Early life adversity and polycystic ovary syndrome among North American pregnancy planners.

Subjective cognitive complaints and performance on objective neuropsychological tests capture complementary perspectives on cognitive aging but often diverge in cognitively unimpaired (CU) older adults. This divergence can reflect measurement context, including differences between performance under structured testing and real‐world cognitive demands, practice effects on repeated assessment, and ceiling or floor constraints of standardized neuropsychological tests that limit sensitivity to subtle changes that might be more detectable in everyday contexts., , Socio‐emotional factors such as mood and anxiety, personality and health beliefs, and individual differences in education attainment or cognitive reserve can differentially influence subjective ratings and objective test performance., , Early biological changes that arise before clinically detectable cognitive impairment, including amyloid and tau accumulation and neurodegeneration or atrophy, may further contribute to disagreement between self‐report and neuropsychological test performance., Prior studies have frequently examined subjective complaints and objective cognition separately or treated one as a predictor or covariate of the other, leaving the joint phenotype largely uncharacterized and contributing to mixed conclusions about clinical significance., Studies that evaluate both self‐reported cognitive decline and objective test performance demonstrate heterogeneous patterns, including subjective cognitive decline (SCD) despite preserved objective performance, reduced insight/awareness characterized by impaired performance with limited complaint, and concordant normal or concordant impairment patterns., , , These profiles differ in everyday functioning and in risk for subsequent cognitive decline and clinical outcomes, although the direction of risk appears to vary across cohorts., However, the biological features underlying those profiles in CU older adults remain incompletely characterized, as many studies focus on a single biomarker, clinic‐based populations, or restrict to the SCD profile alone without parallel evaluation of alternative subjective–objective configurations. Integrating neurobiological markers with subjective–objective profiles may improve biological characterization of cognitive status in CU older adults. Biomarkers that index neurodegeneration and global brain aging, including plasma neurofilament light chain (NfL), structural magnetic resonance imaging (MRI) composites of atrophy in Alzheimer's disease (AD) vulnerable regions, and brain‐predicted age difference (brain‐PAD), provide information on neuronal injury and systems‐level aging. In contrast, plasma phosphorylated tau 217 (p‐tau217) indexes AD‐related amyloid and tau pathology, whereas glial fibrillary acidic protein (GFAP) indexes astroglial activation associated with AD‐related inflammatory processes. Evaluating these biomarkers across profile types may clarify whether discordance between subjective reports and objective performance, or differences across profiles, is accompanied by measurable neurobiological differences. Accordingly, prespecified and transparent definitions of subjective and objective status are essential for valid inference of potential biomarker differences.