitive complaints [R2 = 0.63 (adjusted R2 = 0.6), F(6,75) = 21.1, p &lt;0.001]. Furthermore, a higher number of co‐morbidities (ß = ‐0.31, p = 0.01) was associated with poorer spatial span [R2 = 0.25 (adjusted R2 = 0.19), F(6, 75) = 4.23, p = 0.001]. Within the overall Covid‐negative sample, sleepiness (ß = 0.32, p&lt;0.001) and higher fatigue (ß = 0.54, p&lt;0.001) were associated with greater perceived cognitive complaints [R2 = 0.66 (adjusted R2 = 0.63), F(6, 65) = 20.9, p&lt;0.001]. There were no significant associations with objective cognitive performance within this sample.ConclusionCOVID‐19 infection status was associated with subjective and objective cognitive complaints. Adults aged 35‐63 years with prior COVID‐19 infection appear to be differentially affected. These data add to the body of evidence indicating there are cognitive consequences from COVID‐19 infection.