Subjective Cognitive Function Research Articles

Postsurgery Subjective Cognitive and Short-Term Memory Impairment Among Middle-Aged Chinese Patients

Perioperative neurocognitive disorder, particularly postoperative cognitive impairment, is common and associated with multiple medical and social adversities, although data from China are lacking. To examine the incidence, trajectory, and risk factors for subjective cognitive and short-term memory impairment after surgery in the Chinese population. This cohort study used data from the China Surgery and Anesthesia Cohort to assess surgical patients aged 40 to 65 years from 2 medical centers between July 15, 2020, and March 31, 2023, with active follow-up within 1 year after the surgery. Of 11 158 patients who were successfully recruited (response rate, 94.4%), 10 149 participants were eligible and available for analysis. From this population, separate cohorts were constructed for analyzing subjective cognitive impairment (8105 noncardiac and 678 cardiac surgery patients) and short-term memory impairment (5246 noncardiac and 454 cardiac surgery patients). Twenty-four potential risk factors regarding comorbidities, preoperative psychological conditions, anesthesia- or surgery-related factors, and postsurgical events were included. Outcomes included subjective cognitive function measured by the 8-Item Informant Interview to Differentiate Aging and Dementia (AD8; scores range from 0 to 8, with higher scores indicating more severe cognitive impairment) and short-term memory measured by the 3-Word Recall Test (TRT; scores range from 0 to 3, with lower scores indicating more severe short-term memory impairment) at 1, 3, 6, and 12 months after noncardiac and cardiac surgery. Generalized linear mixed models were used to identify risk factors associated with the presence of AD8 (score ≥2) or TRT (score <3) abnormality as well as the aggressively deteriorative trajectories of those cognitive measurements. For noncardiac surgery patients, the AD8 analysis included 8105 patients (mean [SD] age, 52.3 [7.1] years; 3378 [41.7%] male), and the TRT analysis included 5246 patients (mean [SD] age, 51.4 [7.0] years; 1969 [37.5%] male). The AD8 abnormality incidence rates after noncardiac surgery increased from 2.2% (175 of 8105) at 7 days to 17.1% (1059 of 6191) at 6 months after surgery, before appearing to decrease. In contrast, the TRT abnormality incidence rates followed a U-shaped pattern, with the most pronounced incidence rates seen at 7 days (38.9% [2040 of 5246]) and 12 months (49.0% [1394 of 2845]). Similar patterns were seen among cardiac surgery patients for the AD8 analysis (678 patients; mean [SD] age, 53.2 [6.3] years; 393 [58.0%] male) and TRT analysis (454 patients; mean [SD] age, 52.4 [6.4] years; 248 [54.6%] male). Among noncardiac surgery patients, the top risk factors for aggressively deteriorative AD8 trajectory and for AD8 abnormality, respectively, after surgery were preoperative sleep disturbances (Pittsburgh Sleep Quality Index ≥16 vs 0-5: odds ratios [ORs], 4.04 [95% CI, 2.20-7.40] and 4.54 [95% CI, 2.40-8.59]), intensive care unit stay of 2 days or longer (ORs, 2.43 [95% CI, 1.26-4.67] and 3.07 [95% CI, 1.67-5.65]), and preoperative depressive symptoms (ORs, 1.76 [95% CI, 1.38-2.24] and 2.23 [95% CI, 1.79-2.77]). Analyses for TRT abnormality and trajectory, as well as the analyses conducted among cardiac surgery patients, found fewer associated factors. This cohort study of middle-aged Chinese surgery patients found subjective cognitive and short-term memory impairment within 12 months after both cardiac and noncardiac surgery, with multiple identified risk factors, underscoring the potential of preoperative psychological interventions and optimized perioperative management for postoperative cognitive impairment prevention.

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

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

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

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

A - 158 The Effects of Migraine and Traumatic Brain Injury on Subjective Cognitive Functioning in Veterans in the Million Veteran Program.

The relationship between migraine and cognitive symptoms in Veterans is a complex issue, made more challenging by the high prevalence of traumatic brain injury (TBI) in this population. This study examined the relationship between migraine, TBI, and subjective cognitive function. Participants included 338,217 Veterans enrolled in the Million Veteran Program who completed the Medical Outcomes Study Cognitive Functioning Scale Revised (MOS-Cog-R), a self-report measure of cognitive functioning. Veterans were categorized into the following groups: (1) both migraine and TBI history (n = 7828), (2) migraine-only (n = 22,252), (3) TBI-only (n = 24,078), and (4) no history of migraine or TBI (n = 284,059). MOS-Cog-R scales were compared across groups using the Kruskal-Wallis Test for omnibus differences and Dunn's test and Cliff's Delta for effect size calculations of differences between groups. The migraine/TBI group reported the highest prevalence of cognitive symptoms across all domains (range: 76.1% for confusion to 90.5% for forgetfulness). In contrast, the no migraine/TBI group had the lowest prevalence of cognitive problems (range: 32.0% for confusion to 63.7% for forgetfulness). All omnibus group differences were statistically significant (p < 0.001), and nearly all pairwise comparisons were significant, except for some of the migraine-only vs. TBI-only group comparisons. Results showed a "dose-response" relationship between diagnostic group and subjective cognitive symptoms, such that the migraine/TBI group fared the worst, followed by the TBI-only and migraine-only groups, and finally the no migraine/TBI group. Findings set the stage for follow-up work to be conducted within MVP that will address the neurobiological underpinnings of cognitive distress in this population.

A - 146 Subjective and Objective Cognitive Functioning in Women Survivors of Intimate Partner Violence with Repetitive Mild Traumatic Brain Injuries.

This study examined subjective and objective cognitive functioning among women survivors of intimate partner violence (IPV) with a history of repetitive mild traumatic brain injury (mTBI), hypothesizing they would have elevated subjective cognitive complaints and lower objective cognitive test performances compared to national norms. Women were recruited from a domestic violence shelter (N = 16; M = 39.8 ± 7.9years-old) and completed the Neurological Quality-of-Life Cognitive Function questionnaire (Neuro-QoL-CF), Rey Auditory Verbal Learning Test (RAVLT), NIH Toolbox Cognition Battery (NIHTB-CB), and Delis-Kaplan Executive Function System (D-KEFS) Trail Making and Verbal Fluency tests. One-sample t-tests compared mean scores against national norms for the Neuro-QoL-CF, RAVLT trials 1-5 and delayed recall, NIHTB-CB Crystallized-Fluid difference score, and D-KEFS composite index score. Nearly all women (81.3%) reported elevated subjective cognitive concerns on the Neuro-QoL-CF, significantly greater than the national average, t = 10.50, p < 0.001, d = 2.62. RAVLT learning, t = 5.41, p < 0.001, d = -1.35, and delayed recall, t = 4.54, p < 0.001, d = -1.28, were significantly lower than the national average. NIHTB-CB difference scores were significantly higher than the national average, t = 5.23, p < 0.001, d = 1.14, indicating worse fluid cognition than anticipated compared to estimated premorbid functioning. Mean D-KEFS composite scores were comparable to national norms, t = 0.73, p = 0.474, d = 0.18. Women survivors of IPV with repetitive mTBI history had greater subjective cognitive concerns and lower cognitive test performances compared to national norms, indicating cognitive health needs in this population. These findings may be attributable to repetitive mTBI or other neurobehavioral variables that may affect this population, including concurrent physical conditions (e.g., headache), mental illness, chronic pain, substance use, or a combination thereof.

B - 59 Testing the Cognitive Model of Pathological Worry as an Explanation for Increased Worry among the Oldest Old.

Based on past research demonstrating increased worry among the oldest old compared to younger older adults, this study tested an existing cognitive model of worry to determine whether differences in executive functioning during aging contribute to increased worry among the oldest old. 97 community-dwelling older adults (M age = 74.49; range = 60-89years) completed self-report questionnaires including the Penn State Worry Questionnaire, Geriatric Anxiety Scale, and Cognitive Problems and Strategies Assessment, and were individually evaluated with neurocognitive measures including the RBANS, DKEFS Color-Word Interference Test, and Modified Wisconsin Card Sorting Test. Two-way ANOVAs revealed no significant differences in worry based on age group (i.e., 60s, 70s, and 80s; F[2, 85] = 1.31, p = 0.28) or gender (F[1, 85] = 3.22, p = 0.08). Further, response inhibition and problem-solving did not predict anxiety or worry severity in multiple regression analyses. Lower education was the only consistent predictor of both anxiety and worry when accounting for cognitive performance, age, and gender. However, subjective cognitive functioning also predicted worry among older adults, independent of objective performance. No age differences in worry or anxiety severity were found. Also, no evidence was found to support age-differences in executive functioning as a contributor to worry presentation in late life. The cognitive model of worry may only be applicable to pathological worry or executive decline among the sample was not pronounced enough to impact anxiety. Overall, this study demonstrates that the cognitive model of worry is not supported in healthy, community-dwelling older adults. However, limitations included limited demographic diversity, small sample size, and limited measurement of executive functioning.

Unraveling brain fog in post-COVID syndrome: Relationship between subjective cognitive complaints and cognitive function, fatigue, and neuropsychiatric symptoms.

"Brain fog" is a frequent and disabling symptom that can occur after SARS-CoV-2 infection. However, its clinical characteristics and the relationships among brain fog and objective cognitive function, fatigue, and neuropsychiatric symptoms (depression, anxiety) are still unclear. In this study, we aimed to examine the characteristics of brain fog and to understand how fatigue, cognitive performance, and neuropsychiatric symptoms and the mutual relationships among these variables influence subjective cognitive complaints. A total of 170 patients with cognitive complaints in the context of post-COVID syndrome were evaluated using a comprehensive neuropsychological protocol. The FLEI scale was used to characterize subjective cognitive complaints. Correlation analysis, regression machine-learning algorithms, and mediation analysis were calculated. Cognitive complaints were mainly attention and episodic memory symptoms, while executive functions (planning) issues were less often reported. The FLEI scale, a mental ability questionnaire, showed high correlations with a fatigue scale and moderate correlations with the Stroop test, and anxiety and depressive symptoms. Random forest algorithms showed an R2 value of 0.409 for the prediction of FLEI score, with several cognitive tests, fatigue and depression being the best variables used in the prediction. Mediation analysis showed that fatigue was the main mediator between objective and subjective cognition, while the effect of depression was indirect and mediated through fatigue. Brain fog associated with COVID-19 is mainly characterized by attention and episodic memory, and fatigue, which is the main mediator between objective and subjective cognition. Our findings contribute to understanding the pathophysiology of brain fog and emphasize the need to unravel the main mechanisms underlying brain fog, considering several aspects.

Mediating Effects of Depression on the Relationship Between Subjective Sleep Quality and Cognitive Function in Healthy Older Adults

Mediating Effects of Depression on the Relationship Between Subjective Sleep Quality and Cognitive Function in Healthy Older Adults

Association Between Bowel Movement Pattern and Cognitive Function: Prospective Cohort Study and a Metagenomic Analysis of the Gut Microbiome.

Little is known regarding the association between intestinal motility patterns and cognitive function in individuals who are baseline cognitively healthy. The gut microbiome may contribute to the association. We examined the association between bowel movement (BM) pattern and cognitive function and explored the role of the gut microbiome in explaining this association. In this prospective study, we leveraged 3 cohort studies, Nurses' Health Study (NHS), NHSII, and Health Professionals Follow-Up Study (HPFS). Participants reported BM frequency and subjective cognitive function. In a subset of NHSII participants, we assessed cognitive function using an objective neuropsychological battery. We profiled the gut microbiome in a subset of participants using whole-genome shotgun metagenomics. General linear models, Poisson regression, and logistic regression were used to quantify the association of BM frequency with different cognitive measurements. We followed 112,753 men and women (women: 87.6%) with a mean age of 67.2 years at baseline (NHS: 76 years, NHSII: 59 years, HPFS: 75 years) for a median follow-up of 4 years (NHSII and HPFS: 4 years, NHS: 2 years). Compared with those with BM once daily, participants with BM frequency every 3+ days had significantly worse objective cognitive function, equivalent to 3.0 (95% confidence interval [CI],1.2-4.7) years of chronological cognitive aging. We observed similar J-shape dose-response relationships of BM frequency with the odds of subjective cognitive decline and the likelihood of having more subsequent subjective cognitive complaints (both p nonlinearity < 0.001). BM frequencies of every 3+ days and ≥twice/day, compared with once daily, were associated with the odds ratios of subjective cognitive decline of 1.73 (95% CI 1.60-1.86) and 1.37 (95% CI 1.33-1.44), respectively. BM frequency and subjective cognitive decline were significantly associated with the overall gut microbiome configuration (both p < 0.005) and specific microbial species in the 515 participants with microbiome data. Butyrate-producing microbial species were depleted in those with less frequent BM and worse cognition, whereas a higher abundance of proinflammatory species was associated with BM frequency of ≥twice/day and worse cognition. Lower BM frequency was associated with worse cognitive function. The gut microbial dysbiosis may be a mechanistic link underlying the association.

Objective and subjective neurocognitive functioning in functional motor symptoms and functional seizures: preliminary findings

ABSTRACT Introduction This study aimed to provide a preliminary assessment of objective and subjective neurocognitive functioning in individuals with functional motor symptoms (FMS) and/or functional seizures (FS). We tested the hypotheses that the FMS/FS group would display poorer objective attentional and executive functioning, altered social cognition, and reduced metacognitive accuracy. Method Individuals with FMS/FS (n = 16) and healthy controls (HCs, n = 17) completed an abbreviated CANTAB battery, and measures of intellectual functioning, subjective cognitive complaints, performance validity, and comorbid symptoms. Subjective performance ratings were obtained to assess local metacognitive accuracy. Results The groups were comparable in age (p = 0.45), sex (p = 0.62), IQ (p = 0.57), and performance validity (p-values = 0.10–0.91). We observed no impairment on any CANTAB test in this FMS/FS sample compared to HCs, although the FMS/FS group displayed shorter reaction times on the Emotional Bias task (anger) (p = 0.01, np2 = 0.20). The groups did not differ in subjective performance ratings (p-values 0.15). Whilst CANTAB attentional set-shifting performance (total trials/errors) correlated with subjective performance ratings in HCs (p-values<0.005, rs = −0.85), these correlations were non-significant in the FMS/FS sample (p-values = 0.10–0.13, rs-values = −0.46–0.50). The FMS/FS group reported more daily cognitive complaints than HCs (p = 0.006, g = 0.92), which were associated with subjective performance ratings on CANTAB sustained attention (p = 0.001, rs = −0.74) and working memory tests (p < 0.001, rs = −0.75), and with depression (p = 0.003, rs = 0.70), and somatoform (p = 0.003, rs = 0.70) and psychological dissociation (p-values<0.005, rs-values = 0.67–0.85). Conclusions These results suggest a discordance between objective and subjective neurocognitive functioning in this FMS/FS sample, reflecting intact test performance alongside poorer subjective cognitive functioning. Further investigation of neurocognitive functioning in FND subgroups is necessary.

The interrelationships of hearing function, allostatic load, and cognitive function: Evidence among middle-aged and older Chinese adults

ObjectivesWe aim to examine the interrelationships of self-reported hearing function, allostatic load (AL), and cognitive function among middle aged and older adults. MethodsOur data were collected from two waves of the China Health and Retirement Longitudinal Study (CHARLS) conducted in 2011 and 2015. The participants' hearing function was measured using self-rated subjective hearing function. Allostatic load (AL) was evaluated by measuring 14 biomarkers associated with physiological health, which were derived from blood samples. Cognitive function was assessed using three domains: episodic memory, mental intactness, and global cognition. To examine the relationships between hearing function, AL, and cognitive function, path analysis with structural equation modeling (SEM) methodology was employed. ResultsAmong individuals aged 60 and above non-hearing aids users, the hearing function at Time 1 (T1) in 2011 has a significant association with the level of AL at T1 (β = 0.02, p < 0.001), as well as on cognitive function at Time 2 (T2) in 2015 (β = −0.1, p < 0.001). Additionally, the AL related to the hearing function at T1 associates an increased risk of AL at T2 (β = 0.5, p < 0.001), and is significantly associated with a decrease of cognitive function scores at T2 (β = −0.4, p < 0.001). However, no significant relationship was found among individuals aged 45 – 59 with non-hearing aids utilizers. Similar findings were in the domains of epidemic memory and mental intactness for cognitive function. ConclusionsThere were interrelationships of subjective hearing function, AL, and cognitive function among aged 60 years and above, but not among those aged 45–59 years old. It may provide valuable insights for identifying subclinical thresholds in the physiological systems of individuals at risk of pathology in cognitive function.

Using network models to explore the associations between posttraumatic stress disorder symptoms and subjective cognitive functioning

Several studies have identified relationships between posttraumatic stress disorder (PTSD) and cognitive functioning. Here, we aimed to elucidate the nature of this relationship by investigating cross-sectional associations between subjective cognitive functioning (SCF) and 1) the PTSD sum score, 2) symptom domains, and 3) individual symptoms. We also investigated temporal stability by testing whether results replicated over a 3-year period. We estimated partial correlation networks of DSM-5 PTSD symptoms (at baseline) and SCF (at baseline and follow-up, respectively), using data from the National Health and Resilience in Veterans Study (NHRVS; N = 1484; Mdn = 65 years). The PTSD sum score was negatively associated with SCF. SCF was consistently negatively associated with the PTSD symptom domains ‘marked alterations in arousal and reactivity’ and ‘negative alterations in cognitions and mood’, and showed robust relations with the specific symptoms ‘having difficulty concentrating’ and ‘trouble experiencing positive feelings’. Results largely replicated at the 3-year follow-up, suggesting that some PTSD symptoms both temporally precede and are statistically associated with the development or maintenance of reduced SCF. We discuss the importance of examining links between specific PTSD domains and symptoms with SCF—relations obfuscated by focusing on PTSD diagnoses or sum scores—as well as investigating mechanisms underlying these relations.Registration Number: 37069 (https://aspredicted.org/n5sw7.pdf)

Older adults' self-reported prospective memory lapses in everyday life: Connections to inflammation and gender

ObjectiveLimited research has focused on the association between inflammatory markers and features of subjective cognitive functioning among older adults. The present work examined links between inflammation and a specific subjective cognitive report: prospective memory (PM), or our memory for future intentions, such as attending an appointment or taking medication. MethodWe assessed self-reported PM lapses using a two-week ecological momentary assessment (EMA) diary protocol via smartphone as well as levels of blood-based inflammation among 231 dementia-free older adults (70–90 years, 66% women) enrolled in the Einstein Aging Study. ResultsOverall, PM lapses were largely unrelated to inflammatory markers. However, a significant gender difference was observed in the link between basal levels of interleukin (IL)-8 and PM lapses: higher levels of basal IL-8 were associated with more PM lapses among men (estimate = 0.98, 95%CI: [0.43, 1.53], p < .001) but not women (estimate = −0.03, 95%CI: [−0.45, 0.39], p = .826). No other significant relationships between PM lapses and basal or stimulated (ex vivo) cytokine levels (IL-1β, IL-4, IL-6, IL-8, IL-10, tumor necrosis factor-alpha [TNF-α]) or C-reactive protein (CRP) emerged. ConclusionElevated levels of IL-8 in older men may possibly be an early indicator of neurodegeneration that relates to PM performance. Future studies should continue to examine PM and inflammation across genders to identify possible mechanisms through which these constructs may indicate neurodegeneration and dementia risk.

Latent class symptom profiles of colorectal cancer survivors with cancer-related cognitive impairment.

Colorectal cancer (CRC) survivors experience cancer-related cognitive impairment and co-occurring symptoms after cancer treatments. There has been little data to inform the risk factors of complex symptom phenotypes in CRC survivors. To determine if subgroups of CRC survivors after cancer treatments could be identified based on the cognitive impairment and common co-occurring symptoms (depression, anxiety, sleep disturbance, fatigue, and pain); and to explore risk factors (sociodemographic and clinical characteristics, perceived stress, and social support) of these subgroups. Latent class profile analysis (LCPA) was used to identify subgroups based on self-reported symptoms in 64 CRC survivors. Cognitive impairment was measured by assessing subjective cognitive function using the Patient-Reported Outcome Measurement Information System (PROMIS) measure. The Kruskal-Wallis test and regression analyses were performed. Three distinct latent classes were identified (Class 1: All Low '28.1%'; Class 2: High Psychological Symptoms (depression/anxiety) '25%'; Class 3: High Somatic Symptoms (fatigue, sleep disturbance, and pain) with High Cognitive Impairment'46.9%'). The pain was the most distinguishable symptom across the latent classes. The high symptom burden group was associated with less time since cancer diagnosis, higher perceived stress levels, and poor emotional social support. Our study adds to the information on interindividual variability in symptom experience of CRC survivors with cognitive impairment. Findings suggest a need for increased attention to screening for co-occurring symptoms (e.g., high pain) and future interventions focused on stress management and social support.

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

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

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

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

Longitudinal relationships between grip strength, subjective memory complaints and cognitive function among middle-aged and older adults in China.

Subjective memory complaints are considered an early sign of cognitive decline. Recent evidence shows that grip strength is an important predictor of cognitive function. However, few studies have compared whether one condition is uniquely associated with cognitive function when another condition is controlled for. To explore the longitudinal associations of cognitive function with subjective memory complaints and grip strength in middle-aged and older adults, with a particular focus on whether one condition is uniquely associated with cognitive function when another condition is considered. A total of 3,877 middle-aged and older adults (aged 45-92years) from the China Health and Retirement Longitudinal Study reported on their demographic and health status and completed measures of grip strength and subjective memory complaints, as well as a series of cognitive tests, every two years between 2011 and 2015. Generalized estimating equation models were used to assess the relationships between grip strength, subjective memory complaints, and cognitive function. Grip strength was longitudinally associated with cognitive function (β = 0.021, 95% confidence interval [CI]: 0.011, 0.030, P < 0.001) independent of subjective memory complaints. In contrast, changes in the subjective memory complaints were not related to cognitive function over time (β = 0.107, 95% CI: - 0.025, 0.238, P = 0.112). Only at baseline subjective memory complaints were associated with poorer cognitive function (β = - 1.142, 95% CI: - 1.309, - 0.975, P < 0.001). Grip strength might be a more important clinical correlate of cognitive function decline over time than subjective memory complaints. Regular assessment and close monitoring of grip strength might help identify individuals who might be at high risk for cognitive impairment.

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

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

Effects of Community Environment, Leisure, and Social Activities on Health Status of Older Adults with Diabetes in South Korea.

This study investigates the effects of community environment, leisure, and social activities on the health status of older adults with diabetes, a serious disease in modern society. Data from the 2020 National Survey of Older Koreans were analyzed. Descriptive statistics were used to assess participants' characteristics, and regression analyses were conducted to assess the effects of community environment, leisure, and social activities. Mediating effects were tested using hierarchical regression analysis and bootstrapping. The key results are as follows. (a) Community environmental satisfaction affected participation in leisure and social activities. (b) Community accessibility had a negative effect on subjective health, while community environmental satisfaction had a positive effect on subjective health, cognitive function, and chronic diseases. (c) Leisure activities had a positive effect on cognitive health, while social activities influenced subjective health, cognitive function, and chronic diseases. (d) Analysis of the mediating effect of leisure and social activities on the relationship between the community environment and health status of older adults with diabetes confirmed a partial mediating effect. To improve older adults' mental and physical health, mere quantitative increases in the community environment will not be sufficient. It is necessary to cultivate and manage professionals to increase opportunities for participation by increasing social exchanges and systematically managing older adults' health.

Subjective and Performance-Based Cognition and Their Associations with Head Injury History in Older Former National Football League Players.

Investigate the association between self-reported subjective and performance-based cognition among older (50-70 years) former professional American football players, as well as the relationship of cognitive measures with concussion history and years of football participation, as a proxy for repetitive head impact exposure. Among older former National Football League (NFL) players ( N = 172; mean age = 60.69 ± 5.64), associations of subjective (Patient Reported Outcome Measurement Information System Cognitive Function-Short Form) and performance-based cognitive measures (Brief Test of Adult Cognition by Telephone [BTACT] Executive Function and Episodic Memory indices) were assessed via univariable and multivariable regression models, with a priori covariates of depression and race. A similar univariate and multivariable regression approach assessed associations between concussion history and years of football participation with subjective and performance-based cognitive measures. In a sample subset ( n = 114), stability of subjective cognitive rating was assessed via partial correlation. Subjective ratings of cognition were significantly associated with performance-based assessment, with moderate effect sizes (episodic memory ηp2 = 0.12; executive function ηp2 = 0.178). These associations were weakened, but remained significant ( P s < 0.05), with the inclusion of covariates. Greater concussion history was associated with lower subjective cognitive function ( ηp2 = 0.114, P < 0.001), but not performance-based cognition. The strength of association between concussion history and subjective cognition was substantially weakened with inclusion of covariates ( ηp2 = 0.057). Years of participation were not associated with measures of subjective or objective cognition ( P s > 0.05). These findings reinforce the importance of comprehensive evaluation reflecting both subjective and objective measures of cognition, as well as the consideration of patient-specific factors, as part of a comprehensive neurobehavioral and health assessment of older former contact sport athletes.