Retrospective metamemory monitoring of semantic memory in community-dwelling older adults with subjective cognitive decline and mild cognitive impairment

ABSTRACT

In neurodegenerative conditions, better memory/cognitive awareness, indexed by greater “metamemory monitoring accuracy”, is linked to stronger cognitive remediation outcomes. Differences in metamemory monitoring accuracy in predementia conditions, which could inform treatment effectiveness, have not been systematically investigated. We utilized a retrospective confidence judgment (RCJ) task for general knowledge recognition in community-dwelling older adults: 106 cognitively healthy (HC), 68 subjective cognitive decline (SCD) despite intact neuropsychological function, 14 amnestic mild cognitive impairment (aMCI), and 31 non-amnestic mild cognitive impairment (naMCI). Participants gave confidence ratings after making recognition responses to general knowledge questions. Recognition accuracy, confidence levels, and absolute and relative RCJ accuracy (i.e., metamemory monitoring accuracy) were analysed. Compared to HC and SCD, absolute RCJ accuracy was significantly poorer in both MCI groups but relative RCJ accuracy was significantly poorer in naMCI, but not aMCI. This novel result may be driven by lower confidence for correct recognition responses in naMCI and suggests that poorer RCJ accuracy in naMCI may be attributable to poorer performance monitoring. We discuss results in relation to the possibility that individuals in distinct preclinical dementia conditions, who have different levels of memory/cognitive awareness, may differentially benefit from cognitive remediation strategies tailored to their levels of memory/cognitive awareness.

KEYWORDS:

• Amnestic mild cognitive impairment
• Non-amnestic mild cognitive impairment
• Metamemory
• Metacognition
• Retrospective confidence judgments
• Semantic memory

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1 Of the 21 participants removed from our analyses due to having GDS scores associated with clinical depression, results from a Pearson chi-square test showed that the frequency of these depressed participants did not significantly differ between groups.

2 Only 8 SCD participants were classified based on informant-report of cognitive concerns. Box-plot analyses showed that these 8 participants were not outliers in any of the relevant demographic or experimental measures.

3 Mean recognition accuracy was calculated using 74 out of the original 75 general knowledge recognition trials, as one particular trial was excluded from our analyses due to an error in how the general knowledge question appeared for some participants.

4 Mean recognition response time was calculated using 74 out of the original 75 general knowledge recognition trials, as one particular trial was excluded from our analyses due to an error in how the general knowledge question appeared for some participants.

Additional information

Funding

This work was supported by National Institute of General Medical Sciences [grant number SC2AG039235]; National Institute on Aging [grant number NIA 1R01AG039409-01,NIA 2 R01 AG03949].