How do sadness, loneliness, and confidence differ between older adults with and without cognitive impairment?

Details

Changes in emotional health are common in typical aging and among people with mild cognitive impairment (MCI) and Alzheimer's disease (AD). This creates a critical need to identify differences in emotional functioning between adults with and without cognitive impairment. The study explored whether the NIH‐Toolbox Emotional Battery (NIHTB‐EB), a set of validated, reliable, and efficient measures, could detect emotional-functioning differences among older adults with varying levels of cognitive impairment.

Data came from Advancing Reliable Measurement in Alzheimer’s Disease and Cognitive Aging (ARMADA), a longitudinal, multi-site study. Participants were recruited from 11 existing cohorts nationwide: 276 cognitively normal (NC) adults, 103 people with MCI, and 69 people with AD; mean age was 78 years (SD = 8.25), and 53.2% were female. Baseline emotional health was assessed in 2019–2020 using NIHTB‐EB. Univariate analyses and analysis of covariance (ANCOVA) tested differences across the three groups on multiple emotional dimensions, adjusting for important covariates; Tukey post-hoc pairwise comparisons were also performed.

After adjustment for age, gender, marital status, and education, clinical group had a significant main effect on sadness, fear-affect, anger–physical aggression, loneliness, self-efficacy, and the negative affect composite score (all p < 0.05; the abstract refers to Figure 1). In Tukey post-hoc comparisons, MCI versus NC differences were 4.18 for negative affect, 3.08 for sadness, and 3.08 for anger–physical aggression; AD versus NC differences were 3.65 for negative affect, 4.60 for anger–physical aggression, 3.95 for loneliness, 4.60 for sadness, and −3.18 for self-efficacy (all p < 0.05; the abstract refers to Figure 1).

The authors concluded that people with MCI and AD reported higher levels of negative emotions and lower self-efficacy than normal controls. Using a comprehensive set of emotional-functioning measures, the findings extended understanding of differences between older adults with and without cognitive impairment in aspects of emotional functioning essential to quality of life. The authors found NIHTB‐EB useful for assessing and differentiating emotional health outcomes among cognitively normal adults and those diagnosed with MCI or AD.