Assessing Error Awareness as a Mediator of the Relationship between Subjective Concerns and Cognitive Performance in Older Adults

Abstract

ObjectivesSubjective concerns of cognitive decline (SCD) often manifest in older adults who exhibit objectively normal cognitive functioning. This subjective-objective discrepancy is counter-intuitive when mounting evidence suggests that subjective concerns relate to future clinical progression to Alzheimer’s disease, and so possess the potential to be a sensitive early behavioural marker of disease. In the current study, we aimed to determine whether individual variability in conscious awareness of errors in daily life might mediate this subjective-objective relationship.Methods67 cognitively-normal older adults underwent cognitive, SCD and mood tests, and an error awareness task.ResultsPoorer error awareness was not found to mediate a relationship between SCD and objective performance. Furthermore, non-clinical levels of depressive symptomatology were a primary driving factor of SCD and error awareness, and significantly mediated a relationship between the two.DiscussionWe were unable to show that poorer error awareness mediates SCD and cognitive performance in older adults. Our study does suggest, however, that underlying depressive symptoms influence both poorer error awareness and greater SCD severity. Error awareness is thus not recommended as a proxy for SCD, as reduced levels of error awareness do not seem to be reflected by greater SCD.

Cognitive complaints in neuropsychologically normal adults: A brief report on the roles of childhood abuse and rumination.

“…Unlike previous research connecting depression to SCC (Buckley, Laming, Chen, Crole, & Hester, 2016), the present study highlights rumination as particularly relevant for SCC. To this end, we also considered symptoms of depression and PTSD, and our data support that the relationships observed here are not due to these constructs alone.…”

Is subjective memory specific for memory performance or general across cognitive domains? Findings from the Seattle Longitudinal Study.

“…In line with previous research; younger participants, the more educated, and those with fewer depressive symptoms reported less frequent forgetting (e.g., Buckley et al, 2016; Gilewski et al, 1990; Hülür et al, 2014; for an overview, see Hertzog & Pearman, 2014). Notably, the associations between these variables and subjective memory were comparable in magnitude to associations between subjective memory and memory performance.…”

“…If subjective memory ratings have discriminant validity for memory performance, subjective memory should be more closely associated with memory performance than with other variables (Hülür & Gerstorf, 2015). So far, such studies of discriminant validity of subjective memory ratings have found that subjective memory ratings are as closely or even more closely associated with variables other than memory, such as depressive symptoms (e.g., Buckley, Laming, Chen, Crole, & Hester, 2016; Crane, Bogner, Brown, & Gallo, 2007; O’Shea et al, 2016), health (Montejo Carrasco, Montenegro-Pena, Lopez-Higes, & Borja, 2016; Rickenbach, Agrigoroaei, & Lachman, 2015) or personality (e.g., Pearman & Storandt, 2005; Steinberg et al, 2013).…”

Translational aspects of the multidisciplinary study of metacognition.

“…More recently, the translational utility of metacognitive experimental tasks has become evident in the context of subjective cognitive decline (SCD)—a “pre-clinical” state receiving growing attention as a potential harbinger to the objective cognitive symptoms that occur in mild cognitive impairment and later in dementia (Buckley, Laming, Chen, Crole, & Hester, 2016; Cosentino et al, 2018). SCD is characterized by the subjective perception that one’s cognition has declined prior to objective evidence of such decline on diagnostic testing (Jessen et al, 2014).…”

“…Determining the integrity of metamemory among individuals with SCD may thus shed important light on its utility as a marker of preclinical AD. Indeed, recent work is attempting to use metamemory frameworks to investigate whether deficits in lower levels of awareness mediate how SCD maps onto objective cognition (Buckley et al, 2016; Cosentino et al, 2018). Results from preliminary studies are mixed, and much work is needed to determine how assessing metacognition and integrating it into the conceptualization of SCD can enhance the utility of this potential biomarker.…”