Self-report scale designed to assess subjective cognitive complaints.

BackgroundMotoric cognitive risk syndrome (MCR) is a pre‐dementia syndrome characterized by the presence of slow gait and cognitive complaints in non‐demented patients. Self‐reported subjective cognitive complaints (SCCs) have been shown to be harbingers of future cognitive decline. Likewise, subjective motoric complaints (SMC) are common with aging, and predict risk for future gait decline. Subjective complaints might have utility in screening and remote assessments. Our objective was to examine the validity of a subjective definition of MCR (presence of subjective motoric AND cognitive complaints) for predicting incident MCR defined using objective gait speed.MethodsFive SMC and 8 SCC questions (independent of the SCCs used in the objective MCR definition) were assessed in a sample of 501 non‐demented community‐dwelling adults age 65 and older. Cox proportional hazard models adjusted for age, sex, education, comorbidities and a test of global cognitive function were used to examine the association between subjective MCR (presence of SMC and SCC) and risk of incident objective MCR (defined as slow gait 1 standard deviation below age and sex means and SCC).ResultsAt baseline, 360 participants (71.1%) reported one or more subjective motoric complaints and 368 (72.7%) reported one or more SCCs. Two‐hundred seventy‐nine participants (55.1%) reported the presence of one or more of both SMC and SCCs (subjective MCR). Participants with subjective MCR were older (77.9 vs. 74.9) and more often female (61.4% vs. 48.4%) than those without subjective MCR. Of the 501 participants, 38 developed objective MCR over a median follow‐up 2.5 years. Subjective MCR was associated with increased risk of developing objective MCR (adjusted hazard ratio (aHR): 3.88, 95% Confidence Interval (CI): 1.58‐9.51). When subjective MCR was defined as the presence of 2 or more SMC and SCC, the association with objective MCR was stronger (aHR: 4.78, 95% CI: 2.45‐9.33).ConclusionsSubjectively defined MCR is associated with increased risk of incident MCR. Remote identification of people at high‐risk for MCR has potential for clinical and research applications especially given the social isolation imposed by the Covid‐19 pandemic.

Although cognitive deficits are frequent in multiple sclerosis (MS), screening for them with tools such as the Montreal Cognitive Assessment (MoCA) test is usually not performed unless there is a subjective complaint. The Multiple Sclerosis Neuropsychological Questionnaire (MSNQ) is among the instruments most commonly used to assess self-reported subjective complaints in MS. Nonetheless, it does not always accurately reflect cognitive status; many patients with cognitive deficits thus fail to receive appropriate referral for detailed neuropsychological evaluation. The objective of this study was to examine the validity of the MoCA test to detect the presence of objective cognitive deficits among patients with MS without subjective complaints using the Minimal Assessment of Cognitive Function in MS (MACFIMS) as the gold standard. The sample included 98 patients who were recruited from a university hospital MS clinic. The MSNQ was used to select patients without subjective cognitive complaints who also completed the MACFIMS, MoCA test and MSQOL-54. 23.5% of patients without subjective cognitive complaints had evidence of objective cognitive impairment on the MACFIMS (z score < -1.5 on two or more tests). The MoCA had a sensitivity of 87% and a specificity of 68% for detecting objective cognitive impairment in this patient population using a cut-off score of 27. A significant proportion of patients without self-reported cognitive impairment do have evidence of cognitive deficits on more exhaustive cognitive assessment. The MoCA is a rapid screening test that could be used to target patients for whom a more detailed neuropsychological assessment would be recommended.

Neural basis of fatigue in post-COVID syndrome and relationships with cognitive complaints and cognition

Neuropsychological dysfunction in chronic fatigue syndrome and the relation between objective and subjective findings.

Introduction. With the increase in cognitive impairment among young people, it is important to timely identify and modify risk factors.The aim of the study was to evaluate early cognitive disorders in relationship with subjective hearing disorders, burnout syndrome, and depression among middle-aged women.Methods. The study involved 310 women aged 26 to 59 years (M=38.6). An online survey was created. Respondents filled in the Cognitive Failures Questionnaire (CFQ), Subjective Cognitive Complaints (SCCs) questionnaire, Shirom-Melamed Burnout Measure (SMBM), and Geriatric Depression Scale (GDS). Sociodemographic factors, addictions, subjectively reported presence of chronic diseases, and subjective hearing disorders were registered by the study questionnaire. Student’s t-test, Chi-square test, Fisher’s exact test, and logistic regression analysis (LRA) were used for data analysis.Results. 34 females (11%) had subjective cognitive failures (CF+ group) and 276 (89%) had not (CF- group). 28.7% of respondents had subjective cognitive complaints (SCC+ group) and 71.3% had not (SCC- group). 23 females (7.4%) had depression and 62 females (20%) were likely to be depressed. 34 (11%) females had significant symptoms of burnout. 30.6% (N=95) self-reported having chronic diseases. 14.84% of females had subjective hearing disorders. The CF+ group had higher GDS scores than the CF- group (M=6.88 vs. M=3.78, p&lt;0.001). Hypothyroidism was the only disease in which differences between the SCC+ and the SCC- groups were found (12.4% vs. 4.5%, p=0.022). Respondents in the CF+ group more often had subjective hearing disorders compared to the CF- group (35.3% vs. 12.3%, p=0.001). The CF+ and the CF-, also the SCC+ and the SCC- groups did not differ by comparing alcohol and drug consumption habits.Conclusions. Depression, burnout syndrome, and subjective hearing disorders are related to subjective experienced cognitive dysfunction, and cognitive complaints are related to hypothyroidism in middle-aged women.

Subjective Cognitive Complaints, Affective Distress, and Objective Cognitive Performance in Persian Gulf War Veterans

Introduction Subjective cognitive complaints (SCC) are associated with future cognitive decline and increased risk of dementia among adults and older adults. Sedentary lifestyle and poor sleep are risk factors for dementia with a complex association with SCC. However, there are limited explorations of sex differences in the interaction between sleep and SCC. Likewise, physical activity’s [PA] effect on this association is poorly understood. The current analysis examined whether PA moderated the relationship between SCC and sleep and if this relationship was further moderated by sex (i.e., 3-way interaction). Methods Adults (N=732, Mage=59.80, 53%-female) reported their average sleep quality, sleep onset latency, and total sleep time over the past month using the Pittsburgh Sleep Quality Index (PSQI) as part of online data collection study. They also completed the International Physical Activity Questionnaire (total weekly minutes; proxy for PA) and Everyday Memory Questionnaire-20-Item Revised (EMQ; total score; proxy for SCC). SPSS PROCESS evaluated interactions between sex, SCC, and PA on sleep, controlling for age, race, and educational attainment. Results PA moderated the relationship between SCC and sleep quality for males [F(1,337)=4.65, p=.032], such that less PA was associated with worse sleep quality for men with lowest SCC (t=7.06, p&amp;lt;.001), intermediate SCC (t=7.15, p&amp;lt;.001), and highest SCC (t=6.45, p&amp;lt;.001). PA moderated the relationship between SCC and sleep quality for females [F(1,318)=4.50, p=.035], such that greater PA was associated with worse sleep quality for women with lowest SCC (t=5.41, p&amp;lt;.001), intermediate SCC (t=6.64, p&amp;lt;.001), and highest SCC (t=8.10, p&amp;lt;.001). A 3-way interaction (PA x SCC x sex) occurred for sleep quality [F(1,721)=9.30, p=.002]. Conclusion In a community sample of adults, poor sleep quality was associated with greater subjective cognitive complaints, with physical activity moderating the association differently between males and females. Differences in social factors (socioeconomic, lifestyle, responsibilities at home) could explain the sex differences. Behavioral sleep interventions may benefit from addressing and optimizing the ideal level of physical activity, which may differ for men and women. Longitudinal data and objective measures of sleep will be imperative to understand this complex relationship and inform interventions. Support (if any) Support: TRIUMPH University of Missouri (McCrae, PI)

Subjective cognitive complaints (SCC) are frequent in elderly populations. PD patients report SCC more often than healthy controls. The association between SCC, objective cognitive impairment and affective symptoms remains controversial. We assessed consecutive PD patients between March 2014 and March 2015. Presence of SCC was defined as a score ≥ 1 in the Non-Motor Symptom Assessment Scale for Parkinson's Disease (NMSS) Domain 5. MoCA was used for cognitive impairment assessment. Pill Questionnaire measured the impact in daily activities. PD with Dementia (PDD) and PD with Mild Cognitive Impairment (PDMCI) were defined as the presence of cognitive impairment with or without impact on daily activities. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scales. Significance was set at p < 0.05. From 134 patients, 128 were included. PDD was diagnosed in 21 (16.4%), PDMCI in 31 (24.2%), and 76 (59.4%) had normal cognition (PDCN). SCC were present in 85% of whole cohort and evenly distributed (p = 0.361), PDD (95.2%), PDMCI (83.9%) and PDCN (82.9%). Severity was significantly different between PDD (20.00 ± 10.81), PDMCI (6.54 ± 5.5) and PDCN (6.97 ± 6.98), p < 0.001. A score ≥ 19 had a specificity of 77.3% and a sensitivity of 78.8% for identifying PDD. In PDCN, SCC severity was found to be related to depression (OR 1.23, CI 95% 1.02-1.47, p = 0.026) more than with MoCA scores (OR: 0.86, CI 95% 0.69-1.05, p = 0.141). SCC are common in PD. Their severity can help distinguish PDD from non-demented PD patients. In PDCN, SCC should alert the clinician for an affective disorder.

ObjectiveCognitive deficits are commonly observed after stroke and have been associated with the cognitive decline and development of dementia in later stages. This study aimed to investigate whether cognition screened at acute stroke units could explain subjective cognitive complaints 3 months after stroke and evaluate how the severity of stroke and age could influence this association.MethodsIn this register-based longitudinal study, data were retrieved from three Swedish registers between November 2014 and June 2019. Information on subjective cognitive complaints (SCC) was collected from the Riksstroke 3-month follow-up form, which were used to analyze the primary outcomes. Cognitive function screened using the Montreal Cognitive Assessment (MoCA) at acute stroke units was expressed as the primary independent variable.ResultsOf the 1977 patients included in the study, 58% were males, the median age was 73 years, and 63% had a minor stroke. A total of 60% of patients had impaired cognition at acute stroke units (MoCA score, <26), of whom 40.3% reported at least 1 cognitive problem after 3 months. In adjusted binary regression analysis models, patients with normal cognitive function had lower odds for SCCs. This pattern was observed regardless of age and in patients with a minor stroke.ConclusionsIntact cognition early after stroke was related to decreased odds of subjective cognitive complaints at the 3-month follow-up. This study highlights the importance of both early cognitive screening after stroke and subjective cognitive complaints, which have been shown to be associated with cognitive decline. Furthermore, we suggest the importance of discussing cognitive function with patients during regular follow-up in primary care, usually 3 months after stroke.

Background/Objectives: Depression, anxiety and apathy are often associated with subjective cognitive complaints (SCCs) in people with Parkinson’s disease (PwPD) without cognitive impairment. Cognitive reserve (CR) enhances emotional resilience, allowing people to better cope with stress and emotional challenges, factors affecting quality of life. We aimed to explore the relationship between CR and mood/anxiety in cognitively intact PwPD with and without SCCs. Methods: In this cross-sectional study we enrolled 133 PwPD and normal cognitive function (age 59.8 ± 6.7 years; disease duration 9.0 ± 5.5 years; male/female 84/49). We assessed cognitive reserve (CR scale), subjective cognitive complaints (with PD-CFRS), QoL (PDQ8), mood, anxiety and apathy (BDI-II; STAI, PAS, Apathy scales). We used a t-test to compare groups (with/without SCC; M/F); correlations and moderation analysis to evaluate the relation between CR and behavioral features and the interplay between CR, behavioral discomfort and QoL. Results: The group with SCCs had significantly (p < 0.05) higher scores in PDQ8, Apathy, STAI, PAS-C and BDI-II scales than those with no SCCs. Males with SCCs had higher scores in PDQ8, Apathy scale and BDI-II while females differed in PDQ8 and Apathy scale scores. In the SCC group, late-life CR was negatively correlated with PAS-C (avoidance behavior) and BDI-II; correlations were confirmed in the male group where CR also correlated with PDQ-8 and PAS persistent anxiety. Conclusions: PwPD and SCCs are more depressed and anxious compared to people without SCCs. Furthermore, we found a relationship between depressive symptoms, anxiety and CR: PwPD with SCCs may rely on cognitive reserve to better cope with the feeling of anxiety and depression, especially in male gender.

Subthreshold depression (SubD) is characterized by clinically relevant depressive symptoms not meeting criteria for major depression. The possible association of SubD with subjective cognitive complaints and/or objective cognitive impairments was investigated in a sample of consecutive, non-demented Parkinson's disease (PD) outpatients. Amongst 115 patients, SubD was identified in 30 patients, major depression in 33; 36 patients were classified as non-depressed. Enrolled patients were administered tests and questionnaires validated in PD for assessing objective and subjective cognitive dysfunctions. On objective cognitive measures SubD patients did not differ from non-depressed patients, whereas depressed patients achieved significantly lower scores than the other two groups. SubD and depressed patients reported more cognitive complaints than non-depressed patients. SubD is a non-motor aspect of PD that is not related to objective cognitive deficits but is associated with subjective cognitive complaints, thus impacting on patients' well-being.

Subjective cognitive complaints (SCC) are the earliest symptom of Alzheimer's disease (AD) progression. Increasing evidence shows an association between poor sleep quality and SCC, but the current conclusions regarding the association between poor sleep quality and SCC in older adults are contradictory. Here, we aimed to explore the correlation of SCC with poor sleep quality among older adults without dementia living in nursing home and community in China. A cross-sectional survey on sleep and psychosomatic health of older adults was conducted in Guangdong, China, between November 2020 and March 2021. Socio-demographic, health-related information, psychological factors, sleep quality and SCC of participants were evaluated through a face-to-face interview. A 9-item Subjective Cognitive Decline Questionnaire (SCD-Q9) was used to measure SCC; SCD-Q9>3 was defined as SCC. The Chinese version of the Pittsburgh Sleep Quality Index (PSQI) was used to evaluate sleep quality; PSQI > 7 was defined as poor sleep quality. The relationship between SCC and sleep quality was evaluated using logistics regression analysis. The study involved 730 participants (mean age 74.14±8.246years). The total SCC prevalence was 59.59%. The SCC group had poor sleep quality than the reference group (p<0.05). Adjusted multiple logistic regression analysis revealed an association of poor sleep quality with SCC (OR=1.841; 95% CI, 1.267-2.647; p=0.001) after controlling for age, sex, residence, education level, marital status, income, smoking, alcohol consumption, tea drinking, multimorbidity, waist circumference, napping duration, anxiety symptoms, and depression symptoms. Hierarchical logistics regression analysis showed an association between sleep quality and SCC among community older adults (OR=2.872; 95% CI: 1.787-4.615; p<0.001), but not in nursing home residents (OR=0.845; 95% CI: 0.437-1.637; p=0.619). Poor sleep quality is associated with SCC in community older adults. Therefore, medical staff should take measures, such as earlier cognitive intervention, to postpone cognitive decline in older adults, in the meantime, earlier management and treatment of sleep disorders should be taken into consideration.

Subjective neurocognition and quality of life in patients with bipolar disorder and siblings

A-106 Diagnostic Predictive Utility of Perceived Subjective Cognitive Complaints Measured by Ascertain Dementia 8 (AD8)

Background and purposeThe objective cognitive trajectory in patients with post-stroke subjective cognitive complaints (SCC) over time remained unknown. We investigated cognitive outcomes in patients with SCC within 1 year after stroke, and determined factors associated with cognitive recovery.MethodsThis study included 599 patients with a clinical diagnosis of post-stroke SCC and evidence of cognitive deficits including Clinical Dementia Rating Scale (CDR) = 0.5, Montreal Cognitive Assessment (MoCA) score <26, and Mini–Mental State Examination score >17 (illiterate) or >20 (primary school) or >24 (junior school or above). Neuropsychological assessment was performed at baseline (2 weeks to 6 months after stroke) and 6-month follow-up visit. Cognitive recovery was operationalized as unimpaired cognition (MoCA score ≥26 and CDR = 0) after 6 months. Factors associated with recovery were defined through logistic regression analysis.ResultsAfter 6 months, 583 patients completed the follow-up with 80 (13.72%) presenting cognitive recovery, among which, 22 (9.48%) cases reported SCC within 2 weeks after stroke, six (10%) at 15–30 days, 13 (15.12%) at 31–60 days, 10 (16.13%) at 61–90 days, five (10.42%) at 91–120 days, nine (23.08%) at 121–150 days, and 15 (26.79%) at 151–180 days. Compared to those reported cognitive complaints at 151–180 days after stroke, patients with early post-stroke SCC had poorer cognitive recovery, which was only significant in individuals with high level of education. Male sex, higher baseline MoCA scores, coffee intake and thalamus lesions were independently associated with high chance of cognitive recovery.ConclusionsAlthough post-stroke SCC contributes to persisting objective cognitive deficits, some patients presented cognitive recovery within 1 year after stroke. Patients with a high education level reporting SCC at earlier stage after stroke had poorer cognitive recovery. Male, higher baseline MoCA scores, coffee intake and thalamus lesions appear to independently predict cognitive recovery.