When mind and measurement diverge; the interplay between subjective cognitive complaints (SCCs), objective cognition, age, and depression in autistic adults

• Published in: Psychiatry research 2024-03, Vol.333, p.115759-115759, Article 115759
• Main Authors: Torenvliet, Carolien, Groenman, Annabeth P., Agelink van Rentergem, Joost A., Radhoe, Tulsi A., Geurts, Hilde M.
• Format: Article
• Language: English
• Subjects: Aging; Autism; Autistic Adults; Cognition; Cognitive difficulties; Depression; Regression trees; Subjective cognitive complaints
• ISSN: 0165-1781; 1872-7123
• DOI: 10.1016/j.psychres.2024.115759

•The largest study on subjective cognitive complaints (SCCs) in autism thus far.•It included 202 autistic and 247 non-autistic adults between 30-85 years.•Eleven cognitive measures, depression symptoms and SCCs were assessed.•SCCs were strongly related to depression, but not cognitive performance.•SCCs do not equal cognitive performance and should be interpreted cautiously. While the increased incidence of dementia and subjective cognitive complaints (SCCs) suggests that autistic adults may face cognitive challenges at older age, the extent to which SCCs predict (future) cognitive functioning remains uncertain. This uncertainty is complicated by associations with variables like depression. The current study aims to unravel the interplay of age, depression, cognitive performance, and SCCs in autism. Using a large cross-sectional cohort of autistic (n=202) and non-autistic adults (n=247), we analyzed associations of SCCs with age, depression, and cognitive performance across three domains (visual memory, verbal memory, and fluency). Results showed a strong significant association between depression and SCCs in both autistic and non-autistic adults. Cognitive performance was not significantly associated with SCCs, except for a (modest) association between visual memory performance and SCCs in autistic adults only. Follow-up regression tree analysis indicated that depression and being autistic were considerably more predictive of SCCs than objective cognitive performance. Age nor sex was significantly associated with SCCs. These findings indicate that self-reported cognitive functioning does not equal cognitive performance, and should be interpreted with care, especially in individuals with high rates of depression. Longitudinal investigations are needed to understand SCCs’ role in dementia and cognitive health in autism.