Cross-sectional association between objective cognitive performance and perceived age-related gains and losses in cognition

Abstract

Objectives: Evidence linking subjective concerns about cognition with poorer objective cognitive performance is limited by reliance on unidimensional measures of self-perceptions of aging (SPA). We used the awareness of age-related change (AARC) construct to assess self-perception of both positive and negative age-related changes (AARC gains and losses). We tested whether AARC has greater utility in linking self-perceptions to objective cognition compared to well-established measures of self-perceptions of cognition and aging. We examined the associations of AARC with objective cognition, several psychological variables, and engagement in cognitive training. Design: Cross-sectional observational study. Participants: The sample comprised 6056 cognitively healthy participants (mean [SD] age = 66.0 [7.0] years); divided into subgroups representing middle, early old, and advanced old age. Measurements: We used an online cognitive battery and measures of global AARC, AARC specific to the cognitive domain, subjective cognitive change, attitudes toward own aging (ATOA), subjective age (SA), depression, anxiety, self-rated health (SRH). Results: Scores on the AARC measures showed stronger associations with objective cognition compared to other measures of self-perceptions of cognition and aging. Higher AARC gains were associated with poorer cognition in middle and early old age. Higher AARC losses and poorer cognition were associated across all subgroups. Higher AARC losses were associated with greater depression and anxiety, more negative SPA, poorer SRH, but not with engagement in cognitive training. Conclusions: Assessing both positive and negative self-perceptions of cognition and aging is important when linking self-perceptions to cognitive functioning. Objective cognition is one of the many variables – alongside psychological variables – related to perceived cognitive losses.

Associations of subjective cognitive and memory decline with depression, anxiety, and two-year change in objectively-assessed global cognition and memory

“…On the other hand, poorer cognition and the subsequent perception of cognitive decline and fear of loss of function may predict symptoms of depression and anxiety (Hill et al, 2016;Kessler et al, 2012;Mol et al, 2008). If this is the case, promoting the acceptance of age-related cognitive changes (Hahn & Lachman, 2015;Huntley et al, 2017;Sabatini et al, 2020Sabatini et al, , 2020aSabatini et al, , 2021, boosting positive effects, decreasing negative effects (Crane et al, 2007), and consultation with health professionals (Hill et al, 2016) may all be potential strategies to reduce SCD and SMD. Alternatively, SCD, SMD, depression and anxiety may all be caused by other factors; for instance, they may both be the consequence of cognitive decline and of neurodegenerative processes.…”

“…Finally, whereas some studies explored whether SCD predicts current cognitive functioning, others explored the predictive role of SCD for future cognitive functioning (Jessen et al, 2014;Jonker et al, 2000;Mendonça et al, 2016;Sabatini et al, 2021). Exploring whether SCD predicts future objective cognitive decline may be the preferred approach, especially with respect to testing the potential use of SCD to identify those individuals at higher risk of cognitive decline.…”

Differences In Awareness of Positive And Negative Age-Related Changes Account For Variability In Health Outcomes

“…The better physical and mental health, and cognitive functioning in the group experiencing many gains and few losses extends literature reporting the separate associations between more AARC gains and better physical and mental health and between fewer AARC losses and better physical and mental health, and cognitive functioning (Sabatini et al, 2020a;Sabatini et al, 2021a). The class having "many gains and few losses" had better physical and mental health, and cognitive functioning than the class experiencing "moderate gains and few losses," suggesting that the presence of gains may be related to higher levels of physical and mental health, and cognitive functioning.…”

“…Finally, higher levels of AARC losses across the ve AARC life domains are correlated with worse cognitive performance (Sabatini et al, 2021a;Zhu and Neupert, 2020). Only one cross-sectional study found that higher levels of AARC gains are related to poorer cognitive performance; however, associations were small to negligible (Sabatini et al, 2021a). As health is more strongly associated with AARC losses than AARC gains (Sabatini et al, 2020a), individuals' current cognitive functioning may be captured by perceived losses, irrespective of the coexistence of perceived gains.…”

“…Finally, higher levels of AARC losses across the ve AARC life domains are correlated with worse cognitive performance (Sabatini et al, 2021a;Zhu and Neupert, 2020). Only one cross-sectional study found that higher levels of AARC gains are related to poorer cognitive performance; however, associations were small to negligible (Sabatini et al, 2021a).…”