Subjective Cognitive Decline symptom burden is associated with self‐perceived risk for AD

Abstract

BackgroundSubjective Cognitive Decline (SCD) refers to a self‐experienced decline in cognitive capacity despite normal performance on objective tests. Research has consistently linked SCD to incident Alzheimer’s disease (AD). The role of perceptions around aging and AD risk in the SCD experience has not been clearly delineated. Here we aimed to determine the association between chronological age, self‐perceived risk for AD, and SCD symptom burden.MethodCommunity‐dwelling participants aged ≥50 years (n = 483), located within the United States were recruited via the crowdsourcing website Amazon Mechanical Turk. They completed a survey consisting of demographic questions and the Subjective Cognitive Decline Questionnaire (SCD‐Q MyCog). The survey also included items about self‐perceived risk for AD (“Do you believe that you are at higher risk of AD than your peers”; endorsed = 1, not endorsed = 0) and an AD family history (endorsed = 1; not endorsed = 0). Linear regression was used to predict SCD total score from combinations of these measures, adjusted for gender.ResultThe sample’s descriptive data were: age M = 64±5.5, range 50–79, SCD total M = 4.7±5.8, range 0–24, 66.5% female. There were 17% (n = 82) who perceived themselves at heightened risk for AD, and 27% (n = 132) with a positive family history. When entered together, high perceived risk predicted higher SCD total whereas family history and age were not predictive: B = 4.9, p<.001, B = ‐.004, p = .99, B = ‐.024, p = .59, respectively, R‐squared = .11. SCD total was M = 8.8±6.6 for the high‐risk, 3.9±5.2 for low‐risk group. Adding age squared did not improve the model: B = ‐.001, p = .88. Interaction analyses revealed a trend for perceived AD risk but not family history to be conditional on age, B = ‐.260, p = .067, B = .060, p = .603..Johnson‐Neyman regions‐of‐significance indicated that beyond age 70, the coefficient for self‐perceived AD risk approached zero and was non‐significant:ConclusionOur findings highlight the importance of self‐perceptions of AD risk for SCD in the youngest old adults (age<70). These individuals appear to evaluate their cognitive capacity in relation to their perceived susceptibility to AD. Interestingly, objective risk (older age, AD family history) does not contribute to this evaluation.