Subjective cognitive decline among diverse older adults: Prevalence and associations with objective cognition

Abstract

Introduction: Subjective cognitive decline (SCD) may precede objective cognitive impairment. We examined prevalence, type of SCD, and associations with neuropsychological measures among diverse older adults.

Methods: The sample included older adults from three ethnoracial groups enrolled in the U.S. Study to Protect Brain Health Through Lifestyle Intervention to Reduce Risk (POINTER) trial. Everyday Cognition (ECog) measured SCD, and neuropsychological function was assessed using global memory, executive function, and processing speed composites.

Results: Hispanic/Latinx participants were more likely to report SCD than non-Hispanic White (NHW) or Black participants, particularly executive function concerns. In the full sample, adjusting for demographics and depression, SCD ratings were associated with most neuropsychological outcomes. In analyses stratified by ethnoracial group, SCD ratings were associated with many of the neuropsychological domains in NHW participants and with processing speed among Black participants; no association was observed in Hispanic/Latinx participants.

Discussion: Prevalence, type of SCD, and associations with cognition varied by ethnoracial group.

Clinical trial registration number: NCT03688126 (ClinicalTrials.gov).

Highlights: Hispanic/Latinx participants endorsed greater subjective cognitive decline (SCD) than other ethnoracial groups. Hispanic/Latinx participants were more likely to endorse executive function concerns. SCD was associated with several neuropsychological domains in non-Hispanic White participants. SCD was related to processing speed for Black participants. SCD was unrelated to objective cognitive performance in Hispanic/Latinx participants.

Keywords: Alzheimer's disease; aging; cognition; ethnoracial differences; memory complaints; risk factors; subjective cognitive concerns; subjective cognitive decline.