Clinical Manifestations.

Area of Science:

• Gerontology
• Cognitive Neuroscience
• Psychology

Background:

• Ecological momentary assessment (EMA) is a valuable tool for assessing subjective cognitive concerns (SCCs) without relying on memory recall.
• Elevated SCCs are linked to an increased risk of cognitive decline, yet research on joint trajectories of SCCs and cognitive function is limited.

Purpose of the Study:

• To investigate the associations between longitudinal trajectories of subjective cognitive concerns (SCCs) and cognitive function using smartphone-based EMA.
• To explore how different patterns of SCCs relate to changes in telephone Montreal Cognitive Assessment (T-MoCA) scores in older adults.

Main Methods:

• Utilized smartphone-based EMA for daily SCC reporting over 14 days and annual T-MoCA assessments in 219 community-dwelling older adults.
• Employed latent class linear mixed-effects models to identify SCC trajectories, adjusting for demographic and clinical factors.
• Analyzed T-MoCA trajectories across SCC groups using linear mixed-effects models with piecewise splines to account for learning effects.

Main Results:

• Identified two SCC trajectory groups: one with consistently low SCCs and another with increasing SCCs.
• No baseline T-MoCA differences were observed between groups, but the increasing SCC group showed declining T-MoCA scores after three years, unlike the low SCC group.

Conclusions:

• Longitudinal trajectories of subjective cognitive concerns are associated with distinct cognitive performance trajectories.
• Increasing SCCs may serve as a predictor of future declines in objective cognitive function.