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Area of Science:

  • Gerontology
  • Cognitive Neuroscience
  • Digital Health

Background:

  • Ecological momentary assessment (EMA) is increasingly used for subjective cognitive concerns (SCCs).
  • Elevated SCCs are linked to higher risks of cognitive decline.
  • Little research has explored joint longitudinal trajectories of SCCs and cognitive function.

Purpose of the Study:

  • To explore associations between SCC trajectories and cognitive function trajectories using smartphone-based EMA.
  • To examine cognitive performance changes in relation to self-perceived cognitive difficulties over time.

Main Methods:

  • 219 community-dwelling older adults (mean age 77.5) participated.
  • Smartphone-based EMA assessed daily SCCs for 14 days, with annual follow-ups (2017-2022).
  • Latent class linear mixed-effects models analyzed SCC trajectories and telephone Montreal Cognitive Assessment (T-MoCA) scores.

Main Results:

  • Two SCC trajectory groups were identified: consistently low SCCs (N=199) and increasing SCCs (N=15).
  • No baseline T-MoCA differences were observed between groups.
  • The increasing SCC group showed declining T-MoCA scores after three years, unlike the low SCC group.

Conclusions:

  • Longitudinal SCC trajectories correlate with distinct cognitive trajectories.
  • Increasing subjective cognitive concerns may predict future declines in objective cognitive performance.