Self-reported Memory Problems Research Articles

DESIGNING TUTORIALS TO AUGMENT MOBILITY FOR OLDER ADULTS WITH COGNITIVE IMPAIRMENT

Abstract The Augmenting User Geocoordinates & Mobility with ENhanced Tutorials (AUGMENT) project aims to support aging adults experiencing navigation difficulties accompanying cognitive impairments due to stroke, mild cognitive impairment, and traumatic brain injury. We describe the process and principles for designing tutorials for Uber and Google Maps, two applications that can support improved mobility for those with navigation difficulties associated with cognitive impairment. Initially we examined predictors of self-reported navigation difficulty in a sample (n=300) of older adults aging normally. In the multiple regression, self-reported memory problems (beta = .35), severity of memory problems (beta=.18), and female gender (beta=.16) were the strongest predictors of wayfinding difficulty in addition to a standardized spatial orientation test (beta=.13). Finding that memory difficulties were strongly related to navigation difficulties even in normal aging implied that tutorials could not make strong demands on retention and helped define the queries for interviews in the needs assessment phase. Next, we interviewed aging adults with cognitive impairment and their care partners about navigation problems, focusing on difficulties using navigation devices and applications. We also presented screenshots of the two target apps and asked simple questions about actions that could be taken. We then designed prototype tutorials using principles such as directing attention to relevant display features by highlighting the features, minimizing extraneous workload, and providing spaced retrieval practice for interactions with the interface. We also describe the iterative design process being used to refine the tutorials and the planned summative test of tutorial efficacy.

Abstract 155: The Relationship Between Positive Psychology Factors and Quality of Life in Long-Term Cardiac Arrest Survivors

Introduction: There is a need to identify factors that can improve quality of life (QoL) post-CA. Long-term CA survivors (i.e., > 1 year) have recommended utilizing positive psychology factors (i.e., psychological strengths that foster well-being) such as mindfulness, existential well-being, and resilient coping to manage survivorship challenges. We explored associations between these factors and QoL. Hypothesis: Higher levels of mindfulness, existential well-being, and resilient coping will be individually associated with better physical, psychological, and social QoL. Goal: Identify factors associated with improved QoL, that may become intervention targets. Methods: Secondary analysis of survey data of long-term CA survivors from the Sudden Cardiac Arrest Foundation. We examined demographic covariates (sex, months since arrest, age, income), self-reported daily memory problems, functional dependence (Lawton Independent Activities of Daily Living Scale), emotional distress (PTSD Checklist-5, Patient Health Questionnaire-4), and positive psychology factors (mindfulness [Cognitive and Affective Mindfulness Scale-Revised], existential well-being [Meaning in Life Questionnaire Presence of Meaning subscale], and resilient coping [Brief Resilient Coping Scale]). We used the WHOQOL-BREF to measure psychological, physical, and social QoL. We conducted 9 multiple regression models to test the individual relationship between each positive psychology factor and each QoL domain, adjusted for demographic covariates, functional dependence, daily memory problems, and emotional distress. Results: We included 129 long-term CA survivors (mean age: 52 years, 52% male, 98% white). In adjusted models, higher mindfulness and resilient coping were associated with better QoL in all domains (βs: 0.19 - 0.56, p < 0.03, R 2 = 0.35 - 0.74); existential well-being was associated with better psychological and social QoL (βs: 0.27- 0.36, p = 0.001, R 2 = 0.4 - 0.72). Conclusion(s): Greater levels of positive psychology factors were associated with better QoL, even after accounting for emotional, cognitive, and functional sequelae. Future interventions should consider teaching these positive psychology factors to CA survivors.

Hearing difficulties and memory problems: the mediating role of physical health and psychosocial wellbeing

Objective To investigate whether the association between hearing difficulties and self-reported memory problems is mediated by physical health and psychosocial wellbeing. Design A cross-sectional study. Path analyses were used to test potential theoretical models (psychosocial-cascade, common cause) of the association between hearing difficulties and memory problems, adjusting for age. Study Sample A sample of 479 adults (18–87 years) completed self-reported outcome measures. Results Half the participants reported clinically significant hearing difficulties and 30% self-reported memory problems. In the direct model, reporting hearing difficulties was associated with a greater likelihood of reporting memory problems (β = 0.17, p = 0.007, 95% Confidence Intervals [CI] = 0.00, 0.01). Hearing difficulties were also associated with poorer physical health, but this did not mediate the association with memory. Psychosocial factors, however, fully mediated the relationship between hearing difficulties and memory problems (β = 0.03, p = 0.019, 95% CI = 0.00, 0.01). Conclusions Adults with hearing difficulties may be more likely to self-report memory problems, irrespective of age. This study supports the psychosocial-cascade model, as the association between self-reported hearing and memory problems was explained entirely by psychosocial factors. Future studies should investigate these associations using behavioural measures, as well as explore whether interventions can reduce the risk of developing memory problems in this population.

A Randomized, Double-Blind, Placebo-Controlled, Parallel Study Investigating the Efficacy of a Whole Coffee Cherry Extract and Phosphatidylserine Formulation on Cognitive Performance of Healthy Adults with Self-Perceived Memory Problems.

Cognition refers to brain functions including memory, learning, and thought processing and is increasingly important to individuals. However, impairment of cognitive function is a concern among North American adults. Therefore, effective and reliable treatments are needed. This randomized, double-blind, placebo-controlled study examined the effects of 42days of Neuriva® supplementation, a whole coffee cherry extract and phosphatidylserine supplement, on memory, accuracy, focus and concentration and learning among 138 healthy adults (40-65years) with self-reported memory problems. Plasma brain-derived neurotrophic factor (BDNF) levels, Computerized Mental Performance Assessment System (COMPASS) tasks, the Everyday Memory Questionnaire (EMQ), and Go/No-Go tests were assessed at baseline and day42. As compared to placebo, Neuriva® supplementation elicited greater improvements at day42 in numeric working memory COMPASS task accuracy outcomes (p ≤ 0.024) which assessed memory, accuracy, and focus and concentration, and reaction time outcomes (p ≤ 0.031) which assessed memory as well as focus and concentration. Neuriva® supplementation improved overall accuracy (p = 0.035) in the picture recognition task that assessed memory, accuracy, and learning compared to placebo. No significant differences between groups were observed for BDNF, the EMQ, or Go/No-Go tests. Results suggest 42days of Neuriva® supplementation was safe, well tolerated, and beneficial in improving memory, accuracy, focus and concentration, and learning in a healthy adult population with self-reported memory problems.

Subjective memory complaints are associated with decreased cortical thickness in Veterans with histories of mild traumatic brain injury

Objective: Memory problems are frequently endorsed in Veterans following mild traumatic brain injury (mTBI), but subjective complaints are poorly associated with objective memory performance. Few studies have examined associations between subjective memory complaints and brain morphometry. We investigated whether self-reported memory problems were associated with objective memory performance and cortical thickness in Veterans with a history of mTBI. Methods: 40 Veterans with a history of remote mTBI and 29 Veterans with no history of TBI completed the Prospective-Retrospective Memory Questionnaire (PRMQ), PTSD Checklist (PCL), California Verbal Learning Test-2nd edition (CVLT-II), and 3 T T1 structural magnetic resonance imaging. Cortical thickness was estimated in 14 a priori frontal and temporal regions. Multiple regressions adjusting for age and PCL scores examined associations between PRMQ, CVLT-II scores, and cortical thickness within each Veteran group. Results: Greater subjective memory complaints on the PRMQ were associated with lower cortical thickness in the right middle temporal gyrus (β = 0.64, q = .004), right inferior temporal gyrus (β = 0.56, q = .014), right rostral middle frontal gyrus (β = 0.45, q = .046), and right rostral anterior cingulate gyrus (β = 0.58, q = .014) in the mTBI group but not the control group (q’s > .05). These associations remained significant after adjusting for CVLT-II learning. CVLT-II performance was not associated with PRMQ score or cortical thickness in either group. Conclusions: Subjective memory complaints were associated with lower cortical thickness in right frontal and temporal regions, but not with objective memory performance, in Veterans with histories of mTBI. Subjective complaints post-mTBI may indicate underlying brain morphometry independently of objective cognitive testing.

Factors Associated with Self-reported Memory Problems of Adult Cancer Survivors Based on the Korea National Health and Nutrition Examination Survey 2019

Objectives: With the development of treatment technology, the percentage of cancer survivors has continued to increase. However, the cognitive decline these patients experience has been overlooked because it is not related to survival. This study investigated factors related to memory problems in patients with cancer.Methods: Using data from the 2019 Korea National Health and Nutrition Examination Survey (KNHANES), this secondary data analysis study attempted to identify factors related to memory problems in cancer survivors. Of the 8,110 survey participants, there were 6,296 adults, aged 19 years or older. Of these, 357 were diagnosed with cancer. Four participants were excluded due to missing values for occupation, income, and body mass index (BMI). Finally, 353 subjects were included in the research analysis. The data were statistically analyzed using IBM SPSS version 28.0.Results: 218 (61.8%) of the cancer survivors reported memory problems. Having a lower-than-average individual income (odds ratio, OR = 2.16, 95% confidence interval, CI = 1.31-3.53, <i>p</i>= 0.003), smoking (OR = 3.19, 95% CI = 1.16-8.72, <i>p</i>= 0.024), and depression (OR = 6.06, 95% CI = 1.33-27.57, <i>p</i>= 0.020) were significant potentiating factors. In contrast, having a job (OR = 0.18, 95% CI = 0.05-0.67, <i>p</i>= 0.011), drinking (OR = 0.26, 95% CI = 0.09-0.81, <i>p</i>= 0.021), and walking three to four days per week (OR = 0.15, 95% CI = 0.03-0.81, <i>p</i>= 0.027) decreased memory problems.Conclusions: Our findings suggest that it is necessary to develop cognitive rehabilitation programs for cancer survivors.

Abstract WP186: Fewer Self-reported Memory Problems Are Associated With Better Blood Pressure Control Post-stroke

Introduction: Memory problems, a common cognitive issue, can have a negative influence on one’s ability to function and contributes to increased risk of secondary stroke. Objective: To examine the association between self-reported memory problems at 6 months and blood pressure control at 12 months post-stroke. Methods: This study utilized follow-up data from the Discharge Educational Strategies for Reduction of Vascular Events (DESERVE) stroke risk factor reduction trial (n=226). Sample size was restricted to those who answered memory questions and had a 12-month blood pressure (BP) reading. Exclusion criteria for DESERVE included any significant memory disorder prior to the baseline stroke. Seven memory domain questions (Table 1) from the Stroke Impact Scale were used separately to assess the association with systolic BP, with control defined as ≤120mmHg, at 12 months in logistic regression models adjusted for race, gender, education, age, and intervention status. Models were additionally adjusted for 6-month BP control as a mediator. Results: Participants were almost equally white (28%), Black (33%), or Hispanic (34%) and 52% were female with a mean age of 65 (SD=13). About 25% had BP control at 6 or 12 months. Memory measures were not significantly associated with BP control prior to adjusting for BP control at 6 months. After adjusting for 6-month BP control, participants with less difficulty remembering things that people just told them (OR=1.69, 95% CI: 1.09, 2.63) or remembering to do things (OR=1.76, 95% CI:1.09, 2.86) had better odds of having their BP controlled at 12 months. Memory items 2 and 4-7 did not show an association with better BP control. Discussion: Stroke survivors who were better at remembering what people told them and remembering to do things were more likely to achieve blood pressure control 1-year post-stroke. Evaluating early memory post-stroke may be an important target for secondary prevention strategies and should be further researched.

Association between subjective cognitive complaints, balance impairment and disability among middle-aged and older adults: Evidence from a population-based cohort study.

To quantify the association between subjective cognitive complaints and balance impairment in relation to the occurrence of disability. In total, 6885 adults aged ≥45 who participated in the China Health and Retirement Longitudinal Study (CHARLS) were followed for 7 years. Subjective cognitive complaints were evaluated by self-reported memory problems. Balance impairment was tested by side-by-side stand, semi-tandem stand and full tandem stand. Disability was measured by activities of daily living (ADL) and instrumental activities of daily living (IADL). Multivariate logistic regression models were applied to test the joint effect between baseline subjective cognitive complaints and balance impairment on disability. The multiplicative interaction was examined. A joint effect of experiencing both subjective cognitive complaints and balance impairment was identified, showing a 1.63-fold higher risk of ADL and IADL disability than those experienced by neither of the two (odds ratio=1.63, 95% confidence interval: 1.36-1.95). There was evidence of multiplicative interaction (P=0.004). Among middle-aged and older people, the coexistence of subjective cognitive complaints and balance impairment may lead to a higher disability risk, which is much higher than the simple sum of the two individual effects. Future interventions are required to target these symptoms simultaneously to reduce the risks of disability. Geriatr Gerontol Int 2022; 22: 1025-1031.

The predictive value of preoperative frailty screening for postoperative outcomes in older patients undergoing surgery for non-metastatic colorectal cancer

The predictive value of preoperative frailty screening for postoperative outcomes in older patients undergoing surgery for non-metastatic colorectal cancer

Prevalence of self-reported memory problems in adults with type 2 diabetes mellitus and cancer in the USA.

To determine the prevalence of memory problems in individuals with or without a history of DM and cancer and assess possible compounding effects of these diseases on self-reported memory problems (SRMP). We used data from the 2009-2018 National Health and Nutrition Examination Survey. We conducted logistic regression analyses to determine the associations among DM, cancer, and SRMP, adjusting for age, sex, race/ethnicity, education, and poverty level. We examined the interaction effects of comorbid DM and cancer on SRMP. We compared participants with both DM and cancer to those with cancer only and to those with no DM or cancer. We included 26,842 adults ≥ 20years old (N = 3374 with DM, N = 23,468 without DM) and 51.87% female. There were 10,434 Whites, 5730 Blacks, 6795 Hispanics, and 3883 other races/multiracial. More individuals with DM reported memory problems than those without DM (p < 0.0001). More individuals with cancer reported memory problems than those without cancer (p < 0.0001). Of those with both DM and cancer, 14.19% reported memory problems. More individuals with DM had cancer than those without DM (p < 0.0001). Of those with both diseases, 55.75% had DM before the cancer diagnosis. DM (odds ratio[OR] = 1.87, 95%CI, 1.55-2.26) and cancer (OR = 1.81, 95%CI, 1.43-2.30) predicted SRMP. The interaction between DM and cancer was significant, and the likelihood of having both diseases compared to having neither DM nor cancer was OR = 2.09, 95%CI, 1.41 - 3.11. Strategies to mitigate SRMP in individuals with comorbid DM and cancer history should consider the impact of both diseases.

Generational Multimorbidity Disease Clusters for British Cohorts Born 1921 – 1960

The aim of this study is the first step in our understanding of the uniqueness and stability of multmorbdity disease patterns for different generations. The unique historical context that each generation has been exposed to is thought to have systemic health impacts and differences in epidemiological make-up (Clouston et al. 2021). Literature suggests that multimorbidity disease patterns, are similar across countries (Hernandez et al, 2021 – in press) and observational points, and that migration into complex disease clusters is more common as people age (Cassell et al, 2018, Kingston et al. 2018). Most commonly reported are Cardiovascular and Metabolic disease clusters which lead to lower quality of life, mortality and morbidity (Kudesia, 2021). We asked: Do multimorbidity disease patterns differ for unique generations? Using the ELSA, the disease clusters of three cohorts were examined; an older cohort, born 1921-1930, a middle cohort born 1931-1940 a younger cohort born 1941-1950 and the ”newest” cohort, born 1951-1960. Self-reported dementia and memory problems lead a specific cluster for the middle cohort, those born in 1931-1940, but not for the other cohorts. While disease patterns were different between sex for other clusters, the disease cluster of dementia and memory problems held similar disease patterns for males and females, with a prevalence of 3%. The dementia/memory problem cluster loaded with cardio/metabolic diseases. This suggests that complex multimorbidity for the British 1931-1940 cohort has had an impact related to dementia and memory problem diagnoses for this specific generation, for males and females alike.

Self-reported Memory Problems 8 Months After COVID-19 Infection

Self-reported Memory Problems 8 Months After COVID-19 Infection

Sex Differences on Montreal Cognitive Assessment and Mini-Mental State Examination Scores and the Value of Self-Report of Memory Problems among Community Dwelling People 70 Years and above: The HUNT Study

Introduction: The aims were to examine if the total and item scores on the Montreal Cognitive Assessment (MoCA) and the Mini-Mental State Examination (MMSE) and self-reported memory problems differed between older women and men, and if self-reported memory problems were associated with scores on the 2 tests. Methods: We included 309 home-dwelling people aged 70 years and older, 155 women, mean age 75.6 (SD 4.1) years, and 154 men, mean age 76.0 (SD 4.6) years. They were examined with MoCA and MMSE, and they answered 2 questions: “have you experienced any memory problems” and “have you experienced significant memory problems the last 5 years?” Results: The participants scored significantly higher on the MMSE (women 28.0 [1.8], men 28.4 [1.4]) than on MoCA (women 24.6 [3.3], men 24.3 [3.1]). Spearman’s rho was 0.36 between the tests. Women scored significantly higher than men on delayed recall of MoCA (3.0 [1.6] vs. 2.4 [1.6]), whereas men scored significantly higher on visuoconstruction (3.8 [1.2] vs. 3.5 [1.0]) and serial subtraction on MoCA (2.7 [0.6] vs. 2.5 [0.8]) and serial sevens on MMSE (4.5 [0.8] vs. 4.1 [1.1]). Multivariate linear regression analyses revealed that female sex, younger age, and higher education were associated with a higher score on MoCA, whereas age and education were associated with a higher score on MMSE. About half of the participants (no sex difference) had experienced significant memory problems the last 5 years, and they had significantly lower scores on both tests. Conclusions: The MoCA score was associated with sex, age, and education, whereas sex did not influence the MMSE score. The question “have you experienced significant memory problems the last 5 years?” may be useful to evaluate older people’s cognition.

Individual Differences and Features of Self-reported Memory Lapses as Risk Factors for Alzheimer Disease Among Adults Aged 50 Years and Older: Protocol for a Coordinated Analysis Across Two Longitudinal Data Sets.

BackgroundIncreasing evidence has promoted the clinical utility of self-reported memory problems for detecting early impairment associated with Alzheimer disease (AD). However, previous studies investigating memory problems often conflated the types of problems (ie, retrospective and prospective) with their features (ie, frequency and consequences). This bias limits the specificity of traditional measures of memory problems and minimizes their ability to detect differential trajectories associated with cognitive decline. In this study, we use a novel measure of self-reported memory problems that uses daily reports of memory lapses to disentangle types from features for analyzing the impact of each dimension in two longitudinal data sets. Furthermore, this study explores the individual difference factors of age and gender as potential moderators of the relationships between self-reported memory lapses and objective cognitive decline.ObjectiveThe aim of this study is to describe the protocol for a secondary data analysis project that explores the relationship between experiences of daily memory lapses and their associations with cognitive decline in middle-aged and older adults.MethodsThis study uses multilevel, coordinated analyses across two measurement burst data sets to examine the links between features and consequences of memory lapses (retrospective and prospective) and their association with objective cognitive decline. This study’s sample (N=392; aged 50-85 years; n=254, 64.8% women) is drawn from two ongoing, nationally funded research studies: The Effects of Stress on Cognitive Aging, Physiology, and Emotion study and the Einstein Aging Study. Both studies assess the daily experience of memory lapses, including the type as well as the emotional and functional outcomes, and objective measures of cognition, such as processing speed and episodic memory. We will use multilevel modeling to test our conceptual model demonstrating that differences in frequency and types of memory lapses show differential trends in their relationships with cognitive decline and that these relationships vary by the age and gender of participants.ResultsThis project was funded in August 2019. The approval for secondary data analysis was given by the institutional review board in February 2020. Data analysis for this project has not yet started.ConclusionsThe early and accurate identification of individuals most at risk for cognitive decline is of paramount importance. Previous research exploring self-reported memory problems and AD is promising; however, limitations in measurement may explain previous reports of inconsistences. This study addresses these concerns by examining daily reports of memory lapses, how these vary by age and gender, and their relationship with objective cognitive performance. Overall, this study aims to identify the key features of daily memory lapses and the differential trajectories that best predict cognitive decline to help inform future AD risk screening tools.International Registered Report Identifier (IRRID)DERR1-10.2196/25233

Does Cognitive Self-Report Measure Type Differentially Predict Cognitive Decline? A Systematic Review

Up to 47% of older adults without measurable cognitive impairment report difficulties with memory and thinking which potentially increases their risk for developing cognitive decline. Many measures are used for assessing self-reported cognition; however, certain types of these measures may be more predictive of cognitive decline. The purpose of this systematic review was to compare the role of cognitive self-report measure types in predicting risk for cognitive decline. PubMed, CINAHL, and PsycINFO databases were searched using the following inclusion criteria: longitudinal studies, outcome of cognitive decline, and two or more cognitive self-report measures. A total of 4,319 articles were identified during the initial search and narrowed to 19 final articles. The Quality in Prognosis Studies tool was used to determine study quality. Six comparison themes emerged during synthesis: self-reported cognition or memory with or without worry; self-reported global cognition or self-reported memory; self-reported memory decline and self-reported executive function decline; self-reported cognition and self-reported memory by others; self-reported memory and self-reported memory problems in comparison with peers; and self-reported memory and self-reported memory affecting daily function. Self-reported memory decline with worry and self-reported memory problems by others were most predictive of future impairment. It was difficult to definitively determine whether certain cognitive self-report measure types where more predictive of risk for cognitive decline because there were very few articles in some of the comparison groups. Future investigations of self-reported cognition should focus on using measures that have been shown to be the most efficacious at predicting risk for cognitive decline.

Self-Reported Memory Problems Are Related to Depressive Symptoms in Older Adults With Certain Personality Traits

Self-reported memory problems and depressive symptoms tend to co-occur in older adults; however, this relationship may depend on personality traits and the type of self-reported memory assessed. Using a coordinated analytic framework, this study examined whether neuroticism, extraversion, and conscientiousness moderated the associations of older adults’ self-reported memory with depressive symptoms at between- and within-person levels across three large, longitudinal datasets (range=8-12 years of follow-up) of community-dwelling older adults with no evidence of cognitive impairment (n=427-6,960; Mage: 69.47- 75.94; 72-84% White; 60-64% Female). Assessments of depressive symptoms (GDS-15 or CES-D) and self-reported memory (perceived memory decline, frequency of forgetting, and current memory rating) were taken annually or biennially; personality was assessed via the IPIP or NEO Five-Factor Inventory. Results were largely consistent across datasets. Specifically, between persons, self-reported memory problems (including perceived memory decline, higher frequency of forgetting, and lower current memory rating) were related to higher depressive symptoms only among older adults higher in neuroticism. In one dataset, results supported a protective effect of conscientiousness such that higher frequency of forgetting was related to lower depressive symptoms among older adults higher in this trait. Within persons and across datasets, at times when perceived memory decline was reported, or current memory rating was lower, depressive symptoms tended to be higher only in older adults higher in neuroticism. Results demonstrate the importance of considering personality traits and the type of self-reported memory when examining associations among reports of memory problems and depressive symptoms in cognitively intact older adults.

Functional Disability in the Context of Cancer Diagnosis: Examining the Within- and Between-Person Associations

Physical functioning is essential for independent living and aging in place among older adults. Although older adults show a general trend of increasing functional disability, it was unclear how cancer diagnosis, which also has an increased incidence rate among older adults, may potentially aggravate the progress of functional decline at the within- and between-person levels. Using 3 waves of the China Health and Retirement Longitudinal Study (CHARLS, 2011-2015), the current study examined the trajectory of functional disability and associated factors over 5 years among older adults with (n = 139) and without cancer (n = 212), who were matched on key demographic characteristics. We considered four contributing factors to disability as specified in the Disablement Process model as covariates, in the context of cancer diagnosis timing at both the within- and between-person levels. These factors were psychological (i.e., depressive symptoms), physical limitations (i.e., pain, fall, and frailty), cognitive impairment (i.e., self-reported memory problems and word recall), and environmental constraints (i.e., social contact and availability of support). Consistent with the literature, there was a general trend of increasing functional disability among all participants over time. At the within-person level, although cancer diagnosis timing was associated with higher levels of functional difficulty, we found a slower increasing rate over time. At the between-person level, functional disability trajectory was not associated with cancer diagnosis timing. These findings suggest that maintenance of physical functioning should be considered at the within-person level, and personalized care is recommended for Chinese older adults with cancer.

Associations between depression and anxiety symptoms with quality of life in cardiac arrest survivors with good neurologic recovery and informal caregivers of cardiac arrest survivors

• About 1 in 5 cardiac arrest survivors and caregivers showed significant depression. • Nearly 1 in 3 cardiac arrest survivors showed significant anxiety. • Over 1 in 3 informal caregivers showed significant anxiety. • Together, depression and anxiety were the strongest predictors of quality of life. Surviving cardiac arrest is characterized by cognitive, psychological, and functional impairments and apprehension over long-term prognosis. We first estimated the proportion of clinically significant depression and anxiety in cardiac arrest survivors and their informal caregivers, then examined the association between depression and anxiety with worse quality of life (QoL). In an online survey, cardiac arrest survivors and caregivers reported demographic and arrest characteristics, the Patient Health Questionnaire-4 (PHQ-4), and the WHOQOL-BREF physical, psychological, and social QoL subscales. Six multiple regression models (three for survivors and three for caregivers) tested associations between PHQ-4 scores with each QoL subscale, adjusted for the following: for survivors – functional dependence, self-reported memory problems, sex, income, months since arrest, and age; for caregivers – months since arrest, age, and income. We included 169 survivors (mean age: 50.8 years, 49.7% women, positive depression screen: 21.3%, anxiety: 29.6%) and 52 caregivers (mean age: 48.7 years, 86.5% women, positive depression screen: 21.2%, anxiety: 36.5%). In adjusted models, depression and anxiety were associated with worse QoL on each subscale (β: -0.39–-0.7, p < .01). We assessed depression and anxiety and QoL cross-sectionally, which cannot exclude bi-directionality. Further, there was a selection bias in our survey, as the majority of survivors were of good neurologic recovery. Depression and anxiety were moderately associated with worse QoL over functional dependence and memory problems in survivors, and worse QoL in caregivers. Future study should explore the feasibility of dyadic interventions in cardiac arrest survivors and informal caregivers.

Abstract 320: Posttraumatic Stress Symptoms Are Associated with Quality of Life in Both Cardiac Arrest Survivors with Good Neurologic Recovery and Caregivers

Introduction: Improvements in cardiac arrest (CA) survival have led to increased attention to quality of life (QoL) of survivors and their caregivers. In survivors, posttraumatic stress symptoms (PTS) are predictive of poor clinical outcome and subjective recovery. This study tested the hypothesis that PTS is associated with QoL in survivors and caregivers. Method: We distributed an online survey to CA survivors and caregivers who were members of the Sudden Cardiac Arrest Foundation. This analysis examined the following items: participant characteristics, PTSD Checklist-5 (PCL-5), Lawton Instrumental Activities of Daily Living scale, and physical, psychological, and social QoL subscales of the WHOQOL-BREF. We followed an identical analytic plan for survivors and caregivers. We identified potential covariates through a bivariate correlation matrix. We then ran three multiple regression models examining associations between PCL-5 scores with each QoL subscale, adjusted for covariates identified from the correlation matrix. Results: A total of 163 survivors (mean age: 50.1 years, 50.3% women, 95.5% white, mean months since arrest: 63.9) and 52 caregivers (mean age: 51.8 years, 86.5% women, 88.5% white, mean months since arrest: 43.2) provided full data. For survivors, the following variables showed significant bivariate associations with any QoL subscale: Lawton scores, self-reported memory problems, male sex, low income, months since CA, age, and CA location; for caregivers, months since CA, age, and low income. In survivors and caregivers, PCL-5 scores were associated with each QoL subscale (β: -.33 - -.54, p &lt; .05) after adjusting for respective covariate sets. Further, in survivors, Lawton scores (β: .23, p &lt;.01), presence of memory problems (β: -.24, p &lt; .01), and male sex (β: .14, p &lt;.05) were associated with physical QoL; presence of memory problems (β: -.26, p &lt; .01) was associated with psychological QoL; and low income (β: -.16, p &lt; .05) was associated with social QoL. In caregivers, months since CA was associated with social QoL (β: .27, p &lt;.05). Conclusion: PTS was associated with QoL in CA survivors and caregivers. Future study should examine the feasibility of in-hospital assessment of PTS in dyads of CA survivors and their caregivers.

Short sleep duration and high exposure to quick returns are associated with impaired everyday memory in shift workers

PurposeTo investigate the relationship between self-reported everyday memory problems the last month, and: (a) shift work schedule, (b) night shifts and quick returns worked the last year, and (c) sleep duration the last month. MethodsIn all, 1,275 nurses completed the Everyday Memory Questionnaire – revised, and answered questions about shift work exposure and sleep duration. We performed multiple linear regression analyses with memory score as dependent variable, and the shift work exposure variables as well as sleep duration as predictors, while adjusting for potential confounders. FindingsHigh exposure to quick returns (β = .10, p < .05) and short sleep duration (β = .10, p < .05) were both positively associated with memory problems, whereas shift work schedule, long sleep duration, night shift exposure, and low and moderate exposure to quick returns were not. DiscussionFrequent insufficient time for rest between shifts as well as short sleep was associated with poorer everyday memory.