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Validation of Self-Reported Cognitive Problems with Objective Neuropsychological Performance in Manganese-Exposed Residents
Bowler, R., S. Adams, C. Wright, V. Gocheva, C. Kircos, M. Colledge, AND D. Lobdell. Validation of Self-Reported Cognitive Problems with Objective Neuropsychological Performance in Manganese-Exposed Residents. Manganese 2016 The Second International Conference on Manganese, New York, NY, September 25 - 28, 2016.
This study addresses research questions under Sustainable and Healthy Communities (2.62). The present study reports findings that investigated self-reported cognitive problems in relation to objective neuropsychological performance measures in people who were exposed to airborne manganese. The study population is based on the two Ohio communities that were part of the Regional Applied Research Effort in Region 5 examining airborne manganese exposure and neurological effects.
There is a lack of validation of self-reported cognitive problems with objective neuropsychological measures. The validity of four self-reported cognitive items from a health questionnaire (HQ) and the Symptoms Checklist 90-Revised (SCL-90-R) was examined with objective clinical neuropsychological test performance in 147 manganese (Mn) exposed residents. These residents were from two Ohio towns exposed to ambient air-Mn from an industrial source with modeled average air-Mn concentrations of 0.54 µg/m3 (range: 0.01-4.58) and were part of a larger study of cognitive, motor, tremor abnormalities and their relationship to Mn exposure.The primarily white (94.6%) participants (aged 30-64) lived in the towns for at least 10 years (range: 10-64) and had 13.9 years of education, on average. In the last 7 days before testing, 94 (64.4%) participants self-reported concentration problems and 105 (71.8%) self-reported memory problems. After adjusting for age and education, participants who self-reported cognitive problems did not perform worse on the objective neuropsychological measures than those who reported not having problems, except on 1 of 17 neuropsychological tests (Stroop Color). Greater levels of depression and female sex predicted having more self-reported cognitive problems. Higher education was associated with fewer self-reported cognitive problems. Measures of Mn in air, blood, hair, and toenails were not associated with subjective cognitive self-reported problems. Residential distance from the Mn source accounted for a small proportion of variance (4%) in cognitive problems but depression remained the largest predictor (21%).These results show that self-report of cognitive problems lack validity when compared to objective neuropsychological test performance. The adults from this Mn-exposed population did not accurately assess their cognitive status. The participants’ misperception of having “cognitive problems” likely is the result of depression. Disclaimer: The views expressed in this work are those of the authors and do not necessarily reflect the views or policies of the EPA and ATSDR.