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DOI: 10.1002/alz.091748
CLINICAL MANIFESTATIONS
POSTER PRESENTATION
NEUROPSYCHOLOGY
A Model of Subjective Cognition in Older Adults:
Correspondence of cognitive complaints with wellbeing, mood
symptoms, and cognitive performance
Shana D. Stites1Carolyn Kuz2Camilla Van Geen2Bob Scavilla3
Joesph Kable2Sarah Barber4
1Department of Psychiatry, PerelmanSchool
of Medicine, University of Pennsylvania,
Philadelphia, PA, USA
2University of Pennsylvania, Philadelphia, PA,
USA
3Fourfront, LLC, Philadelphia, PA, USA
4Georgia State University, Atlanta, GA, USA
Correspondence
Shana D. Stites, Department of Psychiatry,
Perelman School of Medicine, University of
Pennsylvania, Philadelphia, PA, USA.
Email: stites@pennmedicine.upenn.edu
Abstract
Background: Beginning new Alzheimer’s disease (AD) treatments before AD
symptoms are prominent would optimize the benefits of these disease slowing
treatments. To accomplish this goal, clinicians must identify measures of early disease
progression. As a step in doing this, we set out to characterize the relationships
between cognitive complaints, wellbeing, cognitive performance, and metacognitive
calibration in older adults in order to inform a model of cognition in typical older adults.
Method: Sample of 344 adults aged 65+completed an online task. Cognitive complaints
were assessed with 7 domains on the Memory Function Questionnaire (MFQ).
Wellbeing was measured with ratings of overall wellbeing, health, satisfaction with daily
life, anxiety, depression, and Future Time Perspective (FTP) scale. Cognitive performance
was captured through reaction times and accuracy on Forward and Backward Digit
Span (DS) tasks and accuracy on a Dot Matrix Task (DMT). Participants provided
confidence ratings before and after the DMT. Metacognitive calibration (MCC) was
operationalized as the difference between trial accuracy reaction time and global post-
DMT confidence ratings. Results reported are statistically significant at P<0.05 unless
otherwise stated.
Results: Fewer cognitive complains, as indicated by higher reports on all 7 MFQ
domains, were associated with better health, wellbeing, and satisfaction with daily life.
Most domains (6 of 7) were associated with more expansive FTP, higher anxiety (5 of
7), lower depressive symptoms (7 of 7), higher post-task confidence (4 of 7), and better
MCC (4 of 7). For 89% of participants, confidence ratings either decreased or remained
unchanged from before to after the DMT;in the full multivariable model, the group that
had confidence increase after the DMT showed lower accuracy (logit =-3.71, 95%CI -
5.80, -1.61). In the full multivariable model, the group with low MCC (more confident
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© 2024 The Alzheimer’s Association. Alzheimer’s & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer’s Association.
Alzheimer’s Dement. 2024;20(Suppl. 3):e091748. wileyonlinelibrary.com/journal/alz 1of2
https://doi.org/10.1002/alz.091748
2of2 CLINICAL MANIFESTATIONS
than quick) demonstrated worse DMT accuracy (logit =-1.91, 95%CI -3.37, -0.45) and
worse backward DS performance (logit =0.25, 95%CI -0.04, 0.54, p =0.09) compared
to the typical MCC group (confidence∼reaction time).
Conclusion: Cognitive complaints, wellbeing, cognitive performance, post-task
appraisals of confidence in task accuracy, and the consistency between perceptions
and performance (metacognition) are useful constructs for informing a model of
subjective cognition in typical older adults.