Buckley Rachel F, Laming Gemma, Chen Li Peng Evelyn, Crole Alice, Hester Robert
Florey Institute of Neuroscience and Mental Health, Melbourne, Australia.
Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia.
PLoS One. 2016 Nov 10;11(11):e0166315. doi: 10.1371/journal.pone.0166315. eCollection 2016.
Subjective concerns of cognitive decline (SCD) often manifest in older adults who exhibit objectively normal cognitive functioning. This subjective-objective discrepancy is counter-intuitive when mounting evidence suggests that subjective concerns relate to future clinical progression to Alzheimer's disease, and so possess the potential to be a sensitive early behavioural marker of disease. In the current study, we aimed to determine whether individual variability in conscious awareness of errors in daily life might mediate this subjective-objective relationship.
67 cognitively-normal older adults underwent cognitive, SCD and mood tests, and an error awareness task.
Poorer error awareness was not found to mediate a relationship between SCD and objective performance. Furthermore, non-clinical levels of depressive symptomatology were a primary driving factor of SCD and error awareness, and significantly mediated a relationship between the two.
We were unable to show that poorer error awareness mediates SCD and cognitive performance in older adults. Our study does suggest, however, that underlying depressive symptoms influence both poorer error awareness and greater SCD severity. Error awareness is thus not recommended as a proxy for SCD, as reduced levels of error awareness do not seem to be reflected by greater SCD.
认知能力下降的主观担忧（SCD）常出现在认知功能客观正常的老年人中。当越来越多的证据表明主观担忧与未来发展为阿尔茨海默病的临床进程相关，因而有可能成为疾病敏感的早期行为标志物时，这种主观与客观的差异是违反直觉的。在当前研究中，我们旨在确定日常生活中错误意识的个体差异是否可能介导这种主观 - 客观关系。
67名认知正常的老年人接受了认知、SCD和情绪测试，以及一项错误意识任务。
未发现较差的错误意识介导SCD与客观表现之间的关系。此外，非临床水平的抑郁症状是SCD和错误意识的主要驱动因素，并显著介导了两者之间的关系。
我们未能表明较差的错误意识介导老年人的SCD和认知表现。然而，我们的研究确实表明，潜在的抑郁症状会影响较差的错误意识和更高的SCD严重程度。因此，不建议将错误意识作为SCD的替代指标，因为SCD增加似乎并未反映出错误意识水平的降低。
