Hypersensitivity to uncertainty is key feature of subjective cognitive impairment

With an increasingly ageing global population, more people are presenting with concerns about their cognitive function, but not all have an underlying neurodegenerative diagnosis. Subjective cognitive impairment (SCI) is a common condition describing self-reported deficits in cognition without objective evidence of cognitive impairment. Many individuals with SCI suffer from depression and anxiety, which have been hypothesised to account for their cognitive complaints. Despite this association between SCI and affective features, the cognitive and brain mechanisms underlying SCI are poorly understood. Here, we show that people with SCI are hypersensitive to uncertainty and that this might be a key mechanism accounting for their affective burden. Twenty-seven individuals with SCI performed an information sampling task, where they could actively gather information prior to decisions. Across different conditions, SCI participants sampled faster and obtained more information than matched controls to resolve uncertainty. Remarkably, despite their "urgent" sampling behaviour, SCI participants were able to maintain their efficiency. Hypersensitivity to uncertainty indexed by this sampling behaviour correlated with the severity of affective burden including depression and anxiety. Analysis of MRI resting functional connectivity revealed that both uncertainty hypersensitivity and affective burden were associated with stronger insular-hippocampal connectivity. These results suggest that altered uncertainty processing is a key mechanism underlying the psycho-cognitive manifestations in SCI and implicate a specific brain network target for future treatment.

Dementia-Free Older Adults with Subjective Cognitive Impairment Show Lower Mood and No Deficits of Spontaneous Memory Retrieval

The aim of the present study was to investigate whether spontaneous retrieval deficits could be found in individuals with Subjective Cognitive Impairment (SCI). The sample consisted of 52 participants over 65 years of age (mean age = 76.00; SD = 7.48) with 11 males. We asked 26 individuals with SCI and 26 individuals without SCI to perform a prospective memory (PM) task that had previously demonstrated spontaneous retrieval deficits in individuals with Mild Cognitive Impairment. The results did not demonstrate the expected differences in a PM task based on spontaneous retrieval [ t(50) = −.05; p = .964, d = .01]. However, participants’ mood did predict their subjective memory complaints ( β = −.51; p < .001) and their subjective assessment of their future memory performance ( r = −.38; p < .01). The findings are in line with numerous studies which have shown that SCI is more related to mood disturbance than to objective cognitive functioning.

The Impact of Preeclampsia on Work-Related Psychosocial Aspects and Need for Recovery

Women with a history of preeclampsia and/or Hemolysis Elevated Liver enzymes Low Platelets (HELLP) syndrome report impaired cognitive functioning, such as concentration problems and decreased memory function. The presence of subjective cognitive impairment, depressive symptoms and cognitive deficits may affect working abilities.

Influencing Factors of Subjective Cognitive Impairment in Middle-Aged and Older Adults

The purpose of this study was to identify the factors affecting subjective cognitive impairment. We analyzed data from the 2019 Korea Community Health Survey and enrolled 68,546 middle-aged adults, aged 50 to 64 years, and 74,547 older adults, aged 65 years and older, in this study. Multiple logistic regression analysis was performed to identify factors influencing subjective cognitive impairment. Of the participants, 11,926 (17.4%) middle-aged and 21,880 (29.4%) older adults living in the community reported subjective cognitive impairment. Major factors that influenced subjective cognitive impairment in both middle-aged and older adults were gender, subjective stress, depressive symptoms, and alcohol drinking. In contrast to middle-aged adults, the marital status of older adults affected subjective cognitive impairment. Therefore, the factors affecting subjective cognitive impairment in middle-aged and older adults need to be considered for screening and management to prevent cognitive impairment and dementia. In particular, it is necessary to evaluate and manage stress and depressive symptoms from middle age to prevent subjective cognitive impairment.

Disparities in Subjective Cognitive Impairment by Sexual Orientation and Gender in a National Population Based Study of U.S. Adults, 2013–2018

Objectives: This is the first national population-based study to examine cognitive impairment disparities among sexual minority mid-life and older adults. Methods: Using the National Health Interview Survey (2013–2018), we compared weighted prevalence of subjective cognitive impairment by sexual orientation and gender, among those aged 45 plus, applying logistic regressions adjusting for age, income, education, race/ethnicity, and survey years. Results: Sexual minorities (24.5%) were more likely to have subjective cognitive impairment than heterosexuals (19.1%). Sexual minority women had higher odds of greater severity, frequency, and extent of subjective cognitive impairment. Sexual minorities were also more likely to report activity limitations resulting from cognitive impairment and were no more likely to attribute limitations to dementia or senility. Discussion: Cognitive health disparities are of particular concern in this historically and socially marginalized population. The investigation of explanatory factors is needed, and targeted interventions and policies are warranted to address cognitive challenges faced by sexual minorities.

Subjective cognitive impairment and presenteeism mediate the associations of rumination with subjective well-being and ill-being in Japanese adult workers from the community

Background In recent years, the roles of rumination, subjective cognitive impairment (SCI), and presenteeism have been emphasized in occupational mental health. However, associations between rumination, SCI, presenteeism, and psychological well-being are not fully understood. We hypothesized that SCI and presenteeism mediate the associations between rumination and subjective well-being (SWB) and subjective ill-being (SIB). Hence, we investigated the mediating roles of SCI and presenteeism in this study. Methods A total of 458 adult workers (mean age, 40.8±11.9 years; 44.1% male), who were recruited in Tokyo using convenience sampling, were analyzed in this study. The Ruminative Responses Scale, Cognitive Complaints in Bipolar Disorder Rating Assessment, Work Limitations Questionnaire 8, and Subjective Well-being Inventory were used to evaluate rumination, SCI, presenteeism, and psychological well-being (SWB and SIB), respectively. Path analyses were performed to evaluate the relations between these parameters. Results The path analysis indicated that rumination, SCI, and presenteeism were directly and negatively associated with SWB and SIB. Regarding indirect effects, rumination was negatively associated with SWB and SIB via SCI, presenteeism, and both SCI and presenteeism. Furthermore, SCI was negatively associated with SWB and SIB via presenteeism. Conclusions The results suggest that SCI and presenteeism mediate the associations of rumination with SWB and SIB in Japanese adult workers. To address the psychological well-being associated with rumination, evaluating SCI and presenteeism simultaneously may be useful in occupational mental health. This study provides key insights into the development of comprehensive intervention strategy based on the biopsychosocial perspective for worker’s psychological well-being.

Subjective cognitive impairment —more questions than answers

The article is devoted to the actual problem of subjective cognitive impairment, in particular, diagnostic methods, as well as hidden and obvious factors affecting its development. Due to the lack of effective treatment, today special attention is paid to pre-demental cognitive disorders. Aim. Analysis of available literature data on subjective cognitive impairment. Material and methods. Various sources were considered during conducting a literature review on the selected topic. The search depth was more than 15 years. Russian and foreign sources were studied on Internet platforms such as Web of science, UpToDate, PubMed, CyberLeninka, Medscape for selection of literature. Results. According to the studied data, the prevalence of subjective cognitive impairment is quite high in the population, but diagnosis remains difficult due to the lack of susceptible and unified tests. International diagnostic criteria for subjective cognitive impairment are described. The article also presents modern ideas about the obvious and hidden factors that affect the course and prognosis of this state. The possibility of early diagnosis, as one of the most urgent tasks, as well as the methodology of neurocognitive testing are discussed. Conclusion. Subjective cognitive impairment is becoming an increasingly urgent problem every year. In this regard, doctors of various specialties need to focus attention with minimal suspicion of pathology, since at this stage the changes are potentially reversible. There are both explicit and implicit factors that lead to subjective cognitive impairment. Among the hidden factors, the article discusses multitasking, impaired social interaction, gadget addiction, affective disorders, sleep disorders, pain, and COVID-19. For the most effective detection of subjective cognitive disorders, it is necessary to have unified sets of susceptible tests, which are currently under development.

Chemotherapy-related subjective cognitive impairment in breast cancer patients in semi-rural South Africa

Background: Breast cancer is the most commonly diagnosed cancer amongst women worldwide. Whilst current evidence indicates the therapeutic benefits from the use of chemotherapy, self-perceived cognitive difficulties emerged as a frequent occurrence during and after chemotherapy treatment in breast cancer patients.Aim: The current study sought to investigate self-perceived cognitive impairment in a group of breast cancer patients in semi-rural South Africa.Setting: The patients were recruited from an outpatient oncology clinic at a semi-rural, tertiary academic hospital in Gauteng, South Africa.Methods: In a randomised, quantitative, time-based series study, 30 female patients aged 21–60 years (mean age = 50 years) diagnosed with stages II and III breast cancer on CMF (cyclophosphamide, methotrexate, fluorouracil) (n = 10) and FAC (fluorouracil, adriamycin, cyclophosphamide) (n = 20) chemotherapy regimens, completed the self-reported Functional Assessment of Cancer Therapy-Cognition (Fact-Cog) test as a measure of subjective cognitive functioning at three points during the course of treatment (T0, T1, T2).Results: The results of the paired sample t-tests showed the scores on the Fact-Cog test confirmed significant cognitive decline for both treatment groups from baseline (T0) to completion (T2) of chemotherapy; CMF group, t (9) = 2.91, p = 0.017 and the FAC group t (19) = 4.66, p 0.001.Conclusion: This study confirms that self-reported subjective cognitive impairment is common in breast cancer patients who received chemotherapy in a sample of South African patients. The results have implications for the overall care of cancer patients.Contribution: The context-based knowledge engendered by the current study is expected to augment the continuum of care for breast cancer patients.

Altered Functional Connectivity of the Basal Nucleus of Meynert in Subjective Cognitive Impairment, Early Mild Cognitive Impairment, and Late Mild Cognitive Impairment

Background: The spectrum of early Alzheimer's disease (AD) is thought to include subjective cognitive impairment, early mild cognitive impairment (eMCI), and late mild cognitive impairment (lMCI). Choline dysfunction affects the early progression of AD, in which the basal nucleus of Meynert (BNM) is primarily responsible for cortical cholinergic innervation. The aims of this study were to determine the abnormal patterns of BNM-functional connectivity (BNM-FC) in the preclinical AD spectrum (SCD, eMCI, and lMCI) and further explore the relationships between these alterations and neuropsychological measures.Methods: Resting-state functional magnetic resonance imaging (rs-fMRI) was used to investigate FC based on a seed mask (BNM mask) in 28 healthy controls (HC), 30 SCD, 24 eMCI, and 25 lMCI patients. Furthermore, the relationship between altered FC and neurocognitive performance was examined by a correlation analysis. The receiver operating characteristic (ROC) curve of abnormal BNM-FC was used to specifically determine the classification ability to differentiate the early AD disease spectrum relative to HC (SCD and HC, eMCI and HC, lMCI and HC) and pairs of groups in the AD disease spectrum (eMCI and SCD, lMCI and SCD, eMCI and lMCI).Results: Compared with HC, SCD patients showed increased FC in the bilateral SMA and decreased FC in the bilateral cerebellum and middle frontal gyrus (MFG), eMCI patients showed significantly decreased FC in the bilateral precuneus, and lMCI individuals showed decreased FC in the right lingual gyrus. Compared with the SCD group, the eMCI group showed decreased FC in the right superior frontal gyrus (SFG), while the lMCI group showed decreased FC in the left middle temporal gyrus (MTG). Compared with the eMCI group, the lMCI group showed decreased FC in the right hippocampus. Interestingly, abnormal FC was associated with certain cognitive domains and functions including episodic memory, executive function, information processing speed, and visuospatial function in the disease groups. BNM-FC of SFG in distinguishing eMCI from SCD; BNM-FC of MTG in distinguishing lMCI from SCD; BNM-FC of the MTG, hippocampus, and cerebellum in distinguishing SCD from HC; and BNM-FC of the hippocampus and MFG in distinguishing eMCI from lMCI have high sensitivity and specificity.Conclusions: The abnormal BNM-FC patterns can characterize the early disease spectrum of AD (SCD, eMCI, and lMCI) and are closely related to the cognitive domains. These new and reliable findings will provide a new perspective in identifying the early disease spectrum of AD and further strengthen the role of cholinergic theory in AD.