Relationships Between Subjective Cognitive Impairment and Personality Traits: A Systematic Review

Personality traits moderate associations between word recall and subjective memory

Cognitive gerontology research requires consideration of performance as well as perceptions of performance. While subjective memory is positively associated with memory performance, these correlations typically are modest in magnitude, leading to the need to consider whether certain people may show weaker or stronger linkages between performance and perceptions. The current study leveraged personality (NEO Big Five), memory performance (i.e., word recall), and perceptions of memory ability (i.e., metamemory in adulthood and memory decline) data from the St. Louis Personality and Aging Network (SPAN) study (n = 774, mean age: 71.52 years). Extraversion and conscientiousness held the most consistent associations with the cognitive variables of interest, as both traits were positively associated with metamemory and word recall, but negatively associated with subjective decline. Moreover, extraversion moderated associations between word recall and both memory capacity and complaints, insofar that objective-subjective associations were weaker for those adults higher in extraversion. These findings highlight the need to understand how personality influences the sources of information employed for subjective cognitive beliefs.

A multidimensional model of memory complaints in older individuals and the associated hub regions

Memory complaints are highly prevalent among middle-aged and older adults, and they are frequently reported in individuals experiencing subjective cognitive decline (SCD). SCD has received increasing attention due to its implications for the early detection of dementia. This study aims to advance our comprehension of individuals with SCD by elucidating potential cognitive/psychologic-contributing factors and characterizing cerebral hubs within the brain network. To identify these potential contributing factors, a structural equation modeling approach was employed to investigate the relationships between various factors, such as metacognitive beliefs, personality, anxiety, depression, self-esteem, and resilience, and memory complaints. Our findings revealed that self-esteem and conscientiousness significantly influenced memory complaints. At the cerebral level, analysis of delta and theta electroencephalographic frequency bands recorded during rest was conducted to identify hub regions using a local centrality metric known as betweenness centrality. Notably, our study demonstrated that certain brain regions undergo changes in their hub roles in response to the pathology of SCD. Specifically, the inferior temporal gyrus and the left orbitofrontal area transition into hubs, while the dorsolateral prefrontal cortex and the middle temporal gyrus lose their hub function in the presence of SCD. This rewiring of the neural network may be interpreted as a compensatory response employed by the brain in response to SCD, wherein functional connectivity is maintained or restored by reallocating resources to other regions.

How Does Exposure to Dementia Relate to Subjective Cognition? A Systematic Review

Background and Objectives

Subjective cognitive decline (SCD) may be indicative of future objective cognitive decline. However, factors other than objective cognitive performance may influence SCD. This review addresses whether family history or close, nonfamilial exposure to dementia is associated with self-reported SCD.

Research Design and Methods

Searches were conducted in PubMed, PsycINFO, Web of Science, and the Dissertations and Theses database. Eligible articles included measures of self-reported cognition for community-dwelling middle-aged or older adults (40+ years) not diagnosed with dementia, and who had either a family history of dementia, a family member, spouse, or close friend with dementia. The quality of evidence was evaluated using the LEGEND Appraisal Tool. Evidence was synthesized narratively.

Results

A total of 32 articles were included, with 28 rated as good quality. Across studies, the relationship between dementia exposure and SCD was inconsistent. A significant association between exposure and SCD was found in 6 studies; however, 17 reviewed studies found no evidence of a relationship. The remaining 9 studies found mixed associations. Modifying factors that could potentially influence these associations were exploratorily identified among studies to provide context to our results. These factors included dementia worry, emotional closeness, and measurement sensitivity.

Discussion and Implications

Findings of this review suggest that both first-degree relatives and spouses of persons with dementia may have an increased likelihood of reporting SCD, although the current heterogeneity in definitions of exposure to dementia and SCD may influence these findings. In addition to the relationship between dementia exposure and SCD, future research should examine potential modifiers, including meaning attributed to exposure, as identifying how these perceptions affect cognition may promote early intervention.

Five-Factor Model Personality Traits and the Trajectory of Episodic Memory: Individual-Participant Meta-Analysis of 471,821 Memory Assessments from 120,640 Participants

OBJECTIVES

Five-factor model (FFM) personality traits are associated with concurrent memory function and risk of incident dementia but are less consistently associated with the change in episodic memory. The present research analyzes multiple large-scale studies with a consistent analytic approach to evaluate the association between personality and change in episodic memory over time.

METHOD

Across nine public longitudinal data sets, 120,640 participants provided 471,821 memory assessments over up to 26 years (age range 18-108). FFM traits were tested as predictors of the average level (intercept) and change over time (slope) of episodic memory. Results from the individual samples were meta-analyzed to summarize the associations.

RESULTS

Consistent with expectations for the intercept, higher neuroticism was associated with worse memory performance, whereas higher openness and conscientiousness were associated with better performance; extraversion and agreeableness were also associated with better performance. Higher neuroticism and lower conscientiousness were related to declines in memory only in samples with more than two assessments of memory. The other three traits were unrelated to memory slope. The pattern was similar when participants with dementia were excluded from the analysis, and the association with the slope was not moderated by age.

DISCUSSION

FFM traits have a robust association with average memory performance. Higher neuroticism and lower conscientiousness were associated with declines in memory performance only among samples with more than two memory assessments. The heterogeneity across studies suggests that multiple memory assessments are needed to reliably detect change over time, which may be one reason for past inconsistencies across studies.

Subjective memory complaints and social participation among older adults: results from the health and retirement study

Objectives:This study aims to examine whether subjective memory complaints (SMC) contribute to social participation among older adults.Method:The study sample was 4,713 community-dwelling older adults aged 65 years and older from four waves (2010, 2012, 2014, 2016) of the Health and Retirement Study. Hierarchical linear modeling analysis was used to examine the association of SMC with social participation after controlling for factors influencing social participation. Demographic factors (i.e. age, gender, and perceived socioeconomic status) were entered in block 1, health-related factors (i.e. health conditions, perceived health, instrumental activities of daily living, memory-immediate and delayed, and depressive symptoms) were entered in block 2, environmental factors (i.e. perceived social support and strain from spouse, child, family, and friend) were entered in block 3, and SMC was entered in block 4.Results:The result showed that factors significantly contributing to social participation are age (standardized β = -0.08, p < 0.01), perceived socioeconomic status (β = 0.16, p < 0.001), perceived health (β = 0.15, p < 0.001), instrumental activities of daily living (β = 0.12, p < 0.001), memory-immediate and delayed (β = 0.09, p < 0.001; β = 0.08, p < 0.001, respectively), social support from spouse and friend (β = 0.04, p < 0.05; β = 0.13, p < 0.001, respectively), social strain from friend (β = 0.07, p < 0.001), and SMC (β = -0.05, p < 0.001). The demographic factors explained 9.5%, health-related factors explained 8.5%, environmental factors explained 2.4%, and SMC explained 0.1% of the variance in social participation.Conclusion: This finding suggests that SMC may contribute to social participation in older adults.Supplemental data for this article can be accessed online at https://doi.org/10.1080/13607863.2021.1961123 .

Measuring Memory Lapses and Their Impact on Daily Life: Results From Two Daily Diary Studies

Memory lapses (e.g., forgetting a medication) are common for most people, yet past methods of assessment relied upon retrospective reports from long recall windows. Recently, researchers have incorporated daily diary methods to capture memory lapse frequency closer to the experience in real-world environments. This study describes the utility of the Daily Memory Lapses Checklist using data from two 14-day diary studies (Combined Sample = 467; 66% women). Frequency and impact (i.e., irritation and interference) of prospective and retrospective memory lapses were assessed at both individual- and daily levels. Across studies, memory lapses occurred on more than one-third of assessment days. Retrospective lapses were reported more frequently than prospective; however, both lapses had a similar impact. The Daily Memory Lapses Checklist represents a flexible measure that separates the occurrence of a memory lapse from its impact on daily life: metrics that will enhance our understanding of daily experiences of cognitive functioning.

Subjective Cognitive Decline: Level of Risk for Future Dementia and Mild Cognitive Impairment, a Meta-Analysis of Longitudinal Studies

Subjective Cognitive Decline (SCD) in older adults has been identified as a risk factor for dementia, although the literature is inconsistent, and it is unclear which factors moderate progression from SCD to dementia. Through separate meta-analyses, we aimed to determine if SCD increased the risk of developing dementia or mild cognitive impairment (MCI). Furthermore, we examined several possible moderators. Longitudinal studies of participants with SCD at baseline, with data regarding incident dementia or MCI, were extracted from MEDLINE and PsycINFO. Articles were excluded if SCD occurred solely in the context of dementia, MCI, or as part of a specific disease. Pooled estimates were calculated using a random-effects model, with moderator analyses examining whether risk varied according to SCD definition, demographics, genetics, recruitment source, and follow-up duration. Risk of study bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS)-2 tool. 46 studies with more than 74,000 unique participants were included. SCD was associated with increased risk of developing dementia (HR = 1.90, 95% CI 1.52-2.36; OR = 2.48, 95% CI 1.97-3.14) and MCI (HR = 1.73, 95% CI 1.18-2.52; OR = 1.83, 95% CI 1.56-2.16). None of the potential moderating factors examined influenced the HR or OR of developing dementia. In contrast, including worry in the definition of SCD, younger age, and recruitment source impacted the OR of developing MCI, with clinic samples demonstrating highest risk. SCD thus represents an at-risk phase, ideal for early intervention, with further research required to identify effective interventions for risk reduction, and cognitive-behavioural interventions for cognitive management. PROSPERO, protocol number: CRD42016037993.

Optimizing Subjective Cognitive Decline to Detect Early Cognitive Dysfunction

BACKGROUND

The utility of subjective cognitive decline (SCD) as an indicator of preclinical AD is overshadowed by its inconsistent association with objective cognition.

OBJECTIVE

This study examines if manipulations of SCD measurement affect its association with early cognitive dysfunction characteristic of preclinical AD.

METHODS

Cognitively healthy older adults (n = 110) completed SCD questionnaires that elicited complaints in general, compared to 5 years ago (retrospective SCD) and compared to their peers (age-anchored SCD) in binary and Likert scales. Outcome cognitive tasks included an associative memory task (Face-Name Test), a visual short-term memory binding task (STMB test), and a clinical neuropsychological list learning test (Selective Reminder Test).

RESULTS

SCD complaints, when compared to age-matched peers (age-anchored SCD) were endorsed less frequently than complaints compared to 5 years ago (retrospective SCD) (p < 0.01). In demographically adjusted regressions, age-anchored ordinal-rated SCD was associated with short term memory binding (β= -0.22, p = 0.040, CI = -0.45, -0.01), associative memory (β= -0.26, p = 0.018, CI = -0.45, -0.06), and list learning (β= -0.31, p = 0.002, CI = -0.51, -0.12). Retrospective and general ordinal-rated SCD was associated with associative memory (β= -0.25, p = 0.012, CI = -0.44, -0.06; β= -0.29, p = 0.003, CI = -0.47, -0.10) and list learning only (β= -0.25, p = 0.014, CI = -0.45, -0.05; β= -0.28, p = 0.004, CI = -0.48, -0.09).

CONCLUSION

Ordinal age-anchored SCD appears better suited than other SCD measurements to detect early cognitive dysfunction characteristic of preclinical AD.

Within-Person Associations of Self-Reports of Memory Impairment and Depressive Symptoms in Older Adults: Moderation of Relationships Over Time by Personality

OBJECTIVES

The current study examined within-person associations of self-reports of impaired current memory functioning and perceived decline with depressive symptoms in older adults without cognitive impairment, and whether these associations were moderated by individuals' levels of neuroticism, conscientiousness, and extraversion.

METHODS

Samples were drawn from the Einstein Aging Study (EAS), Rush Memory and Aging Project (MAP), Minority Aging Research Study (MARS), Health and Retirement Study (HRS), and National Health and Aging Trends Study (NHATS), with over 8,000 participants (65+ years) included across datasets. In a series of coordinated analyses, multilevel linear models tested within-person relationships over periods of up to 22 years.

RESULTS

Across HRS and NHATS samples, self-reports of impaired current memory functioning covaried with depressive symptoms over time. This association was moderated by neuroticism, such that the association was stronger for individuals with higher levels of neuroticism. Across all samples, perceived memory decline covaried with depressive symptoms over time. This association was moderated by neuroticism in MAP/MARS, HRS, and NHATS, such that the association was stronger for individuals with higher levels of neuroticism.

DISCUSSION

Self-reports of impaired current memory functioning and perceived memory decline are important determinants of older adults' psychological well-being. In our results, at times when older adults perceive poorer memory functioning or decline, they also tend to report more depressive symptoms. Further, results from two larger datasets suggest that individuals' level of neuroticism may determine the extent to which self-reports of memory impairment and depressive symptoms covary over time.

Daily linkages among high and low arousal affect and subjective cognitive complaints

Objectives: Subjective cognitive complaints may be an early indicator of Alzheimer's disease pathology and related dementias that can be detectable prior to objective, performance-based decline. Negative and positive affective states (NA and PA, respectively) are established psychosocial correlates of cognition in older adulthood and have demonstrated capacity for meaningful within-person fluctuations based on person-environment interactions, age, and measurement approach.Method: We utilized data from a 100-day, microlongitudinal study of 105 community-dwelling older adults (M_age = 63.19, SD = 7.80, Range = 52-88) to explore within- and between-person associations between high and low arousal NA and PA, and memory- and attention-related complaints.Results: For memory-related complaints, those who reported experiencing greater NA-high arousal had increased forgetfulness (OR = 2.23, 95%CI: 1.11-4.49, p < .05). Within persons, reporting more NA-high arousal than usual was associated with increased forgetfulness (OR = 1.01, 95%CI: 1.004-1.018, p < .01). For attention-related complaints, those who reported experiencing greater NA-low arousal had increased trouble staying focused (OR = 2.34, 95%CI: 1.17-4.66, p < .05). Within persons, reporting more NA-low arousal (OR = 1.02, 95%CI: 1.01-1.03, p < .001) and less PA-high arousal (OR = 0.96, 95%CI: 0.95-0.97, p < .001) than usual was associated with increased trouble staying focused. Additionally, reporting more PA-low arousal than usual was associated with decreased trouble staying focused among those with higher levels of conscientiousness (OR = 0.72, 95%CI: 0.57-0.92, p < .01).Conclusion: Results from this study offer a means to maximize resource allocation and personalized cognitive health efforts by pinpointing for whom and on which days boosting PA and/or reducing NA may both serve as pathways to benefit daily subjective cognition.

Self-Reported Personality Traits and Informant-Rated Cognition: A 10-Year Prospective Study

Personality traits, such as higher Neuroticism and lower Conscientiousness, are associated with risk of Alzheimer's disease and other dementias. A diagnosis of dementia relies, in part, on informant ratings of the individual's cognitive status. Here we examine whether self-reported personality traits are associated with four measures of informant-rated cognition up to a decade later. Participants from the Health and Retirement Study (N = 2,536) completed a five-factor model measure of personality in 2006 or 2008. Informants completed the 2016 Harmonized Cognitive Assessment Protocol (HCAP), which included ratings of the participant's current cognitive functioning and change in cognitive function over the last decade assessed with the IQCODE, Blessed, 1066, and CSID. Controlling for characteristics of the participant, informant, and their relationship, higher Neuroticism and lower Conscientiousness were associated consistently with worse informant-rated cognition. The association between Openness and better informant-rated cognition was due primarily to higher baseline cognitive function. Extraversion and Agreeableness were associated with better informant-rated cognition only among participants who were cognitively intact at follow-up. The present research suggests that knowledgeable informants are able to detect cognitive deficits associated with personality.

A Systematic Review and Meta-Analysis of the Association between Personality and Cognitive Failures / Complaints

This systematic review examined the associations of personality traits with cognitive failures and cognitive complaints across the adult lifespan. We first present three conceptual models (cognitive abilities, mental processes, and reporting bias) that could explain why personality is related to such behaviors. We then conducted five separate meta-analyses with 10-17 cross-sectional samples (N = 7,642 - 10,564) that were identified through a systematic literature search following the MOOSE guidelines. Higher neuroticism (r = .39, 95% CI [0.32, 0.45]) and lower conscientiousness (r = -.36, 95% CI [-.42, -.29]) were related to more cognitive failures and complaints. Lower scores on the remaining traits were also associated with more cognitive failures and complaints, yet to a weaker extent (extraversion: r = -.14, 95% CI [-.20, -.08]; openness: r = -.07, 95% CI [-.11, -.03]; agreeableness: r = -.13, 95% CI [-.21, -.05]). With the current empirical evidence, it is not possible to tell which of the three conceptual models explains how much of the associations. For neuroticism, there is more support for the mental processes than the reporting bias model, but more research is needed to fully test mechanistic models. We provide several suggestions for future research to address existing limitations of the literature on personality and cognitive failures and complaints.

Five Factor Model Personality Traits and Subjective Cognitive Failures

Momentary lapses in memory, perception, or action, known as cognitive failures, are relatively common. These lapses may reflect, in part, aspects of psychological functioning, such as personality traits. The present research addresses how Five Factor Model personality traits and facets are associated with cognitive failures, and whether these associations are accounted for by depressed affect. Participants (N=5,133; 50% female) who ranged in age from 18 to 91 completed an online survey that assessed their personality traits, cognitive failures, and depressed affect. Higher neuroticism was associated with more cognitive failures, whereas Conscientiousness and Agreeableness were associated with fewer failures, controlling for sociodemographic characteristics. Controlling for depressed affect reduced the associations in most cases by about 50%, but most relations were still apparent. Facet-level analyses provided a more detailed picture of how the traits are associated with cognitive failures. Subjective perceptions of lapses in cognition are associated with basic personality traits and may reflect, in part, processes related to those traits beyond depressed affect.

Combined Influences of Dementia Exposure and Personality on Self-Reported Memory Problems

The current study investigated whether having a first-degree relative with dementia influenced older adults' self-reported memory, if personality traits moderated these associations, and whether these associations differed by the type of item asked (ie, frequency of memory problems vs perceived memory decline). Data drawn from the Einstein Aging study included 454 older adults (Mage = 76.64, standard deviation = 4.77, 66.96% white, and 63% female). Multilevel modeling analyses showed participants who had a first-degree relative with dementia reported more frequent memory problems and were more likely to report memory decline over the past year. Among participants with a first-degree relative with dementia, higher levels of neuroticism were related to reports of more frequent memory problems at baseline, whereas higher levels of conscientiousness and lower levels of extraversion were related to reports of more frequent memory problems over time. Future research should consider personality traits and family history of dementia as potential contributors to self-reported memory problems.

Neuroticism biases memory self-report in women

Reports of memory problems are associated with cognitive decline risk and other adverse health outcomes, and the personality trait of neuroticism is known to influence these reports. Since women tend to have higher neuroticism as well as a unique risk profile for cognitive decline, we examined the relationship between neuroticism and responses to two memory self-report items (self- and age-anchored comparisons) among women (n = 1,132; M_age = 52.71; SD = 13.99) in the Midlife in the United States Refresher Study. Multivariate regression demonstrated that women lower in neuroticism may be more likely to make a distinction between self-comparisons vs. age-anchored comparisons of memory.

The influence of personality on memory self-report among black and white older adults

Self-reported memory problems are often the first indicator of cognitive decline; however, they are inconsistently associated with objective memory performance and are known to be influenced by individual factors, such as personality. The current study examined the relationships between personality traits and self-reported memory problems in cognitively intact older adults, and whether these associations differ across Black and White older adults. Data were collected annually via in-person comprehensive medical and neuropsychological examinations as part of the Einstein Aging Study. Community-dwelling older adults in an urban, multi-ethnic area of New York City were interviewed. The current study included a total of 425 older adults (Mage = 76.68, SD = 4.72, 62.59% female; 72.00% White). Multilevel modeling tested the associations of neuroticism, conscientiousness, extraversion, openness, and agreeableness with self-reported memory problems. Results showed that neuroticism was positively related to frequency of memory problems and perceived ten-year memory decline only when other personality traits were not accounted for. Extraversion was negatively related to frequency of memory problems and perceived ten-year decline for both White and Black participants. However, conscientiousness was negatively related to perceived ten-year decline for Black participants only. Our findings highlight the importance of examining the association of all five personality traits with self-reported memory problems, as well as examining whether these associations differ for participants from different race/ethnicities.