Language, Subjective Cognitive Decline and Help Seeking in Latinx

Abstract

AbstractBackgroundSubjective cognitive decline (SCD) is a marker of Alzheimer’s disease and related dementia (ADRD) risk, as well as a reason why older adults seek medical help. However, whether the concept of SCD has utility in Latinx populations has been questioned because SCD’s inconsistent associations with cognition in this population. Measurement factors, such as how we ask about SCD (e.g., age‐anchoring) and person factors (e.g., preferred language) may influence the reported level of measured SCD and/or its association with cognition and help‐seeking.MethodsParticipants included 699 (50 years and older) Latinx individuals enrolled in the Offspring study of Racial and Ethnic Disparities in Alzheimer’s Disease. Participants completed two independent SCD measures that queried if memory had become worse (general SCD) and if it had become worse compared to others their age (age‐anchored SCD). Memory was assessed via the Selective Reminding Test (SRT) total and delayed raw scores. Help‐seeking was assessed by one item that asked if individuals had talked to a nurse/doctor about their cognitive concerns. In a series of linear and logistic regressions, we evaluated the cross‐sectional relationship between 1) SCD (general and age‐anchored) and memory performance and 2) SCD and help‐seeking. Models were stratified by preferred language (English‐speakers/Spanish‐speakers) and adjusted for age, sex, education, and medical burden.ResultsSpanish‐speaking Latinx participants were on average older, had less educational attainment, had greater medical burden, and reported more general SCD, but not age‐anchored SCD, than English‐speaking Latinx participants. Memory scores did not differ across language groups. General SCD was associated with help‐seeking in Spanish‐speakers only. Greater age‐anchored SCD was associated with lower SRT total score in English‐ (R2 = 0.158, B = ‐4.289, CI = ‐8.342,‐0.236) and Spanish‐speakers (R2 = 0.178, B = ‐5.889, CI = ‐10.875,‐0.904), as well as greater help‐seeking in both groups (English‐speaking: R2 = 0.078, B = 0.842, CI = 0.056,1.740; Spanish‐speaking: R2 = 0.277, B = 2.202,CI = 1.571,2.833).ConclusionsAcross language groups, age‐anchored SCD was consistently associated with memory performance and help‐seeking among Latinx adults. In contrast, general SCD was associated with help‐seeking only in Spanish‐speakers, and not associated with memory performance. This study is the first to demonstrate the utility of age anchoring SCD assessments within both English‐ and Spanish‐speaking Latinx individuals.