Subjective Cognitive Function Research Articles

Sensory impairment, loneliness, and the discordance between subjective and objective cognitive function among older adults: A multi-cohort study

ObjectivesThis study aimed to examine the association between sensory impairment and the discordance between subjective/objective cognitive function among older adults and test the mediating effect of loneliness. MethodsWe used data from four cohort studies conducted in 16 countries (N = 19,119). Sensory impairment and subjective cognitive impairment were self-reported. Objective cognitive impairment was measured in three dimensions. Generalized estimating equations were conducted to examine the association between sensory impairment and discordance in subjective/objective cognitive function. Cross-lagged panel model and a bootstrap method with 2,000 samples were employed to verify the mediating effect. ResultsSensory impairment was related to an increased risk of subjective cognitive impairment (OR = 4.70, 95 % CI 4.33–5.10), objective impairment (OR = 1.51, 95 %CI 1.31–1.74), as well as the discordance in subjective/objective cognitive function (OR = 1.35, 95 %CI 1.06–1.71 for older adults with normal subjective cognitive function). In contrast, sensory impairment was associated with a decreased risk of discordant subjective/objective cognitive function among those with subjective cognitive impairment (OR = 0.79, 95 %CI 0.66–0.94). Moreover, loneliness mediated the association between sensory impairment and subjective cognitive impairment (standardized indirect effect = 0.002, 95 %CI 0.001–0.004), objective cognitive impairment (standardized indirect effect = 0.005, 95 %CI 0.003–0.007) as well as the discordance in subjective/objective cognitive function (standardized indirect effect = 0.001, 95 %CI 0.001–0.003 for older adults with normal subjective cognitive function). ConclusionsSignificant association between sensory impairment and discordance in subjective/objective cognitive function and the mediating role of loneliness were revealed, varying by subjective cognitive function. Early screening on sensory impairment and targeted interventions on loneliness should be considered in future policies on cognitive impairment.

The Effects of a Single-Session Virtual Rumination Intervention to Enhance Cognitive Functioning in Veterans With Subjective Cognitive Symptoms: Multimethod Pilot Study.

Subjective cognitive concerns (SCCs) entail perceived difficulties in thinking or memory, often reported without substantial objective evidence of cognitive impairment. These concerns are prevalent among individuals with a history of brain injuries, neurological conditions, or chronic illnesses, contributing to both psychological distress and functional limitations. They are increasingly considered to be a risk factor for future objective decline. A considerable number of individuals reporting SCCs also exhibit mental health symptoms, such as a history of trauma, depression, or anxiety. Interventions that address modifiable emotional and cognitive factors related to SCC could improve functioning and quality of life. Therefore, the use of emotion regulation strategies, especially those directed at minimizing rumination, could serve as a promising focus for interventions aimed at mitigating subjective cognitive concerns in veteran populations. This pilot study explored the feasibility, acceptability, and preliminary efficacy of a brief, 1-session emotion regulation intervention called "Worry Less, Remember More." The Worry Less, Remember More intervention was designed to reduce rumination and improve subjective cognitive functioning in veterans with subjective cognitive changes (N=15). We randomized 15 veterans to either the active telehealth condition or waitlist control and completed the intervention. Participants were aged between 31 and 67 (mean 49.5, SD 10.1) years, and the sample was primarily male (12/15, 83%) and White (10/15, 67%). The most common diagnoses were posttraumatic stress disorder and depression. Following the intervention, veteran input was sought through semistructured interviews with a subset of 12 participants, examining feasibility, acceptability, and perceived efficacy. Preliminary efficacy was also measured using pre- and postintervention self-report measures. Veterans reported that this intervention was acceptable, with 92% (11/12) of the sample reporting that they benefited from the intervention and would recommend the intervention to others with similar difficulties. Semistructured interviews revealed difficulties with feasibility, including problems with the remote consenting process, forgetting appointments, and needing additional strategies to remember to consistently use the interventions. The intervention improved self-reported cognitive symptoms on quantitative measures but did not improve self-reported rumination. This pilot study establishes the preliminary feasibility, acceptability, and efficacy of the Worry Less, Remember More intervention for veterans with subjective cognitive symptoms. Future iterations of the intervention may benefit from simplifying the electronic consent process, providing reminders for appointments, and incorporating compensatory cognitive strategies to assist with using the telehealth system, as well as applying the strategies learned in the intervention. While future research is needed with larger samples, including nonveteran populations, the intervention may also be a useful clinical tool to bridge care between neuropsychology clinics and mental health treatment.

The association between neighborhood disadvantage and subjective cognitive functioning among Black women (PL4.003)

The association between neighborhood disadvantage and subjective cognitive functioning among Black women (PL4.003)

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.

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

Cognitive reserve moderates the relationship between childhood maltreatment, objective and subjective cognition, and psychosocial functioning in individuals with first-episode psychosis.

This study aimed to assess the relationship between childhood maltreatment (CM), objective and subjective cognition, and psychosocial functioning in adults with first-episode psychosis (FEP) by examining the moderating role of cognitive reserve (CR). A secondary objective was to explore whether unique CM subtypes (physical and/or emotional abuse, sexual abuse, physical and/or emotional neglect) were driving this relationship. Sixty-six individuals with FEP (Mage = 27.3, SD = 7.2 years, 47% male) completed a comprehensive neuropsychological test battery, the Cognitive Complaints in Bipolar Disorder Rating Assessment (COBRA), the Functioning Assessment Short Test (FAST), the Childhood Trauma Questionnaire (CTQ), and the Cognitive Reserve Assessment Scale in Health (CRASH). Linear regression analyses were conducted to evaluate the interaction effect of CR between CM and cognitive and psychosocial variables, controlling for age, sex, and social desirability (CTQ-denial-minimization). In adults with FEP overall CM interacted with CR to predict COBRA-subjective cognitive complaints, but not neurocognitive or psychosocial functioning. Sexual abuse and physical neglect interacted with CR to predict verbal memory. Most of the CM subtypes interacted with CR to predict FAST-leisure time, whereas only emotional neglect interacted with CR to predict FAST-interpersonal relationships. Overall, greater CR was related to better functioning. The current results indicate that associations between specific CM subtypes, subjective and objective cognition, and psychosocial domains are moderated through CR with greater functioning. Early interventions focused on CR seeking to improve cognitive and psychosocial outcomes, with emphasis on improving subjective cognitive functions would be beneficial for individuals with FEP and CM. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Above and Beyond Number of Illnesses: A Two-Sample Replication of Current Approaches to Depressive Symptoms in Multimorbidity

ABSTRACT Objectives To expand current models of depressive symptoms in older adults with multimorbidity (MM) beyond the number of illnesses as a predictor of worsened mental health. Methods Two-sample replication study of adults ≥62 years old with ≥ two chronic illnesses, who completed validated questionnaires assessing depressive symptoms, and disease- and treatment-related stressors. Data were analyzed using hierarchical linear regression. Results The model of cumulative number of illnesses was worse at explaining variance in depressive symptoms (Sample 1 R2  = .035; Sample 2 R2  = .029), compared to models including disease- and treatment-related stressors (Sample 1 R2  = .37; Sample 2 R2  = .47). Disease-related stressors were the strongest factor associated with depressive symptoms, specifically, poor subjective cognitive function (Sample 1: b = -.202, p = .013; Sample 2: b = -.288, p < .001) and greater somatic symptoms (b = .455, p < .001; Sample 2: b = .355, p < .001). Conclusions Using the number of illnesses to understand depressive symptoms in MM is a limited approach. Models that move beyond descriptive relationships between MM and depressive symptoms are needed. Clinical implications Providers should consider the role of somatic symptom management in patients with MM and depressive symptoms.

Social Frailty and Functional Status in Japanese Older Adults: The Mediating Role of Subjective Cognitive Function

ObjectiveThis study aimed to explore the direct and indirect effects of social frailty on functional state trajectories mediated by subjective cognitive function in older adults. DesignLongitudinal study. Setting and ParticipantsOverall, 514 adults aged ≥65 years living in a suburban area of central Japan were included in this study. MethodsFive-item social frailty index (going out, visiting, feeling helpful, living alone, and talking to others), subjective cognitive function from the Kihon Checklist, and instrumental activities of daily living disability. Latent growth curve models were applied to examine the longitudinal relations among the variables. ResultsDuring the 6-year follow-up in latent growth curve models, the initial level of social frailty in older adults was negatively associated with that of functional status (β = −0.53, P < .001), and the rate of change in social frailty was negatively associated with that in functional status (β = −0.78, P < .001). In the mediation model, the indirect effect from the social frailty level to functional status level through subjective cognitive function level was significant (β = −0.14, 95% CI −0.29, −0.09); the rates of change in subjective cognitive function mediated the relationship between those in social frailty and functional status (β = −0.35, 95% CI –0.46, −0.25). Conclusions and ImplicationsThis study found that there is an association between social frailty and functional status in Japanese older adults. Subjective cognitive function mediated this relationship. Hence, additional research is required to investigate additional potential factors linking social frailty and functional status in order to gain a better understanding of the underlying mechanisms.

Effectiveness of a Nursing Student-led Comprehensive Health Promotion Program for Rural Older Adults: Toward Community-based Learning

Objectives This study investigates the effects of a nursing student-led comprehensive health-promotion program for rural older adults on perceived health, depression, cognitive function, and life satisfaction.&#x0D; Methods A non-equivalent control group pre-post study design was adopted, and rural older adults aged 65 years and over were divided into the experimental (n=41) and control group (n=31). The experimental group underwent a comprehensive health-promotion program once-a-week for six weeks. Data analysis was performed using SPSS 26.0 statistical program, and the differences in subjective health, depression, cognitive function, and life satisfaction between the experimental and control groups after the program were tested by independent t-test, and reliability was analyzed by Cronbach's α.&#x0D; Results There were no significant differences in perceived health, depression, cognitive function, and life satisfaction at baseline between the two groups. After the program, there was a significant difference in life satisfaction between the control and experimental groups, and no significant difference in subjective health, depression, or cognitive function; however, the pre-post paired t-test for life satisfaction in the experimental group was not statistically significant.&#x0D; Conclusions A comprehensive program developed based on the needs of rural elders was an partially effective nursing intervention in increasing life satisfaction. The findings of this study may be useful in developing effective nursing student-led health promotion programs and interventions for rural older adults. In addition, this study suggests the possibility of nursing student-led health promotion programs centered on community-based learning as an alternative health service.&#x0D;

Can motor decline be a modifiable marker of clinical progression in subjective cognitive decline? A national prospective cohort study

ObjectivesSubjective cognitive decline represents a critical stage for preventing mild cognitive impairment and dementia, but the links between clinical progression in the subjective cognitive decline stage and various motor functions remain inconclusive. This cohort study aimed to elucidate the independent and joint associations between the clinical progression of subjective cognitive decline and motor functions. MethodsWe enrolled 4880 community-dwelling elderly participants from a national cohort and used Cox proportional hazard regression model and restricted cubic spline models to explore the longitudinal associations between motor functions (gait, strength, balance, and endurance) and the clinical progression of subjective cognitive decline. ResultsDuring 5-years follow-up, 1239 participants experienced clinical progression. After adjusting for demographics, vascular burden, body components, and polypharmacy, gait speed [hazard ratios (HRs)= 0.96, 95% confidence interval (CI) 0.94–0.99], chair stand test (HRs=1.02, 95%CI 1.01–1.03), and endurance limitation in jogging 1 kilometer (HRs=1.18, 95%CI 1.04–1.34) were significantly associated with clinical progression. Among all participants, individuals characterized by poor upper- and lower-body strength, as well as those with slow pace and reduced endurance, faced the highest risk of cognitive impairment. ConclusionsThis study emphasizes the potential of gait speed, muscle strength, and endurance as non-cognitive indicators of clinical progression in subjective cognitive decline. Understanding their combined effectiveness may reveal primary physiological mechanisms contributing to the dual decline of motor and cognition.

A randomised controlled trial assessing the effects of weather sensitivity profile and walking in nature on the psychophysiological response to stress in individuals with coronary artery disease. A study protocol

BackgroundThe following protocol pertains to a pioneer study, aiming to investigate how weather sensitivity and walking in different environments affects the psychophysiological responses to the stress of individuals with coronary artery disease (CAD) during rehabilitation (WE_SENSE_THE_NATURE). This randomised control trial will provide fresh insight on the influence of the environmental exposure in CAD patients, as it is seldom investigated in association to the disease. Additionally, findings on the link between personality traits and cognitive functions (especially cognitive flexibility), and weather sensitivity may help reveal a fine-grained perspective on the treatment possibilities for individuals with CAD at risk to stress-vulnerability.MethodsThe proposed protocol is for a randomised control trial among individuals attending a cardiac rehabilitation program. We aim to recruit 164 individuals, collecting information related to demographic characteristics, weather sensitivity, functional capacity, personality traits, subjective mental health status, cognitive function, and basal cortisol level of participating individuals. Basal cortisol level refers to cortisol concentration in saliva and will be tested in the morning and the afternoon prior to the day of the experiment. After baseline measurements, the patients will be randomly assigned to either walking outdoors or walking indoors. All measures and their sequential order will remain the same within each group, while the treatment condition (i.e., walking environment) will vary between groups. On the day of the experiment, hemodynamic parameters (assessed via 6-hour blood pressure measurements), stress level (consisting of assessments of cortisol level), and mood (assessed using visual analogues scale) will be registered. Cold stress test will be administered to evaluate the effect of walking in different environments.DiscussionThe outcomes of this study may have direct clinical applications for the use of different types of exercise environments in cardiac rehabilitation programs. Awareness about the potential influence of weather sensitivity on the psychophysiological reactions to stress in individuals with CAD may contribute to a timely planning and implementation of actions leading to improved medical care services and preventive measures, especially considering the expected weather oscillations and extreme weather events due to unfolding of the climate change.Trial registrationThis protocol has been retrospectively registered in ClinicalTrials.gov with identifier code: NCT06139705 on November 20, 2023.

Effect of dairy consumption on cognition in older adults: A population-based cohort study.

We aimed to assess the effect on cognitive function of adding dairy (total, fermented, non-fermented, full fat, low fat, and sugary) to the diet and of substituting some food groups for dairy. Secondary analysis of a prospective population-based cohort study. We analyzed data from 1334 cognitively healthy participants (median age 67 years at baseline) with a mean follow-up of 5.6 years from the CoLaus|PsyColaus cohort in Lausanne, Switzerland. The participants completed a food frequency questionnaire at baseline and cognitive tests at baseline and at follow-up. Clinical dementia rating was the primary outcome. Subjective cognitive decline, memory, verbal fluency, executive and motor functions were secondary outcomes. Our exposure was the consumption of total and 5 sub-types of dairy products (g/d). We used marginal structural models to compute average causal effects of 1) increasing dairy consumption by 100 g/d and 2) substituting 100 g/d of meat, fish, eggs, fruits and vegetables with dairy on the outcomes. We used inverse probability of the treatment and lost to follow-up weighting to account for measured confounding and non-random loss to follow-up. Overall, the effects of adding dairy products to the diet on cognition were negligible and imprecise. No substitution had a substantial and consistent effect on clinical dementia rating. The substitution of fish [11.7% (-3% to 26.5%)] and eggs [18% (2.3%-33.7%)] for dairy products could negatively impact verbal memory and neurolinguistic processes. We found no effect of adding dairy to the diet or substituting meat, vegetables or fruit for dairy on cognitive function in this cohort of older adults. The substitution of fish and eggs for dairy could have a negative effect on some secondary outcomes, but more studies modeling food substitutions are needed to confirm these results.

Spontaneous recovery from post‐COVID‐19 brain fog

AbstractBackgroundOne‐third of individuals who contract novel coronavirus disease 2019 (COVID‐19) reportedly experience persistent symptoms, including respiratory issues, headache, dizziness, taste disorders, fatigue, and various psychiatric and neurological symptoms, known as post‐acute sequelae of SARS‐CoV‐2. In this case report, we present a patient who became aware of brain fog, which is cognitive impairment, approximately 2 months after their COVID‐19 symptoms had resolved, accompanied by anxiety and depression.Case PresentationThe patient, a 35‐year‐old Japanese man, was infected with COVID‐19 and resumed work approximately 2 weeks later after symptoms improved. Approximately 1 month after returning to work, the patient's concentration became impaired and he started making noticeable errors at work. These symptoms did not improve, leading him to the outpatient clinic specializing in COVID‐19 sequelae at our hospital. Here, he underwent blood tests, electroencephalography, and head magnetic resonance imaging, which did not reveal any abnormalities. Cognitive decline due to COVID‐19 sequelae was therefore suspected, prompting his evaluation in our department approximately 5 months after his initial COVID‐19 infection. Detailed cognitive function tests were performed. He was monitored without the use of medications, and his cognitive function gradually improved. Approximately 11 months after his initial COVID‐19 infection, the same cognitive function tests were conducted again, because his subjective cognitive function symptoms had disappeared, and improvement was observed in many items.ConclusionSince brain fog is a relatively common sequela, we emphasize the importance of keeping this in mind from the initial consultations and comparing results over time.

The prognosis of delirium in older outpatients.

Delirium is a common and serious neuropsychiatric disorder. The prognosis of delirium in older patients living at home has not been studied often before. The aim of this study is to examine the prognosis of delirium in patients attending a memory clinic of a psychiatric hospital. The study population consisted of 85 outpatients diagnosed with delirium between October 2013 and October 2014. Seventeen patients had already been diagnosed as having dementia. Three months after the diagnosis, consenting patients underwent a follow-up visit. We recorded delirium status (remitted or not), new dementia diagnosis, subjective cognitive functioning compared to baseline and to before delirium, level of daily functioning, and place of residence. After 3 months, 45 (53%) had recovered from delirium, 19 (22,4%) had persistent/recurrent delirium, 12 (14%) patients had died, and another nine (11%) could not be revisited for other reasons than death. None of the 64 re-examined patients reported that their cognitive functioning had recovered to the pre-delirium level, and the mean level of daily functioning did not substantially improve either. The rate of diagnosed dementia increased to 63.8%, and 18 patients (28.1%) had moved to a nursing home. Delirium in older outpatients has a poor prognosis. A larger study on the risk factors of the prognosis of delirium in older persons living at home is advised.

The impact of musical reward responses on cognitive function in older adults with type 2 diabetes

Cognitive decline is prevalent in older adults with type 2 diabetes (T2DM). The use of music has emerged to improve cognitive health. Even though reward from music has been shown to improve cognitive function, no studies have focused on specific factors of musical reward. This study investigated which factors of musical reward impact cognitive function in older adults with T2DM. A secondary data analysis was conducted with 185 older adults with T2DM and subjective cognitive decline. Among the musical reward factors, mood regulation significantly influenced subjective cognitive function (β = 0.315; p < 0.001). The findings suggest that music interventions for older adults with T2DM may need to focus on managing their psychological states for the intervention to have beneficial effects on cognitive function. Future rigorous studies with larger sample sizes should be done to obtain robust evidence for optimal music interventions for older adults with T2DM.

Individual and dual trajectories of insomnia symptoms and body mass index before and after retirement and their associations with changes in subjective cognitive functioning

BackgroundWe examined individual and dual trajectories of insomnia symptoms and body mass index (BMI) before and after retirement, and their associations with changes in subjective cognitive functioning after retirement. MethodsWe used the Helsinki Health Study's (n = 2360, 79% women, aged 40–60 at baseline, Finland) repeated surveys to identify the developmental patterns of insomnia symptoms and BMI (2000–2017) and changes in subjective cognitive functioning (2017–2022). We analysed the data using latent group-based dual trajectory modelling and logistic regression analysis. ResultsThree latent groups were identified for insomnia symptoms (stable low, decreasing and increasing symptoms) and BMI (stable healthy weight, stable overweight and stable obesity). Insomnia symptoms were associated with declining subjective cognitive functioning and largely explained the effects in the dual models. Conclusion:The association between dual trajectories of insomnia symptoms and BMI with subjective cognitive decline is dominated by insomnia symptoms.

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.

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.

RESILIENCE AND AGE MODIFY INFLUENCES OF STRESS AND POSITIVE EXPERIENCES ON SUBJECTIVE COGNITION

Abstract The COVID-19 pandemic is a major, chronic, worldwide stressor related to poorer health and well-being, especially among older adults, but less is known about risk and protective factors related to cognitive functioning during this stressful time. This eight-week study of 229 community-dwelling middle-aged and older adults (Mage=71.1; 74% women) examined associations between the intensities of weekly stress and positive experiences on subjective cognitive functioning. We also examined how age and trait resilience modified these associations. Zero-inflated Poisson models revealed a positive association between the intensity of stress and self-reported cognitive difficulties (γ=0.34, SE=0.07), whereas the intensity of positive experiences was associated with fewer difficulties (γ=-0.09, SE=0.03). Age moderated the effect of stress (γ=-0.01, SE=0.002), with the old-old having more subjective cognitive difficulties under more intense stress than the young-old. Resilience modified effects of stress and positive experiences, respectively, on cognition (γ=0.04, SE=0.01 and γ=-0.01, SE=0.01). Those with lower resilience reported more cognitive difficulties under more intense compared to less intense stress; this association was slightly attenuated for people with more resilience. Similar associations emerged between resilience and positive experience intensity. Older age was a risk factor for subjective cognitive difficulties during the COVID-19 pandemic, especially under conditions of high weekly stress, whereas resilience was a protective factor. Although those high in resilience appeared to be more sensitive to cognitive difficulties during more intense positive experiences, they still reported fewer difficulties than those low in resilience. Older adults’ cognitive resilience during the COVID-19 pandemic was heterogeneous and multifactorial.

PATTERNS OF USE, RISK FACTORS, AND ATTITUDES OF OLDER ADULT CANNABIS USERS

Abstract While cannabis use continues to increase among older adults (OA), research within this population is limited. This study aimed to describe OA patterns of use, risk factors, and subjective effects of cannabis use. OA cannabis users ages 60-79 (N=17, Mage=68.29, SD=5.61) were 94% White and 59% women, with an average education of 15.94 years (SD=2.38). Participants completed online questionnaires and semi-structured interviews regarding medical and mental health, subjective cognitive functioning, and cannabis use patterns and attitudes. Participants reported M=33.41 years of cannabis use (SD=20.15) with an average age of first use of 20.11 years (SD=10.40). Current use was reported as 4.29 days/week (SD=3.14). Current reasons for use were recreational (n=6), medical (n=2), or both (n=8). The most common medical conditions for which participants reported using cannabis were arthritis/joint pain (n=4) and disordered sleep (n=4). The most commonly reported benefits of cannabis use were relaxation (n=8), improved sleep (n=6), improved mood/anxiety (n=6), cognitive enhancement (n=5), and pain management (n=4). Common drawbacks included subjective cognitive decline (n=7), social hindrance (n=6), and health complications (n=5), whereas 5 participants reported no drawbacks. Most participants (76%) reported discussing cannabis use with their physician, although only 38% of those reported that discussion was helpful. Disconnect between OA cannabis users and their physicians could result in cannabis use that is contraindicated by preexisting medical conditions or medications. Emphasis should be placed on individualized psychoeducation regarding the potential risks/benefits of cannabis use as well as continuing education for physicians regarding cannabis use in OA.