JMIR Publications

ABSTRACT

Background:

Adults may experience subjective cognitive decline (SCD). However, it is unclear whether SCD is related to measurable cognitive impairment, particularly women ages 40 to 60 and early dementia. Further, Medicare has mandated assessment of cognitive and memory function in individuals over 65 as part of the Medicare Annual Wellness Visit. In order to assess possible impairment and change over time, efficient, objective measures of SCD are needed.

Objective:

To assess the relationship between performance on an online continuous recognition task (CRT, MemTrax) and age, sex, and memory concern.

Methods:

This study evaluated CRT performance in participants aged 21-99 who enrolled in an online program (HAPPYneuron) to measure mental functions, including those who reported concerns about them. This program asked participants if they had complaints about their memory, and then the program offered them the opportunity to assess cognition using the CRT. This CRT instructs individuals to attend to visual stimuli (50 images) and respond as quickly as possible to repeated images (25 images). The CRT components were used to measure learning and memory (as related to HITs, response to a repeated image), executive function (as related to CRs, correctly not responding to an initial image presentation), and processing speed (HIT-RTs, average response time to HITs).

Results:

Analysis of 18,178 (5,795 males, 32%; 12,383 females, 68%) only included those who answered the sex, age, and memory questions. There were 11,786 (65%) between 40 and 70 years of age. Females outnumbered males by over two-fold, beginning about 35 years of age, peaking at 55 years of age at over three-fold, and falling below two-fold at about 65 years of age. Approximately 30% more men complained of memory problems than those who did not, primarily 30 – 60 years old. About 80% more women complained of memory problems, over two-fold more than women who did not, 30-50 years old. The number of HITs, number of CRs, and HIT-RTs varied little between men and women. While those without memory complaints generally performed better than those with memory complaints, there was little difference in performance levels for each group between males and females. For all groups, there was a gradual reduction of performance over age for HITs and CRs and a slowing of HIT-RTs.

Conclusions:

Most subjects were 40-65, more than twice as many females, suggesting that these demographics have a relationship to concern about SCD. However, there was little difference between males and females for the various CRT components, though SCD was associated with impairment. Age-related declines were progressive, the largest being in slower processing speed, presumably to compensate for age-related changes in cognitive function. Present results suggest clinicians may use these metrics to quantify patient concerns expressed in the primary care setting. Clinical Trial: none