Self-reported cognitive inconsistency in older adults.

Insight into one's own cognitive abilities, or metacognition, has been widely studied in developmental psychology. Relevance to the clinician is high, as memory complaints in older adults show an association with impending dementia, even after controlling for likely confounds. Another candidate marker of impending dementia under study is inconsistency in cognitive performance over short time intervals. Although there has been a recent proliferation of studies of cognitive inconsistency in older adults, to date, no one has examined adults' self-perceptions of cognitive inconsistency. Ninety-four community-dwelling older adults (aged 70-91) were randomly selected from a parent longitudinal study of short-term inconsistency and long-term cognitive change in aging. Participants completed a novel 40-item self-report measure of everyday cognitive inconsistency, including parallel scales indexing perceived inconsistency 5 years ago and at present, yielding measures of past, present, and 5-year change in inconsistency. The questionnaire showed acceptable psychometric characteristics. The sample reported an increase in perceived inconsistency over time. Higher reported present inconsistency and greater 5-year increase in inconsistency were associated with noncognitive (e.g., older age, poorer ADLs, poorer health, higher depression), metacognitive (e.g., poorer self-rated memory) and neuropsychological (e.g., poorer performance and greater 5-year decline in global cognitive status, vocabulary, and memory) measures. Correlations between self-reported inconsistency and neuropsychological performance were attenuated, but largely persisted when self-rated memory and age were controlled. Observed relationships between self-reported inconsistency and measures of neuropsychological (including memory) status and decline suggest that self-perceived inconsistency may be an area of relevance in evaluating older adults for memory disorders.