Metacognitive Differences in Amnestic Mild Cognitive Impairment and Healthy Cognition: A Cross-Sectional Study Employing Online Measures

Abstract

This study aimed to examine metacognitive abilities in individuals diagnosed with amnestic mild cognitive impairment (aMCI) by using online metacognitive measures during cognitive tasks. A total of 100 participants were enrolled, all aged 50 or older (mean age = 61.98; SD = 6.27), and with a minimum of six years of education (mean = 14.95; SD = 2.94). The sample included 50 individuals with aMCI (34 females) and 50 healthy controls (HC) (33 females). Both groups underwent metacognitive versions of memory tasks (Doors and People) and executive functions tasks (Wisconsin Card Sorting Test). Metacognition was assessed through confidence ratings given after each answer (referred to as metacognitive monitoring) and the accuracy of the participants’ decisions to include or exclude answers from their final scores (known as metacognitive control). The results showed that although individuals with aMCI were aware of their cognitive limitations—evidenced by their lower confidence ratings across all tasks—they still exhibited overconfidence relative to their actual performance. Moreover, they included a greater number of incorrect answers in their final scores compared to the healthy control group. These findings suggest that while individuals with aMCI retain some level of awareness, their self-evaluations appear to lack precision. This observation was consistent across both types of cognitive tasks. The results underscore the need for additional research to better understand metacognition in MCI as well as the interplay between metacognitive monitoring and control.

The Efficacy of a Metacognitive Training Program in Amnestic Mild Cognitive Impairment: A 6-Month Follow-Up Clinical Study

“…Yet, compared to cognitively healthy older adults, they display less accuracy when monitoring their performance during task engagement [23][24][25][26]. Accordingly, in a previous work by our team, we found that people with MCI although they were aware of their struggles during task engagement, as reflected by their confidence ratings, they were less accurate in their decisions to choose between wrong and right responses compared to cognitively healthy individuals [27]. Further, previous evidence about the difficulties that people with MCI have with prospective and not retrospective memory self-monitoring abilities [23] shows the need for training specific aspects of metamemory in MCI.…”

Metacognitive beliefs of efficacy about daily life situations and use of cognitive strategies in amnestic mild cognitive impairment: a cross-sectional study

“…It is important to note that this study is part of a broader project wherein participants underwent supplementary neuropsychological tests. The differences in cognitive performance between the two groups based on these scores are detailed in another publication by our team ( Bampa et al, 2023 ). The neuropsychological assessment included a variety of tools: The Geriatric Depression Scale ( Yesavage et al, 1982 ; Fountoulakis et al, 1999 ), the Beck Depression Inventory ( Beck et al, 1961 ), the Beck Anxiety Inventory ( Beck et al, 1988 ), and the Short Anxiety Screening ( Sinoff et al, 1999 ; Grammatikopoulos et al, 2010 ) were implemented to rule out affective disorders.…”

Metacognitive Awareness of Older Adult Drivers with Mild Cognitive Impairment: Relationships with Demographics, Subjective Evaluation of Cognition, and Driving Self-Efficacy

“…The extensive neuropsychological damage and progressive cerebral atrophy that characterize MCI may lead to inaccurate recognition of deficits, with the loss of awareness marking a transitional point from MCI to dementia [ 30 ]. The inability to metacognitively assess abilities decreases even from the initial stages, reaching a percentage up to 60%, with the individuals underreporting or even distorting their symptoms, highlighting a gap between metacognitive self-awareness and accurate self-evaluation [ 18 , 31 ]. A similar study found that 23% of drivers with MCI had reduced metacognitive awareness of their deficiencies [ 32 ].…”