We investigated the impact of culturally relevant social, educational, and language factors on cognitive test performance among Spanish speakers living near the US–Mexico border.

Participants included 254 healthy native Spanish speakers from the Neuropsychological Norms for the US–Mexico Border Region in Spanish (NP-NUMBRS) project (Age: M = 37.3, SD = 10.4; Education: M = 10.7, SD = 4.3; 59% Female). A comprehensive neuropsychological battery was administered in Spanish. Individual test scaled scores and T-scores (based on region-specific norms adjusted for age, education, and sex) were averaged to create Global Mean Scaled and T-scores. Measures of culturally relevant factors included a self-reported indicator of educational quality/access (proportion of education in Spanish-speaking country, quality of school/classroom setting, stopped attending school to work), childhood socioeconomic environment (parental education, proportion of time living in Spanish-speaking country, childhood socioeconomic and health status, access to basic resources, work as a child), and Spanish/English language use and fluency.

Several culturally relevant variables were significantly associated with unadjusted Global Scaled Scores in univariable analyses. When using demographically adjusted T-scores, fewer culturally relevant characteristics were significant. In multivariable analyses, being bilingual (p = .04) and working as a child for one’s own benefit compared to not working as a child (p = .006) were significantly associated with higher Global Mean T-score, accounting for 9% of variance.

Demographically adjusted normative data provide a useful tool for the identification of brain dysfunction, as these account for much of the variance of sociocultural factors on cognitive test performance. Yet, certain culturally relevant variables still contributed to cognitive test performance above and beyond basic demographics, warranting further investigation.

Methamphetamine and cannabis are two widely used, and frequently co-used, substances with possibly opposing effects on the central nervous system. Evidence of neurocognitive deficits related to use is robust for methamphetamine and mixed for cannabis. Findings regarding their combined use are inconclusive. We aimed to compare neurocognitive performance in people with lifetime cannabis or methamphetamine use disorder diagnoses, or both, relative to people without substance use disorders.

423 (71.9% male, aged 44.6 ± 14.2 years) participants, stratified by presence or absence of lifetime methamphetamine (M−/M+) and/or cannabis (C−/C+) DSM-IV abuse/dependence, completed a comprehensive neuropsychological, substance use, and psychiatric assessment. Neurocognitive domain T-scores and impairment rates were examined using multiple linear and binomial regression, respectively, controlling for covariates that may impact cognition.

Globally, M+C+ performed worse than M−C− but better than M+C−. M+C+ outperformed M+C− on measures of verbal fluency, information processing speed, learning, memory, and working memory. M−C+ did not display lower performance than M−C− globally or on any domain measures, and M−C+ even performed better than M−C− on measures of learning, memory, and working memory.

Our findings are consistent with prior work showing that methamphetamine use confers risk for worse neurocognitive outcomes, and that cannabis use does not appear to exacerbate and may even reduce this risk. People with a history of cannabis use disorders performed similarly to our nonsubstance using comparison group and outperformed them in some domains. These findings warrant further investigation as to whether cannabis use may ameliorate methamphetamine neurotoxicity.

This study investigated the relationship between various intrapersonal factors and the discrepancy between subjective and objective cognitive difficulties in adults with attention-deficit hyperactivity disorder (ADHD). The first aim was to examine these associations in patients with valid cognitive symptom reporting. The next aim was to investigate the same associations in patients with invalid scores on tests of cognitive symptom overreporting.

The sample comprised 154 adults who underwent a neuropsychological evaluation for ADHD. Patients were divided into groups based on whether they had valid cognitive symptom reporting and valid test performance (n = 117) or invalid cognitive symptom overreporting but valid test performance (n = 37). Scores from multiple symptom and performance validity tests were used to group patients. Using patients’ scores from a cognitive concerns self-report measure and composite index of objective performance tests, we created a subjective-objective discrepancy index to quantify the extent of cognitive concerns that exceeded difficulties on objective testing. Various measures were used to assess intrapersonal factors thought to influence the subjective-objective cognitive discrepancy, including demographics, estimated premorbid intellectual ability, internalizing symptoms, somatic symptoms, and perceived social support.

Patients reported greater cognitive difficulties on subjective measures than observed on objective testing. The discrepancy between subjective and objective scores was most strongly associated with internalizing and somatic symptoms. These associations were observed in both validity groups.

Subjective cognitive concerns may be more indicative of the extent of internalizing and somatic symptoms than actual cognitive impairment in adults with ADHD, regardless if they have valid scores on cognitive symptom overreporting tests.

Management of finances is one of the earliest domains of daily living to decline in the neurodegenerative disease process, and poorer financial literacy is associated with worse cognition even in healthy, normative aging. However, some studies have demonstrated that cognitively normal older adults demonstrate preserved real-world financial outcomes despite the presence of age-related cognitive decline. One account for this discordance posits that older adults rely on intact financial knowledge to circumvent negative effects of declining fluid cognitive abilities. Also important to real-world financial behavior is insight into one’s level of financial knowledge and expertise (i.e., subjective financial confidence), which in some studies has been shown to have an equal or stronger influence on real-world financial behaviors compared to objective financial knowledge. This study investigated older adults’ financial abilities by identifying groups of individuals with discrepancies between objective financial knowledge and subjective financial confidence and exploring cognitive and non-cognitive (demographic, personality) factors associated with discrepancy group membership.

Participants were 4,610 older adults (M age 71.18 ± .91) from the Wisconsin Longitudinal Study who answered 12 true-false questions on financial concepts (accuracy) and rated their confidence on each response. Standardized scores of accuracy and confidence were used to classify participants into three discrepancy groups (1) Overconfident (confidence >1 SD above accuracy), (2) Underconfident (accuracy >1 SD above confidence), and (3) Equal (accuracy and confidence within 1 SD). Logistic regression examined factors associated with discrepancy group membership.

Higher financial accuracy was moderately correlated with greater confidence (r=.42, p<.001). Approximately 29% of participants had standardized accuracy and confidence scores that differed by one standard deviation or more, with 14% of participants belonging to an “Overconfident” group and 15% to an “Underconfident” group. Lower likelihood of Overconfidence group membership was associated with higher levels of education (OR = .87, 95% CI [.82, .93], p<.001) and better cognitive performance on tests of delayed recall (OR = .90, 95% CI [.84, .97], p=.006) and numerical reasoning (OR = .94, 95% CI [.91, .97], p<.001), while higher extraversion was associated with increased likelihood of Overconfidence (OR = 1.03, 95% CI [1.00, 1.05], p=.04). Lower likelihood of Underconfident group membership was associated with better performance on cognitive tests of delayed recall (OR = .90, 95% CI [.84, .96], p=.002), male sex (OR = .60, 95% CI [.47, .77], p<.001), and lower levels of conscientiousness (OR = .95, 95% CI [.92, .99], p<.001), while better letter fluency performance was associated with increased likelihood of Underconfidence (OR = 1.03, 95% CI [1.00, 1.06], p=.04).

Objective financial knowledge and subjective financial confidence are related yet distinct aspects of financial literacy. Discrepancies between financial knowledge and confidence are related to both cognitive and non-cognitive factors, such as personality and differing life experiences associated with educational attainment and sex-related social roles. Results may help clinicians identify profiles of older adults (e.g., high confidence and low knowledge/"Overconfident”) at risk for dysfunctional financial behaviors, including susceptibility to fraud and/or irresponsible financial decision-making.

Early detection is critical to the effective management of Alzheimer’s Disease (AD) and other forms of dementia. Existing screening assessments are often costly, require substantial expertise to administer, and may be insensitive to mild changes in cognition. A promising alternative is automatically measuring features of connected speech (c.f., Ostrand & Gunstad, 2021, Journal Geriatric Psych & Neurol) to predict impairment. Here, we built on prior work examining how well speech features predicted cognitive impairment. Unique to the current work, we attempted to capture more holistic effects of cognitive impairment by examining the relevance of linguistic features that measure sentential or discourse context properties of speech, including the context in which filler words (e.g., um) occur, and the predictability of individual words within their sentence context, computed from a large computational language model (GPT-2).

Participants completed the Cookie Theft picture description task, with data available in the DementiaBank corpus (Becker et al., 1994, Arch Neurol). Descriptions that contained at least 50 words (N = 214) were submitted to an automatic feature calculation pipeline written in Python to calculate various part-of-speech counts, lexical diversity metrics, and mean lexical frequency, as well as multiple metrics related to lexical surprisal (i.e., how surprising a word is given its context).

Surprisal of individual words was computed using the pre-trained GPT-2 transformer language model (Radford et al., 2019, Comput. Sci.) by computing word probability given the previous 12 words. Multiple linear regression was performed using 17 linguistic features jointly as predictors, and Mini-Mental State Examination (MMSE) score as the outcome variable. Simple regressions were calculated between each feature and MMSE scores to examine the predictability of each linguistic feature on cognitive decline.

A multiple linear regression model containing all linguistic features plus demographic information (age, sex, education) significantly predicted MMSE scores (Adjusted R2 = 0.41, F20, 193 = 8.37, p < .001), and explained significantly more variance in MMSE scores than did demographic variables alone (F17193 = 6.85, p < .001). Individual predictors that were significantly correlated with MMSE score included: how unexpected an individual’s word choices were, given the preceding context (median surprisal: r = -0.33, p < 0.001; interquartile range: r = 0.18, p < 0.02), mean lexical frequency (r = -0.50, p < .001), and usage of definite articles (r = 0.31, p < 0.001), nouns (r = 0.26, p < .001), and empty words (r = -0.25, p < 0.001).

Participants with lower MMSE scores, indicating greater impairment, used more frequent, yet more surprising, words, and produced more empty words and fewer definite articles and nouns. These results suggest that measures of semantic specificity and coherence of speech could be meaningful predictors of cognitive decline, and can be computed automatically from speech transcriptions. The results also provide novel evidence that computational approaches to estimating lexical predictability may have value in predicting the degree of decline, motivating future work in other speech elicitation tasks and differing clinical groups.

Most neuropsychological tests were developed without the benefit of modern psychometric theory. We used item response theory (IRT) methods to determine whether a widely used test – the 26-item Matrix Reasoning subtest of the WAIS-IV – might be used more efficiently if it were administered using computerized adaptive testing (CAT).

Data on the Matrix Reasoning subtest from 2197 participants enrolled in the National Neuropsychology Network (NNN) were analyzed using a two-parameter logistic (2PL) IRT model. Simulated CAT results were generated to examine optimal short forms using fixed-length CATs of 3, 6, and 12 items and scores were compared to the original full subtest score. CAT models further explored how many items were needed to achieve a selected precision of measurement (standard error ≤ .40).

The fixed-length CATs of 3, 6, and 12 items correlated well with full-length test results (with r = .90, .97 and .99, respectively). To achieve a standard error of .40 (approximate reliability = .84) only 3–7 items had to be administered for a large percentage of individuals.

This proof-of-concept investigation suggests that the widely used Matrix Reasoning subtest of the WAIS-IV might be shortened by more than 70% in most examinees while maintaining acceptable measurement precision. If similar savings could be realized in other tests, the accessibility of neuropsychological assessment might be markedly enhanced, and more efficient time use could lead to broader subdomain assessment.

Patients with Parkinson’s disease (PD) exhibit impaired semantic and socioemotional processes, which are thought to be related to dysfunctions in the fronto-striatal circuit. However, little is known about how the memory enhancement by these processes was reduced in PD. The present study investigated this issue.

The retrieval performance of face memories encoded by semantic and socioemotional processes was compared between 24 PD patients and 24 age-matched healthy controls (HC). During encoding, participants were presented with unfamiliar faces and made judgment about them in three encoding conditions of semantic judgment (Semantics), attractiveness judgment (Attractiveness), and form judgment (Form). In Semantics, participants rated to what degree each face looked like an office worker, whereas in Attractiveness, participants rated how attractive each face was. The Form condition as a control required participants to judge the shape of each face. During retrieval after encoding, participants made old or new judgment for target and distracter faces.

In HC, the retrieval of faces encoded by Semantics and Attractiveness was significantly more accurate than that encoded by Form, whereas this memory enhancement was not identified in PD. In addition, individual scores in frontal lobe function and long-term memory correlated with the retrieval performance of memories encoded in Semantics and Attractiveness but not Form.

These findings suggest that the processing of semantic and socioemotional signals conveyed from faces could be impaired in PD and that the impairment of these processes could decrease the enhancement of face memories by semantic and socioemotional elaborations.

Alzheimer's disease (AD) is associated with the accumulation of neuropathological beta-amyloid (Ab) plaques, which is thought to be caused by an imbalance between Ab overproduction and dysfunctional Ab clearance. Both animal and human studies have shown that increased cerebrospinal fluid (CSF) levels of Ab peptides, especially Ab-38 and Ab-40 due to their high solubility, may be indicators of overall Ab dysregulation in preclinical AD, years before pathological Ab plaques begin to aggregate. This overabundance of Ab and later sequestration onto plaques eventually triggers a cascade of subsequent brain changes that may lead to cognitive decline. Indeed, alterations in gray matter integrity may play a role, as imaging studies have shown specific atrophy patterns in preclinical AD, particularly in language regions of the bilateral temporal lobes, which relate to cognitive performance. Here, we aimed to explore whether temporal lobe cortical volume is implicated in the relationship between increased CSF Ab levels and cognitive decline, as measured by confrontation naming performance -- an age-independent language task often impaired in preclinical AD -- in AD-vulnerable populations.

We selected 87 non-demented Veterans (Sex: 99% male; Age: M=68.2, SD=3.7; Education: M=15.5, SD=2.2) from the Alzheimer's Disease Neuroimaging Initiative-Department of Defense (ADNI-DOD) database based on available Boston Naming Test (BNT) scores, CSF measures of Ab-38 and Ab-40, and structural neuroimaging data. The 30-item BNT assessed confrontation naming performance. CSF Ab concentrations were measured using a 2D-UPLC-tandem mass spectrometry method outlined by ADNI-DOD. T1-weighted images were acquired on a 3T scanner and processed by ADNI to calculate cortical volumes (CVs) for regions of interest (ROIs); the present study focused on three bilateral ROIs in the temporal lobe (fusiform gyrus [FFG], inferior temporal gyrus [ITG], and middle temporal gyrus [MTG]). All CVs were adjusted (CV_adj) for intracranial volume (ICV) using the covariance formula (CV_adj = CV - b [ICV - mean(ICV)]). Linear regression models explored the relationship between CSF Ab peptides and BNT with temporal lobe ROIs as moderators using the PROCESS macro.

CV of the bilateral FFG significantly moderated the relationship between BNT performance and both CSF Ab-38 (p=.025, R2=.05, b=.0008) and Ab-40 (p=.016, R2=.06, b=.0002) levels. We then explored effects of the left and right FFG separately and found that the relationship between CSF Ab-38 and BNT was significantly moderated by the left FFG (p=.032, R2=.05, b=.0006) and nominally by the right FFG (p=.072, R2=.03, b=.0006). The relationship between CSF Ab-40 and BNT was significantly moderated by both the left (p=.032, R2=.05, b=.0001) and right (p=.038, R2=.04, b=.0001) FFG. CV of the bilateral ITG and MTG had no effect on any model (all p >.10).

Increased Ab may trigger alterations in neural gray matter integrity, specifically in the FFG of the temporal lobe, and these changes may in turn be implicated in AD-related cognitive decline, particularly in the language domain. These findings suggest that biomarker models incorporating CSF Ab and CV may aid early identification of disease and risk for cognitive decline in preclinical AD stages, which could help inform early interventions.

In the aftermath and continuance of the COVID-19 pandemic, the field of neuropsychology has experienced a burgeoning literature base on remote telehealth practices. These practices include both videoconference and telephone modalities. Several studies to date have proposed evidence suggesting that inperson and remote telehealth assessments demonstrate comparable results. One of the major limitations to telehealth practices is the scarcity of measures of processing speed. A widely used measure is the Oral Trail Making Test, which has two trials (A & B). Oral Trails B is often conceptualized as a measure of set-shifting and cognitive flexibility. And validity studies support Oral Trails B having strong test-retest reliability and correlation to its written counterpart. In contrast, there is contention as to whether Oral Trails A can be conceptualized as a measure of basic attention and speed versus simple numerical automaticity. Importantly, to our knowledge, the test-retest reliability of Oral Trails A administered specifically via telephone has never been reported in a healthy sample. The following study presents test-retest reliability for the Oral Trails A and B (in a healthy control group) administered as part of a larger study investigating the effects of deep diaphragmatic breathing on cognitive functioning.

Eighty healthy young adults with elevated stress levels were recruited from a major metropolitan city at a major university. The subjects had to be between the ages of 18 to 29 and self-reported Perceived Stress Scale score >13. The subjects could not practice any form of meditation, yoga, or breathing exercise regularly. Additionally, they could not have any severe medical or psychiatric disorder, be actively suicidal; have a substance use disorder within the past year, or use of medication with a known negative impact on cognition or autonomic nervous system (ANS) arousal. Participants were randomized to a waitlist control group or an intervention group. Cognitive assessments were administered over the phone to both groups (pre and post-treatment) and self-report measures were completed online due to quarantine restrictions.

Among participants in the waitlist control group, the mean difference (MD) between time points on OTMT-A (MD= -0.17, SD= 1.69) was small and not significant (p>0.05). The mean difference for OTMT-B (MD= -13.06, SD=26.99) was large and significant (p=0.01). Bivariate Pearson correlations were computed revealing a significant moderate strength relationship between OTMT-A performance across time points (r=0.6, p<0.001). In contrast, performance on OTMT-B across time points revealed a nonsignificant, weak relationship (r=0.2, p=1.94).

These results do not support literature demonstrating strong test-retest reliability for OTMT-B. Furthermore, this is the first study establishing test-retest reliability for the OTMT-A as administered via a novel telephonic modality. Given the novel and non-standardized method of administration, the data should be interpreted with caution. Nonetheless, given the weak relationship in OTMT-B performance and the only moderate relationship of OTMT-A performance across time points, the results suggest that the OTMT may not be highly reliable as administered via a telephonic modality.

Cognitive disengagement syndrome (CDS; previously known as “sluggish cognitive tempo” or SCT) refers to a set of behavioral symptoms characterized by slowed thinking/behavior, daydreaming, and mental fogginess or confusion. It has been described as related to, yet separate from, symptoms associated with Attention-deficit Hyperactivity Disorder (ADHD) inattention. There is a paucity of research on CDS within pediatric epilepsy populations despite substantial risk factors inherent to the disorder and a large proportion of patients with comorbid ADHD. This study therefore describes CDS as reported by parents for a large sample of children with epilepsy. Relationship between epilepsy variables (e.g., number of antiepileptic drugs [AEDs], seizure frequency, seizure type) and CDS symptoms was explored. Additionally, considering the negative association between CDS and academic performance in other populations, the relationship between parentrated CDS and academic risk factors was examined.

Participants included 151 children with epilepsy (mean age = 11y, range 6-18y; 55% male; IQ>70), referred for outpatient neuropsychological assessment. As part of routine clinical care, parents completed the Penny Sluggish Cognitive Tempo Scale (SCT) and the Colorado Learning Difficulties Questionnaire (CLDQ). Scores and basic demographic information were extracted from an IRB approved clinical database; the IRB granted approval for retrospective chart review to extract additional medical variables. Parent report of CDS included total CDS score and three subdomains: Sleepy/Sluggish, Low Initiation, and Daydreamy. Higher scores represent greater parent-reported difficulties. Independent samples t-tests compared the participants’ means on total CDS and each subdomain to the normative sample. Analysis of variance was conducted to determine differential impact of seizure type (Generalized, Focal, or Multifocal) on total CDS and each subdomain. Correlations between other medical variables, scores on the CLDQ, and parent ratings on the SCT were examined.

Parents of children with epilepsy rated overall CDS total and subdomain scores as significantly higher compared to the normative means with highest elevation in symptoms of Low Initiation (p = <.001). Total CDS was associated with increased parent-reported academic difficulties; however, of the three subdomains, only Low Initiation was significantly associated with concerns for academic functioning. Number of AEDs was associated with increased symptoms on the Sleepy/Sluggish subdomain only. Seizure frequency was associated with total CDS and Sleepy/Sluggish symptoms, though this finding is likely mediated by increased number of AEDs for those with more frequent seizures. Seizure type was not associated with significant differences in Total CDS or CDS subdomains.

Children with epilepsy are at increased risk for experiencing slowed thinking and cognitive disengagement. Low initiation is particularly elevated in pediatric epilepsy populations, which may lead to increased academic difficulties. Potential interventions targeting low initiation may therefore have benefit in the academic setting for children with epilepsy, regardless of epilepsy type.

Patients with mild Alzheimer’s disease dementia are more susceptible to false memories than healthy older adults. Evidence that these patients can use cognitive strategies to reduce false memory is inconsistent.

In the present study, we examined the effectiveness of conservative responding and item-specific deep encoding strategies, alone and in combination, to reduce false memory in a categorized word list paradigm among participants with mild Alzheimer’s disease dementia (AD), amnestic single-domain mild cognitive impairment (MCI), and healthy age-matched older controls (OCs). A battery of clinical neuropsychological measures was also administered.

Although use of conservative responding alone tended to reduce performance in the MCI and OC groups, both deep encoding alone and deep encoding combined with conservative strategies led to improved discrimination for both gist memory and item-specific recollection for these two groups. In the AD group, only gist memory benefited from the use of strategies, boosted equally by deep encoding alone and deep encoding combined with conservative strategies; item-specific recollection was not improved. No correlation between the use of these strategies and performance on neuropsychological measures was found.

These results suggest that further evaluation of these strategies is warranted as they have the potential to reduce related and unrelated memory errors and increase both gist memory and item-specific recollection in healthy older adults and individuals with amnestic MCI. Patients with AD were less able to benefit from such strategies, yet were still able to use them to reduce unrelated memory errors and increase gist memory.

Freezing of gait (FoG) in Parkinson’s disease (PD) has been associated with response inhibition. However, the relationship between response inhibition, neural dysfunction, and PD remains unclear. We assessed response inhibition and microstructural integrity of brain regions involved in response inhibition [right hemisphere inferior frontal cortex (IFC), bilateral pre-supplementary motor areas (preSMA), and subthalamic nuclei (STN)] in PD subjects with and without FoG and elderly controls.

Twenty-one people with PD and FoG (PD-FoG), 18 without FoG (PD-noFoG), and 19 age-matched controls (HC) completed a Stop-Signal Task (SST) and MRI scan. Probabilistic fiber tractography assessed structural integrity (fractional anisotropy, FA) among IFC, preSMA, and STN regions.

Stop-signal performance did not differ between PD and HC, nor between PD-FoG and PD-noFoG. Differences in white matter integrity were observed across groups (.001 < p < .064), but were restricted to PD versus HC groups; no differences in FA were observed between PD-FoG and PD-noFoG (p > .096). Interestingly, worse FoG was associated with higher (better) mean FA in the r-preSMA, (β = .547, p = .015). Microstructural integrity of the r-IFC, r-preSMA, and r-STN tracts correlated with stop-signal performance in HC (p ≤ .019), but not people with PD.

These results do not support inefficient response inhibition in PD-FoG. Those with PD exhibited white matter loss in the response inhibition network, but this was not associated with FoG, nor with response inhibition deficits, suggesting FoG-specific neural changes may occur outside the response inhibition network. As shown previously, white matter loss was associated with response inhibition in elderly controls, suggesting PD may disturb this relationship.

Subjective cognitive complaints are common in individuals with Parkinson’s disease and Essential Tremor. One scale often used to capture the type and severity of subjective cognitive concerns is the Cognitive Change Index-20 (CCI-20). Created by Saykin et al (2006), the CCI-20 is a questionnaire that assesses perception of cognitive changes in memory, executive function, and language domains. Despite its multidomain structure, previous research has not empirically examined whether the CCI-20's underlying factor structure aligns with the cognitive domains proposed during its original development. Thus, the goal of the current study was to investigate the factor structure of the CCI-20 in individuals with movement disorders (Parkinson’s disease, Essential Tremor) who are known to experience varying degrees of cognitive sequelae as part of their disease progression.

Participants included a convenience sample of 216 non-demented individuals with Parkinson disease (n=149) or Essential Tremor (n=67) who were seen at the University of Florida Fixel Institute Movement Disorders Center. All received the CCI-20 as part of a neuropsychological evaluation. The CCI-20 consists of 20 items, rated on a 5-point Likert scale, that ask questions about change in memory (12 items), executive function (5 items), and language (3 items) over the past 5 years. An exploratory factor analysis was conducted on CCI-20 scores using Promax rotation with factor extraction based on scree plot visual inspection and Kaiser’s rule (eigenvalues >1.0). Cronbach’s alpha was used to assess internal consistency reliability. Finally, Spearman correlations determined associations between factors and mood measures of depression (Beck Depression Inventory-II, BDI-II), apathy (Apathy Scale, AS), and anxiety (State-Trait Anxiety Inventory, STAI).

Because the Parkinson’s disease and Essential Tremor groups did not statistically differ in their CCI-20 total scores, they were combined into a single group for analyses. This resulted in 216 participants who were well-educated (m=15.01±2.92), in their mid-60's (m=67.72±9.33), predominantly male (63%), and non-Hispanic White (93.6%). The factor analysis resulted in 3 factors: factor 1 included 8 memory items (items 1-4, 6, 10-12; loadings from .524 to .920); factor 2 included all executive and language (items 13-20; loadings from .605 to .824), and factor 3 included four remaining memory items (items 5, 7-9; loadings from .628 to .810). Reliability of the 20 CCI items was good (a = .94), and reliability within each factor ranged from adequate (Factor 3, a = .78) to good (Factors 1 and 2, a = .90). All factors showed significant weak to moderate associations with BDI-II, AS, and STAI (state and trait) scores.

The CCI-20 revealed three distinct dimensions of subjective cognitive complaints that did not correspond to the memory, executive function, and language domains. Rather, the CCI-20 was decomposed into two different dimensions of memory complaints and one dimension of non-memory complaints. Mood symptoms played a significant role in driving all dimensions of subjective cognitive complaints. Future studies should confirm this triadic structure in a healthy older adult sample and explore the relationship between factors and objective cognitive performance beyond the contribution of mood. T32-AG061892; T32-NS082168