Biopsychosocial Factors Facilitating or Compromising Momentary Cognitive Performance in Everyday Environments

ImportanceOccupational therapy practitioners often assist a range of clients (e.g., people with schizophrenia, older adults, students, etc.) by addressing their cognitive functioning so they can engage in daily tasks. Thus, a better research-based understanding of real-time biopsychosocial factors that can impact everyday cognitive performance in real life can be useful. Ambulatory cognitive assessments are administered in people's natural environments, making them better suited compared to traditional formal cognitive tests for understanding factors that can impact cognitive performance in real life.ObjectiveTo examine how a range of biopsychosocial factors impact cognitive performance in real life as assessed by eight smartphone-based ambulatory cognitive tests and passively recorded survey response times.DesignSmartphone-based cognitive tests and surveys were completed daily by participants over 10 days. Associations between each cognitive test and biopsychosocial factor were examined in separate multilevel regression models.ParticipantsA total of 393 U.S. adults.MeasuresThe eight cognitive measures covered the domains of processing speed, working memory, recognition memory, and executive functioning. Biopsychosocial factors considered were distractors, prior activity, substances just taken, and psychological state.ResultsCognitive performance was better when participants reported no distractions, were alone, were more focused, had higher levels of energy or excitement, and had greater happiness.Conclusions and RelevanceUnderstanding how biopsychosocial factors affect cognitive performance may assist occupational therapy practitioners and other healthcare professionals in helping clients more deliberately adjust situations to facilitate cognitive performance when needed (e.g., for job tasks, exams, following instructions to take medications, etc.).