School of Psychology, Trinity College Dublin, Dublin, Ireland.
Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland.
Alzheimers Dement. 2024 Nov;20(11):7437-7452. doi: 10.1002/alz.13885. Epub 2024 Oct 9.
Early detection of both objective and subjective cognitive impairment is important. Subjective complaints in healthy individuals can precede objective deficits. However, the differential associations of objective and subjective cognition with modifiable dementia risk factors are unclear.
We gathered a large cross-sectional sample (N = 3327, age 18 to 84) via a smartphone app and quantified the associations of 13 risk factors with subjective memory problems and three objective measures of executive function (visual working memory, cognitive flexibility, model-based planning).
Depression, socioeconomic status, hearing handicap, loneliness, education, smoking, tinnitus, little exercise, small social network, stroke, diabetes, and hypertension were all associated with impairments in at least one cognitive measure. Subjective memory had the strongest link to most factors; these associations persisted after controlling for depression. Age mostly did not moderate these associations.
Subjective cognition was more sensitive to self-report risk factors than objective cognition. Smartphones could facilitate detecting the earliest cognitive impairments.
Smartphone assessments of cognition were sensitive to dementia risk factors. Subjective cognition had stronger links to most factors than did objective cognition. These associations were not fully explained by depression. These associations were largely consistent across the lifespan.
早期发现客观和主观认知障碍都很重要。在健康个体中,主观抱怨可能先于客观缺陷。然而,客观和主观认知与可改变的痴呆风险因素的差异关联尚不清楚。
我们通过智能手机应用程序收集了一个大型的横断面样本(N=3327,年龄 18 至 84 岁),并量化了 13 个风险因素与主观记忆问题和三个客观执行功能测量(视觉工作记忆、认知灵活性、基于模型的计划)之间的关联。
抑郁、社会经济地位、听力障碍、孤独、教育、吸烟、耳鸣、运动少、社交网络小、中风、糖尿病和高血压都与至少一种认知测量的损伤有关。主观记忆与大多数因素的联系最紧密;在控制抑郁后,这些关联仍然存在。年龄对这些关联的影响不大。
主观认知比客观认知对自我报告的风险因素更敏感。智能手机可以促进检测到最早的认知障碍。
智能手机评估认知对痴呆风险因素敏感。主观认知与大多数因素的联系比客观认知更紧密。这些关联不能完全用抑郁来解释。这些关联在整个生命周期中基本一致。