INS NYC 2024 Program

Poster	Poster Session 11 Program Schedule 02/17/2024 10:45 am - 12:00 pm Room: Shubert Complex (Posters 1-60) Poster Session 11: Cultural Neuropsychology \| Education/Training \| Professional Practice Issues Final Abstract #23 Objective Versus Subjective Cognition Differentially Predict Quality of Life Among Canadian Adults who are Homeless or Precariously Housed Michelle Blumberg, York University, Toronto, Canada Caitlin Terao, York University, Toronto, Canada Suzanne Mckeag, York University, Toronto, Canada Vicky Stergiopoulos, Centre for Addiction and Mental Health, Toronto, Canada Stephen Hwang, Unity Health Toronto, Toronto, Canada Kristina Gicas, University of the Fraser Valley, Abbotsford, Canada Category: Assessment/Psychometrics/Methods (Adult) Keyword 1: neurocognition Keyword 2: quality of life Keyword 3: everyday functioning Objective: Cognitive impairment is prevalent among persons who are homeless. These individuals also experience poor outcomes, such as substandard quality of life (QoL). Cognition plays an important role in functional outcomes in psychiatric populations and may be critical for homeless individuals who face numerous daily challenges. However, little is known about how unique dimensions of cognition may differentially impact important outcomes in this population. There is a commonly reported discrepancy between how individuals perform on cognitive tests (objective) and how they perceive their cognitive abilities (subjective). Studies in psychiatric populations indicate poor subjective cognition is related to greater psychiatric symptoms, whereas poor objective cognition is associated with brain injury and psychosis. A deeper understanding of the nature of objective and subjective cognition is critical to understanding the determinants of poor outcomes in this marginalized population. The goal of the current study was to examine objective and subjective cognition and their relative contributions to QoL within a sample of homeless and precariously housed individuals. It was hypothesized that (1) objective and subjective cognition would be uncorrelated, and (2) worse subjective cognition, but not objective cognition, would be associated with worse QoL. Participants and Methods: One hundred and six adults were recruited from shelters in Toronto, Canada, or were individuals from a recent community-based study of homeless persons who consented to be re-contacted for future studies (M_age = 43 years, 54% male). Objective cognition was assessed using the NIH Toolbox Cognition Battery. Subjective cognition was assessed using the PROMIS Cognitive Function-Short Form survey. Primary outcomes included four domains of QoL (physical, psychological, social, environment) assessed with the WHO Quality of Life BREF. Psychiatric diagnoses (psychotic, mood, substance use) were assessed with the Mini Neuropsychiatric Interview. Pearson correlations were conducted to examine the association between objective and subjective cognition. A series of multiple linear regressions were conducted to predict the four domains of QoL from objective and subjective cognition. Psychiatric diagnoses, age, and sex were included as covariates. Results: Objective cognition was uncorrelated with subjective cognition, r = .09, p = .390. Better subjective cognition was associated with better physical (B = 0.54, p <.001), psychological (B = 0.58, p < .001), social (B = 0.27, p = .011), and environmental (B = 0.39, p < .001) QoL. Objective cognition was not a predictor of QoL. Older age was associated with worse physical (B = -0.03, p < .001), psychological (B = -0.02, p = .002), and social (B = -0.01, p = .027) QoL. Diagnosis of a psychotic disorder predicted worse social QoL (B = -0.84, p = .003). Male sex was associated with better psychological QoL (B = 0.44, p = .014). Conclusions: The present study is the first to compare the relative contributions of objective and subjective cognition to poor outcomes in a homeless population. Subjective cognition significantly predicted all domains of QoL, suggesting that subjective cognition may be an important domain to assess when evaluating the needs of homeless persons who comprise an underserved population.

Poster

02/17/2024
10:45 am - 12:00 pm
Room: Shubert Complex (Posters 1-60)

Poster Session 11: Cultural Neuropsychology | Education/Training | Professional Practice Issues

Final Abstract #23

Objective Versus Subjective Cognition Differentially Predict Quality of Life Among Canadian Adults who are Homeless or Precariously Housed

Michelle Blumberg, York University, Toronto, Canada
Caitlin Terao, York University, Toronto, Canada
Suzanne Mckeag, York University, Toronto, Canada
Vicky Stergiopoulos, Centre for Addiction and Mental Health, Toronto, Canada
Stephen Hwang, Unity Health Toronto, Toronto, Canada
Kristina Gicas, University of the Fraser Valley, Abbotsford, Canada

Category: Assessment/Psychometrics/Methods (Adult)

Keyword 1: neurocognition
Keyword 2: quality of life
Keyword 3: everyday functioning

Objective:

Cognitive impairment is prevalent among persons who are homeless. These individuals also experience poor outcomes, such as substandard quality of life (QoL). Cognition plays an important role in functional outcomes in psychiatric populations and may be critical for homeless individuals who face numerous daily challenges. However, little is known about how unique dimensions of cognition may differentially impact important outcomes in this population. There is a commonly reported discrepancy between how individuals perform on cognitive tests (objective) and how they perceive their cognitive abilities (subjective). Studies in psychiatric populations indicate poor subjective cognition is related to greater psychiatric symptoms, whereas poor objective cognition is associated with brain injury and psychosis. A deeper understanding of the nature of objective and subjective cognition is critical to understanding the determinants of poor outcomes in this marginalized population. The goal of the current study was to examine objective and subjective cognition and their relative contributions to QoL within a sample of homeless and precariously housed individuals. It was hypothesized that (1) objective and subjective cognition would be uncorrelated, and (2) worse subjective cognition, but not objective cognition, would be associated with worse QoL.

Participants and Methods:

One hundred and six adults were recruited from shelters in Toronto, Canada, or were individuals from a recent community-based study of homeless persons who consented to be re-contacted for future studies (M_age = 43 years, 54% male). Objective cognition was assessed using the NIH Toolbox Cognition Battery. Subjective cognition was assessed using the PROMIS Cognitive Function-Short Form survey. Primary outcomes included four domains of QoL (physical, psychological, social, environment) assessed with the WHO Quality of Life BREF. Psychiatric diagnoses (psychotic, mood, substance use) were assessed with the Mini Neuropsychiatric Interview.

Pearson correlations were conducted to examine the association between objective and subjective cognition. A series of multiple linear regressions were conducted to predict the four domains of QoL from objective and subjective cognition. Psychiatric diagnoses, age, and sex were included as covariates.

Results:

Objective cognition was uncorrelated with subjective cognition, r = .09, p = .390. Better subjective cognition was associated with better physical (B = 0.54, p <.001), psychological (B = 0.58, p < .001), social (B = 0.27, p = .011), and environmental (B = 0.39, p < .001) QoL. Objective cognition was not a predictor of QoL. Older age was associated with worse physical (B = -0.03, p < .001), psychological (B = -0.02, p = .002), and social (B = -0.01, p = .027) QoL. Diagnosis of a psychotic disorder predicted worse social QoL (B = -0.84, p = .003). Male sex was associated with better psychological QoL (B = 0.44, p = .014).

Conclusions:

The present study is the first to compare the relative contributions of objective and subjective cognition to poor outcomes in a homeless population. Subjective cognition significantly predicted all domains of QoL, suggesting that subjective cognition may be an important domain to assess when evaluating the needs of homeless persons who comprise an underserved population.