INS NYC 2024 Program

Poster	Poster Session 02 Program Schedule 02/15/2024 08:00 am - 09:15 am Room: Shubert Complex (Posters 1-60) Poster Session 02: Aging \| MCI \| Neurodegenerative Disease - PART 1 Final Abstract #7 The Relationship of Cognitive Intraindividual Variability to Psychiatric Symptoms in Older Adults With and Without Objective Cognitive Impairment and Subjective Cognitive Decline Anika Bhatia, University of Texas at Austin, Austin, United States Bonnie Scott, University of Texas at Austin, Austin, United States Robin Hilsabeck, University of Texas at Austin, Austin, United States Category: MCI (Mild Cognitive Impairment) Keyword 1: psychometrics Keyword 2: neurocognition Keyword 3: neuropsychiatry Objective: The earliest neurobehavioral and neurocognitive manifestations of a neurodegenerative process are described in the literature as mild behavioral impairment (MBI) and subjective cognitive decline (SCD), respectively. While MBI includes a variety of psychiatric symptoms linked to cognitive dysfunction even in younger otherwise healthy adults, SCD is defined by the presence of such complaints occurring in the absence of objective evidence of impairment. However, even in the absence of persistent impairment within a single cognitive domain, increasing performance inconsistency on neuropsychological testing, also known as cognitive intraindividual variability (IIV), has been shown to improve the prediction of cognitive status above and beyond demographics, genetic risk, and vascular integrity. The purpose of the present study was to (1) compare the prevalence rate of mood (anxiety and dysphoria) and motivational (apathy and disinhibition) disturbances in individuals with and without objective cognitive impairment and SCD and (2) determine if cognitive IIV varies as a function of these neuropsychiatric co-morbidities. Based on prior work showing that motivational changes may be among the earliest preclinical symptoms associated with a neurodegenerative process and that even primary mood disturbances are often associated with variable attention, we hypothesized that individuals with SCD and mild cognitive impairment (MCI) would have the highest prevalence of psychiatric comorbidities associated with greater cognitive IIV. Participants and Methods: Baseline data were extracted for 1651 participants (ages 50–96) enrolled in the Texas Alzheimer's Research and Care Consortium, including 455 with MCI and 1196 cognitively normal individuals with (SCD=266) and without (CN=930) SCD. All participants underwent a comprehensive neuropsychological battery and completed the NPI-Q. Demographically corrected z-scores for each test were used to calculate our IIV metrics as the standard deviation of scores (1) across all tests (IIV-Across) and (2) between mean scores computed for each cognitive domain (IIV-Between). Results: SCD and MCI groups had significantly more individuals with anxiety (25.2% vs. 23.1%), dysphoria (24.4% vs. 26.8%), and apathy (17.7% vs. 15.8%) than their CN counterparts (Anxiety=8.7%; Dysphoria=9.7%; Apathy=3.3%), while the SCD group (12.0%) had a significantly higher rate of disinhibition than both CN (1.0%) and MCI (7.3%) groups which also differed significantly from each other. Overall, MCI participants had significantly greater IIV-Across than CN participants; no other between-group comparisons on IIV metrics reached statistical significance. Within CN and MCI groups, there were no significant differences in either IIV metric between individuals with and without psychiatric comorbidities. Within the SCD group, individuals with anxiety, dysphoria, and apathy (but not disinhibition) had significantly greater IIV-Across, while individuals with dysphoria had significantly greater IIV-Between. Significant correlations between IIV metrics and psychiatric severity ratings were limited to the SCD group, wherein greater dysphoria was associated with greater IIV-Across and more severe symptoms of apathy, dysphoria, and anxiety with IIV-Between. Conclusions: Findings suggest that individuals with SCD have elevated rates of psychiatric distress that are associated with greater cognitive IIV. Future research should examine whether the combination of psychiatric distress and cognitive IIV is more likely to be associated with cognitive decline in older adults with SCD.

Poster

02/15/2024
08:00 am - 09:15 am
Room: Shubert Complex (Posters 1-60)

Poster Session 02: Aging | MCI | Neurodegenerative Disease - PART 1

Final Abstract #7

The Relationship of Cognitive Intraindividual Variability to Psychiatric Symptoms in Older Adults With and Without Objective Cognitive Impairment and Subjective Cognitive Decline

Anika Bhatia, University of Texas at Austin, Austin, United States
Bonnie Scott, University of Texas at Austin, Austin, United States
Robin Hilsabeck, University of Texas at Austin, Austin, United States

Category: MCI (Mild Cognitive Impairment)

Keyword 1: psychometrics
Keyword 2: neurocognition
Keyword 3: neuropsychiatry

Objective:

The earliest neurobehavioral and neurocognitive manifestations of a neurodegenerative process are described in the literature as mild behavioral impairment (MBI) and subjective cognitive decline (SCD), respectively. While MBI includes a variety of psychiatric symptoms linked to cognitive dysfunction even in younger otherwise healthy adults, SCD is defined by the presence of such complaints occurring in the absence of objective evidence of impairment. However, even in the absence of persistent impairment within a single cognitive domain, increasing performance inconsistency on neuropsychological testing, also known as cognitive intraindividual variability (IIV), has been shown to improve the prediction of cognitive status above and beyond demographics, genetic risk, and vascular integrity. The purpose of the present study was to (1) compare the prevalence rate of mood (anxiety and dysphoria) and motivational (apathy and disinhibition) disturbances in individuals with and without objective cognitive impairment and SCD and (2) determine if cognitive IIV varies as a function of these neuropsychiatric co-morbidities. Based on prior work showing that motivational changes may be among the earliest preclinical symptoms associated with a neurodegenerative process and that even primary mood disturbances are often associated with variable attention, we hypothesized that individuals with SCD and mild cognitive impairment (MCI) would have the highest prevalence of psychiatric comorbidities associated with greater cognitive IIV.

Participants and Methods:

Baseline data were extracted for 1651 participants (ages 50–96) enrolled in the Texas Alzheimer's Research and Care Consortium, including 455 with MCI and 1196 cognitively normal individuals with (SCD=266) and without (CN=930) SCD. All participants underwent a comprehensive neuropsychological battery and completed the NPI-Q. Demographically corrected z-scores for each test were used to calculate our IIV metrics as the standard deviation of scores (1) across all tests (IIV-Across) and (2) between mean scores computed for each cognitive domain (IIV-Between).

Results:

SCD and MCI groups had significantly more individuals with anxiety (25.2% vs. 23.1%), dysphoria (24.4% vs. 26.8%), and apathy (17.7% vs. 15.8%) than their CN counterparts (Anxiety=8.7%; Dysphoria=9.7%; Apathy=3.3%), while the SCD group (12.0%) had a significantly higher rate of disinhibition than both CN (1.0%) and MCI (7.3%) groups which also differed significantly from each other. Overall, MCI participants had significantly greater IIV-Across than CN participants; no other between-group comparisons on IIV metrics reached statistical significance. Within CN and MCI groups, there were no significant differences in either IIV metric between individuals with and without psychiatric comorbidities. Within the SCD group, individuals with anxiety, dysphoria, and apathy (but not disinhibition) had significantly greater IIV-Across, while individuals with dysphoria had significantly greater IIV-Between. Significant correlations between IIV metrics and psychiatric severity ratings were limited to the SCD group, wherein greater dysphoria was associated with greater IIV-Across and more severe symptoms of apathy, dysphoria, and anxiety with IIV-Between.

Conclusions:

Findings suggest that individuals with SCD have elevated rates of psychiatric distress that are associated with greater cognitive IIV. Future research should examine whether the combination of psychiatric distress and cognitive IIV is more likely to be associated with cognitive decline in older adults with SCD.