Modifiable dementia risk factors associated with objective and subjective cognition.

INTRODUCTION: Early detection of both objective and subjective cognitive impairment is important. Subjective complaints in healthy individuals can precede objective deficits. However, the differential associations of objective and subjective cognition with modifiable dementia risk factors are unclear. METHODS: We gathered a large cross-sectional sample (N = 3327, age 18 to 84) via a smartphone app and quantified the associations of 13 risk factors with subjective memory problems and three objective measures of executive function (visual working memory, cognitive flexibility, model-based planning). RESULTS: Depression, socioeconomic status, hearing handicap, loneliness, education, smoking, tinnitus, little exercise, small social network, stroke, diabetes, and hypertension were all associated with impairments in at least one cognitive measure. Subjective memory had the strongest link to most factors; these associations persisted after controlling for depression. Age mostly did not moderate these associations. DISCUSSION: Subjective cognition was more sensitive to self-report risk factors than objective cognition. Smartphones could facilitate detecting the earliest cognitive impairments. HIGHLIGHTS: Smartphone assessments of cognition were sensitive to dementia risk factors. Subjective cognition had stronger links to most factors than did objective cognition. These associations were not fully explained by depression. These associations were largely consistent across the lifespan.

Reliable, rapid, and remote measurement of metacognitive bias.

Metacognitive biases have been repeatedly associated with transdiagnostic psychiatric dimensions of 'anxious-depression' and 'compulsivity and intrusive thought', cross-sectionally. To progress our understanding of the underlying neurocognitive mechanisms, new methods are required to measure metacognition remotely, within individuals over time. We developed a gamified smartphone task designed to measure visuo-perceptual metacognitive (confidence) bias and investigated its psychometric properties across two studies (N = 3410 unpaid citizen scientists, N = 52 paid participants). We assessed convergent validity, split-half and test-retest reliability, and identified the minimum number of trials required to capture its clinical correlates. Convergent validity of metacognitive bias was moderate (r(50) = 0.64, p < 0.001) and it demonstrated excellent split-half reliability (r(50) = 0.91, p < 0.001). Anxious-depression was associated with decreased confidence (ß = - 0.23, SE = 0.02, p < 0.001), while compulsivity and intrusive thought was associated with greater confidence (ß = 0.07, SE = 0.02, p < 0.001). The associations between metacognitive biases and transdiagnostic psychiatry dimensions are evident in as few as 40 trials. Metacognitive biases in decision-making are stable within and across sessions, exhibiting very high test-retest reliability for the 100-trial (ICC = 0.86, N = 110) and 40-trial (ICC = 0.86, N = 120) versions of Meta Mind. Hybrid 'self-report cognition' tasks may be one way to bridge the recently discussed reliability gap in computational psychiatry.

Elevated emotion network connectivity is associated with fluctuations in depression.

Elevated emotion network connectivity is thought to leave people vulnerable to become and stay depressed. The mechanism through which this arises is however unclear. Here, we test the idea that the connectivity of emotion networks is associated with more extreme fluctuations in depression over time, rather than necessarily more severe depression. We gathered data from two independent samples of N = 155 paid students and N = 194 citizen scientists who rated their positive and negative emotions on a smartphone app twice a day and completed a weekly depression questionnaire for 8 wk. We constructed thousands of personalized emotion networks for each participant and tested whether connectivity was associated with severity of depression or its variance over 8 wk. Network connectivity was positively associated with baseline depression severity in citizen scientists, but not paid students. In contrast, 8-wk variance of depression was correlated with network connectivity in both samples. When controlling for depression variance, the association between connectivity and baseline depression severity in citizen scientists was no longer significant. We replicated these findings in an independent community sample (N = 519). We conclude that elevated network connectivity is associated with greater variability in depression symptoms. This variability only translates into increased severity in samples where depression is on average low and positively skewed, causing mean and variance to be more strongly correlated. These findings, although correlational, suggest that while emotional network connectivity could predispose individuals to severe depression, it could also be leveraged to bring about therapeutic improvements.

Using smartphones to optimise and scale-up the assessment of model-based planning.

Model-based planning is thought to protect against over-reliance on habits. It is reduced in individuals high in compulsivity, but effect sizes are small and may depend on subtle features of the tasks used to assess it. We developed a diamond-shooting smartphone game that measures model-based planning in an at-home setting, and varied the game's structure within and across participants to assess how it affects measurement reliability and validity with respect to previously established correlates of model-based planning, with a focus on compulsivity. Increasing the number of trials used to estimate model-based planning did remarkably little to affect the association with compulsivity, because the greatest signal was in earlier trials. Associations with compulsivity were higher when transition ratios were less deterministic and depending on the reward drift utilised. These findings suggest that model-based planning can be measured at home via an app, can be estimated in relatively few trials using certain design features, and can be optimised for sensitivity to compulsive symptoms in the general population.