Factors associated with subjective cognitive decline in dementia‐free older adults—A population‐based study

Abstract

Background Subjective cognitive decline (SCD) is common in older adults, affects quality of life (QoL), and may represent the earliest clinical manifestation of cognitive decline evolving to dementia. Still little is known about factors associated with SCD. Objectives (1) Assess the associations between SCD and demographic, social, clinical, and personality characteristics as well as QoL, with and without adjustment for objective cognitive performance, and (2) investigate the relations between neuroticism, QoL, and SCD. Methods Cross‐sectional analysis of a cohort of 1567 dementia‐free community‐dwellers from the urban area of Lausanne, Switzerland, aged 64 years and older (mean age 70.9 ± 4.7 years), from CoLaus/PsyCoLaus. SCD was assessed using a validated 10‐item questionnaire. Personality traits, QoL, and perceived social support were evaluated using self‐report measures. Information on depression and anxiety status and socioeconomic characteristics including professional activity were elicited using a semi‐structured interview. Cognitive functioning was assessed through a comprehensive neuropsychological test battery. Statistical analysis was based on logistic regression. Results SCD was present in 18.5% of the sample and it was associated with lower performance in memory and verbal fluency tasks. After controlling for possible confounders, professional activity, neuroticism, and current depression were associated with SCD. Exploratory analysis revealed associations of SCD with QoL, neuroticism, and their interaction. Conclusion Besides objective cognitive performance, SCD is related to several psychosocial factors in dementia‐free community‐dwelling older people. These findings are relevant for the development of healthcare interventions to reduce cognitive complaints, improve QoL, and prevent cognitive decline in general population.

Sex Differences on Montreal Cognitive Assessment and Mini-Mental State Examination Scores and the Value of Self-Report of Memory Problems among Community Dwelling People 70 Years and above: The HUNT Study

“…A recent large epidemiological community-based study from Norway reported that 35% of adults older than 70 years had a diagnosis of MCI, and a Swiss community-based study reported a prevalence of 18.5%. In addition, a review reported a prevalence of 23.8% for the diagnosis of subjective cognitive decline [42, 49, 50]. We suggest that raised awareness about memory problems as a possible first sign of dementia and insight into their own decline of memory function by increasing age could explain the high proportion of complainers of both sexes.…”

“…The association between memory complaints and significant cognitive impairment and dementia has been examined in numerous studies, but only some studies have compared self-reported cognitive complaints (SCC) with scores on the MMSE and MoCA among home-dwelling older people [34-42]. All these studies indicate that older adults with SCC are at higher risk of developing dementia than those with no complaints, although a systematic review concludes that one should not use SCC as a predictor of future development of dementia [35].…”

Are subjective cognitive complaints associated with executive functions and mental health of older adults?

“…Furthermore, little is known about the role played by other psychological factors in predicting the occurrence of subjective cognitive complaints. Concerning this issue, recently, Zullo et al ( 2021 ) argued that cognitive complaints in older individuals are predicted by higher neuroticism and depressive symptoms and are associated with lower extraversion and worse categorical verbal fluency skills. A related research trend showed that global psychological well-being in healthy aging was predicted by self-reported depressive symptoms and two metacognitive measures, including CFQ score (Fastame et al 2014a ).…”

“…Specifically, the current study intended to investigate the following: (1) the nature of the relationships between the CFQ (Broadbent et al 1982 ) scores and several self-reported psychological well-being measures (i.e., including optimism) and objectively assessed executive functions, respectively; (2) whether older individuals reporting higher CFQ (Broadbent et al 1982 ) scores also reported lower mental health indices and showed worse measures of executive functioning. Overall, following Zullo et al ( 2021 ), the current study intended to provide a better understanding of the link between several psychological factors (i.e., the efficiency of executive functions and mental health) and a well-known self-reported metacognitive functioning measure that assesses perception, motor, and memory errors in everyday life, namely the CFQ (Broadbent et al 1982 ). That is, by embracing an applied perspective, the emerging evidence could provide useful information for the implementation of preventive and empowering interventions aimed at improving the quality of life in the last decades of life.…”

“…Furthermore, due to the lack of previous evidence, no a priori hypotheses were proposed on the relationship between subjective cognitive complaints and self-reported optimism in late adulthood. Finally, previous research (Hohman et al 2011 ; Jonker et al 1996 ; Shakeel and Goghari 2017 ; Zullo et al 2021 ) has provided controversial evidence on the associations between executive functions and subjective cognitive complaints in normal aging, therefore no additional a priori hypotheses were proposed.…”