Prevalence Of Subjective Cognitive Decline Research Articles

Socioeconomic and medical determinants of state-level subjective cognitive decline in the United States.

It is important to understand the socioeconomic and medical determinants of subjective cognitive decline (SCD) at a population level in the United States. The primary outcomes are state-level rates of SCD and SCD-related functional impairment in adults aged ≥ 45, both measured in the Behavioral Risk Factor Surveillance System from 2016 to 2022. The exposures are state-level rates of poverty, unemployment, homelessness, college education, racial and ethnic minorities, uninsurance, smoking, hypertension, diabetes, and obesity as well as household income and physician density. The strongest state-level associations with rates of SCD were the prevalence of diabetes (rho=0.64), hypertension (rho=0.59), and poverty (rho=0.58; all p<0.001), and with SCD-related functional impairment were prevalence of poverty (rho=0.71), diabetes (rho=0.68), and hypertension (rho=0.53; all p<0.001). This study highlights critical links between SCD and socioeconomic and medical determinants in adults aged ≥ 45 in the United States, including the prevalence of poverty, diabetes, and hypertension. State-level analysis reveals socioeconomic and medical risk factors for subjective cognitive decline (SCD) at a population level. The prevalence of poverty is a critical contributor to the state-level prevalence of SCD. The prevalence of diabetes and hypertension are also strong state-level determinants of SCD. Addressing the burden of cognitive decline at the population level necessitates targeting socioeconomic and medical factors.

Investigating Caregiving Dynamics and Subjective Cognitive Decline: An Analysis Using BRFSS Database Insights

Background: Subjective cognitive decline (SCD), characterized by self-reported memory or cognitive difficulties, is an increasing concern among older adults. This study utilizes data from the Behavioral Risk Factor Surveillance System (BRFSS) to examine SCD prevalence, professional consultation patterns, and caregiving dynamics among U.S. adults aged 45 years and older. Objectives: To explore trends in the prevalence of SCD, the extent of professional consultation among those experiencing SCD, and recent caregiving activities. The study aims to identify demographic variations and assess changes over time. Methods: This cross-sectional study analyzes BRFSS data from 2020 and 2022, which includes self-reported data on cognitive symptoms, professional consultation, and caregiving activities. Descriptive statistics and age-adjusted prevalence estimates were computed for SCD, professional consultation, and caregiving activities. Comparative analyses were performed to identify trends between 2020 and 2022, and to assess variations across demographic groups. Results: Between 2020 and 2022, the age-adjusted prevalence of SCD among adults aged 45 and older rose from 9.7% to 11.7%, affecting both genders. Prevalence increased from 9.4% to 11.8% for males and from 10.0% to 11.7% for females. In 2022, Black non-Hispanic adults had a prevalence of 12.2%, Hispanic adults 12.3%, Asian non-Hispanic adults 9.4%, Hawaiian or Pacific Islander non-Hispanic adults 9.9%, American Indian or Alaska Native non-Hispanic adults 21.1%, and Multiracial non-Hispanic adults 19.2%. Professional consultation rates declined from 47.7% to 44.3%. Caregiving for individuals with dementia or cognitive impairment was reported by 22.4% in 2020, decreasing slightly to 21.3% in 2022. General caregiving showed a slight increase from 18.9% to 19.5%. Variations in SCD prevalence and caregiving activities were observed across gender, race, and ethnicity. Conclusion: The study highlights a rising trend in SCD and variations in professional consultation and caregiving dynamics. These findings emphasize the need for targeted public health strategies to address cognitive decline and support caregivers. Enhancing access to healthcare and caregiver resources is crucial for improving outcomes for affected individuals and their caregivers.

Capturing subjective cognitive decline with a new combined index in low education patients with Parkinson's disease.

Subjective Cognitive Decline (SCD) refers to self-reported cognitive decline with normal global cognition. This study aimed to capture SCD among low educated patients with Parkinson's disease (PD) using a newly established indicator. We recruited 64 PD patients with low education levels (education ≤12 years) for the study. The presence of SCD was determined based on a Unified Parkinson's Disease Rating Scale Part I (1.1) score ≥ 1. Spearman analysis and multivariate binary logistic regression analyses were conducted to investigate factors associated with the PD-SCD group. The receiver operating characteristic (ROC) curve was used to evaluate the sensitivity and specificity of the new combined index. The prevalence of SCD in PD patients was 43.75%. Low educated PD-SCD patients had higher scores on the Non-Motor Symptoms Scale (NMSS), Parkinson's Fatigue Scale (PFS), Epworth Sleepiness Scale (ESS), as well as higher scores on the UPDRS-I and UPDRS-II, compared to PD patients without SCD. They also demonstrated poorer performance on the Montreal Cognitive Assessment (MoCA), particularly in the domains of executive abilities/attention/language. Multivariate binary regression confirmed the significant association between PD-SCD and MoCA-executive abilities/attention/language. Based on these findings, a combined index was established by summing the scores of MoCA-executive abilities, MoCA-attention, and MoCA-language. ROC analysis showed that the combined index could differentiate PD-SCD patients with an area under the curve (AUC) of 0.876. A score of 12 or less on the combined index had a sensitivity of 73.9% and a specificity of 76.2% for diagnosing PD-SCD. These low education patients with PD-SCD may exhibit potential PD-related pathological changes. It is important for clinicians to identify PD-SCD patients as early as possible. The newly combined index can help capture these low educated PD-SCD patients, with an AUC of 0.867, and is expected to assist clinicians in earlier identification and better management of PD patients.

Exploring the Association Between Loneliness, Subjective Cognitive Decline, and Quality of Life Among Older Thai Adults: A Convergent Parallel Mixed-Method Study.

Examining the rising prevalence of subjective cognitive decline as an early indicator of dementia in adults, this study investigates its complex interaction with loneliness and quality of life in individuals with preclinical dementia. Using a convergent parallel mixed-method approach, we employed Structural Equation Modeling on a cohort of 149 older adults. Qualitative insights were derived from focused group discussions and in-depth semi-structured interviews with a cohort of 23 older adults. Loneliness emerges as a pivotal contributor, exerting a discernible partial indirect effect on quality of life through subjective cognitive decline (indirect effect = -0.145, p = .006). Noteworthy differentials surfaced, with the impact of subjective cognitive decline on quality of life heightened in those with chronic diseases (△χ2 = 6.139, p = .013). Loneliness, wielding a palpable impact, intricately interlaces with quality of life, the nexus of which is intricately mediated by subjective cognitive decline.

Sleep Quality and Subjective Cognitive Decline among Older Adults: The Mediating Role of Anxiety/Depression and Worries.

Subjective cognitive decline (SCD) in older individuals has been implicated as a possible precursor to Alzheimer's disease. Poor sleep quality and anxiety/depressive symptoms have been linked to the progression of SCD, but these associations and older adults' worries have yet to be fully established in the Chinese older adult population, which is one of the largest in the world. The aim of this study was to explore the relationship between sleep quality, anxiety/depression symptoms, and worries, and SCD prevalence among Chinese community-dwelling older individuals. A total of 707 adults aged between 60 and 99 from Shanghai, China, completed self-report questionnaires that covered their cognitive and mental well-being, as well as demographic information. Subjective cognitive decline (SCD) was evaluated using the memory/cognition syndromes of the old adult self-report (OASR). Sleep quality, anxiety/depression, and worries were measured from their respective sections of the OASR. The general linear regression models showed that poorer sleep quality was associated with an increased prevalence of anxiety/depression symptoms, worries, and SCD among older adults. As suggested by the mediation analysis, anxiety/depression and worries were significant mediators in the relationship between sleep quality and SCD prevalence, and these two factors also have a serial mediation effect between sleep quality and SCD prevalence. Poorer sleep quality is associated with a higher rate of SCD among older adults, and a higher prevalence of anxiety/depression and worries mediate this relationship, suggesting possible mechanism pathways that lead to SCD. These factors may provide the basis for early, targeted interventions for older adults' mental health preservation and improved quality of life.

A household survey of the prevalence of subjective cognitive decline and mild cognitive impairment among urban community-dwelling adults aged 30 to 65

While it is possible to detect cognitive decline before the age of 60, and there is a report indicating that certain cognitive abilities peak in one's 30s, the evidence regarding cognitive problems in populations younger than 65 years is scarce. This study aims to (1) determine the proportion of community-dwelling adults with different cognitive status, and (2) determine the prevalence of neuropsychiatric behaviors. A population-based survey was conducted in Chiang Mai, Thailand. Individuals aged 30 to 65 were recruited and assessed for demographic data, memory complaints, cognitive performance, and neuropsychiatric symptoms using self-reported questionnaires. In a total of 539 participants, 33.95% had mild cognitive impairment (MCI), 7.05% had subjective cognitive decline (SCD), and 52.50% had neuropsychiatric symptoms. The risk of MCI increased with age, and neuropsychiatric symptoms were significantly higher in those with MCI or SCD than in those without (p < 0.001). The most common complaints were sleep problems, anxiety, and irritability. Screening for MCI in adults aged < 65 years might be useful. However, further investigation on the appropriate age to screen and the program’s cost-effectiveness is suggested.

191 Ethnoracial Disparities in Subjective Cognitive Decline Among Sexual Minority Men in the U.S.

OBJECTIVES/GOALS: Sexual minority men (SMM) of color are at greater dementia risk than their White and non-SMM counterparts. The purpose of this study is to examine the relative effects of ethnoracial minority status, sexual minority status, and the intersection of both on dementia risk for men in the U.S. using subjective cognitive decline (SCD) as a proxy for dementia. METHODS/STUDY POPULATION: Data will be weighed to represent population estimates from 35 states’ 2019-2022 Behavioral Risk Factor Surveillance System Survey to describe SCD among 4 study groups consisting of SMM and non-SMM who are from minoritized ethnoracial groups (i.e., minoritized ethnoracial gay and bisexual men, minoritized ethnoracial heterosexual men), and White SMM and White non-SMM (i.e., White gay and bisexual men, White heterosexual men) aged ≥45 years. Logistic regressions and adjusted odds ratios will determine SCD prevalences and test for differences between prevalence and demographic characteristics (i.e., education, employment, income, marital status, health coverage, and depression). RESULTS/ANTICIPATED RESULTS: Due to excess chronic stress from belonging to multiple intersecting marginalized identities, we expect that SMM from minoritized ethnoracial groups will have a greater prevalence and higher odds of SCD after accounting for demographic factors when compared to groups that benefit from both “White Privilege” and heterosexism (White non-SMM, White SMM, and minoritized ethnoracial non-SMM). We also expect the odds of SCD to be higher in minoritized ethnoracial SMM when compared to White non-SMM and minoritized ethnoracial non-SMM. The odds of SCD are expected to be higher in White SMM compared to White non-SMM. DISCUSSION/SIGNIFICANCE: This is the first population-based study to apply an intersectional lens to examine dementia risk across the axes of race, sexual orientation, and gender identity. Findings from this study can inform targeted interventions to address the needs and experiences of LGBTQ+ subgroups at risk or living with dementia.

COMPARING SELF-REPORTED MEASURES OF SUBJECTIVE COGNITIVE DECLINE

Abstract Symptoms of subjective cognitive decline (SCD) can be early indicators of possible future dementia. Estimates of self-reported SCD prevalence are available from various data sources including the Behavioral Risk Factor Surveillance System’s (BRFSS) current Cognitive Decline Optional Module. Recent revisions to the Module were proposed based on input from subject matter experts, including reducing introductory phrasing and refining question and response options. It is unknown how these changes may impact estimates of SCD prevalence. To assess whether prevalence of SCD differs based on Module phrasing and conceptualizations of SCD-related questions, this analysis used data (n=3526) from the 2022 FallStyles survey. Respondents were randomly assigned to one of two groups receiving different sets of Module questions: group A received questions mirroring the former language and group B received the revised phrasing. Estimates were weighted to match the 2021 US Current Population Survey. SCD prevalence among respondents aged ≥18 years was 8.9% in group A versus 16.9% in group B. Among adults aged ≥45 years, SCD prevalence in group A (9.3%) was similar to the 2019-2020 BRFSS estimate (9.8%), while it was nearly double (17.6%) in group B. Within both groups, SCD prevalence was higher among those earning less than $25,000, with lower educational attainment, and who identified as female than their counterparts. Simplified prompts and refined questions may provide higher estimates of SCD prevalence. Given the subjective interpretation of respondents’ own memory changes involved in measuring SCD, understanding the impact of question phrasing and language is critical when interpreting resulting data.

High prevalence of subjective cognitive decline in older Chinese adults: a systematic review and meta-analysis.

Subjective cognitive decline (SCD) is considered a preclinical stage of Alzheimer's disease. However, reliable prevalence estimates of SCD in the Chinese population are lacking, underscoring the importance of such metrics for policymakers to formulate appropriate healthcare strategies. To systematically evaluate SCD prevalence among older Chinese adults. PubMed, Web of Science, The Cochrane Library, Embase, CNKI, Wanfang, VIP, CBM, and Airiti Library databases were searched for studies on SCD in older Chinese individuals published before May 2023. Two investigators independently screened the literature, extracted the information, and assessed the bias risk of the included studies. A meta-analysis was then conducted using Stata 16.0 software via a random-effects model to analyze SCD prevalence in older Chinese adults. A total of 17 studies were included (n = 31,782). The SCD prevalence in older Chinese adults was 46.4% (95% CI, 40.6-52.2%). Further, subgroup analyzes indicated that SCD prevalence was 50.8% in men and 58.9% among women. Additionally, SCD prevalence in individuals aged 60-69, 70-79, and ≥ 80 years was 38.0, 45.2, and 60.3%, respectively. Furthermore, SCD prevalence in older adults with BMI <18.5, 18.5-24.0, and > 24.0 was 59.3, 54.0, and 52.9%, respectively. Geographically, SCD prevalence among older Chinese individuals was 41.3% in North China and 50.0% in South China. In terms of residence, SCD prevalence was 47.1% in urban residents and 50.0% among rural residents. As for retired individuals, SCD prevalence was 44.2% in non-manual workers and 49.2% among manual workers. In the case of education, individuals with an education level of "elementary school and below" had an SCD prevalence rate of 62.8%; "middle school, "52.4%; "high school, "55.0%; and "college and above, "51.3%. Finally, SCD prevalence was lower among married individuals with surviving spouses than in single adults who were divorced, widowed, or unmarried. Our systematic review and meta-analysis identified significant and widespread SCD prevalence in the older population in China. Therefore, our review findings highlight the urgent requirement for medical institutions and policymakers across all levels to prioritize and rapidly develop and implement comprehensive preventive and therapeutic strategies for SCD.Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023406950, identifier: CRD42023406950.

Prevalence of subjective cognitive decline and its association with physical health problems among urban community dwelling elderly population in South India

AbstractBackgroundThe incidence of cognitive disorders is increasing in India1. Stage II of the preclinical Alzheimer’s Disease (PCAD) is characterised by subjective complaints of decline in cognition, termed Subjective Cognitive Decline (SCD)2,3. Objective assessments of cognition is normal in that stage. There are no studies from India that looked at SCD in the community. Our study aims to look at the prevalence of SCD in an urban dwelling elderly population and its correlates.Method418 individuals above the age of 60 were screened using Subjective Memory Complains Questionnaire (SMCQ) and also screened for medical and psychiatric illness. Objective measurement of cognitive functions was done using MOCA.Results372(92.5%) had reported at least 1 subjective complaint using the participant version of the Subjective Memory Complaint Questionnaire(SMCQ). Among those without any reported subjective complaints,17(56.6%) had objective cognitive impairment on assessments. In total,13 (3.49%) had normal cognition and 179(48.12%) of the evaluated subjects had pre‐MCI SCD. There is no statistically significant association between physical health parameters of Diabetes mellitus and Hypertension or any sociodemographic variables except educational attainment. The mean subjective complaints score is lesser and means objective cognition scores are higher in those with higher secondary school educational attainment (p value&lt;0.001) when compared to those who don’t.ConclusionsThere is significant morbidity of cognitive decline in the elderly. Subjective memory complaints are present in most of the elderly(92.5%) and 179(48.12%) had pre‐MCI SCD. SCD is a complex condition that requires further longitudinal studies with biomarker assessment to understand the mechanism of progression to AD.

Urban‐rural differences in the prevalence of Subjective Cognitive Decline in India: A comparative study

AbstractBackgroundSubjective Cognitive Decline (SCD), defined as a self‐experienced persistent cognitive decline with a normal performance in objective neuropsychological assessments is one of the first clinical manifestations of dementia. SCD has a strong association with depression, and more research is needed to understand the relationship between the two. When they co‐occur the risk of developing dementia increases. Despite the increased focus on the preclinical stages of dementia such as SCD there is limited research on its prevalence specifically in India. The present study aims to bridge this research gap by estimating the prevalence of SCD in India and assessing urban‐rural differences in its prevalence as well as sociodemographic factors.MethodThe study used data from two ongoing community‐based prospective cohort studies, namely the Tata Longitudinal Study of Ageing (TLSA) and Srinivaspura Aging, Neuro Senescence and COGnition (SANSCOG) in urban Bangalore and Srinivaspura respectively (Sundarakumar et al., 2020). Baseline data collected from 4429 participants aged 45 years and older were included in the analysis. The study used Clinical Dementia Rating Scale (CDR) scores and participants' responses to the questions pertaining to subjective cognitive impairment in Cognitive Function Instrument (CFI) and Geriatric Depression Scale (GDS) to estimate the prevalence of SCD.ResultOf 4429 participants recruited between 2015 and 2022, a total of 1010 (22.8%) participants [median (IQR) age, 60 (15)] were classified as having SCD. As shown in Tabe1, the prevalence was higher in the rural cohort than in the urban cohort (25.1% vs 14.0%, p&lt;0.001). The rural cohort was also found to be comparatively younger (57 (15) vs 63 (14)), and have fewer years of education (4 (9) vs 15(2)). Depression was found to have significant association with SCD in both the cohorts, with more depressive symptoms observed in the rural cohort. As shown in Table 2, the prevalence of SCD was higher in women than men in the urban cohort.ConclusionThe study’s findings indicate that despite being comparatively younger, the rural cohort had a higher prevalence of SCD, potentially due to the protective effect of higher years of education in the urban cohort.

P153: The CIMA-Q and CompAS cohort studies on factors associated with Alzheimer's disease (AD): Exploring sociodemographic, health and neuropsychological profile of Subjective Cognitive Decline (SCD) participants from two culturally differentiated samples.

Objective:To explore commonalities and differences in the sociodemographic, health, and neuropsychological characteristics of participants with SCD recruited in two culturally differentiated cohort studies, namely CIMA-Q (Canada; Bellevile et al., 2019) and CompAS (Spain; Juncos et al., 2012).Methods:Older adults with subjective cognitive complaints of the CompAS (N=251; 68.92% women; Control: 30.3%; SCD: 25.9%; MCI: 28.7%) and the CIMA-Q (N=179; 71.5% women; Control:16.1%; SCD: 36.8%; MCI:28.6%) were recruited, respectively, from primary care centers and memory clinics, excluding patients with dementia and other neurological or psychiatric disturbances. Cognitive complaints were assessed considering coincident items of the QAM and MFE questionnaires. Cut-off points for the 5%ile were calculated independently in both samples and according to this, participants were classified as SCD or controls (CompAS: N= 141; CIMA-Q: N=161) considering complaints relevance at baseline (Pereiro et al., 2021). Participants underwent neuropsychological assessment. Participants diagnosed as Mild Cognitive Impairment (MCI) were excluded from the analysis. Between cohort-studies and inter-group (control, SCD) differences were tested in the sociodemographic, health and neuropsychological measures considered. The Holm-Bonferroni correction was applied to reduce the probability of type I error (p&lt;.003).Results:Identical cut-off points for 5%ile were obtained in both samples though SCD prevalence was slightly higher in CIMA-Q. For both samples, equivalence between Control and SCD participants in sociodemographic, health, functionality, and neuropsychological measures was observed. Only complaints and depressive symptomatology was significantly higher in SCD participants than in controls in both CompAS and CIMA-Q studies.Participants of the CIMA-Q, Controls and SCD, showed significantly higher age, cognitive reserve proxies, comorbidity, and better attentional performance than the CompAS participants (see Table 1). CompAS participants, Controls and SCD, showed more neuropsychiatric symptomatology than CIMA-Q participants (see Table 1).Conclusions:Control and SCD participants showed equivalence on sociodemographic, health, functional, and neuropsychological measures in both studies. However, significant between-sample differences in the two groups, particularly in SCD participants, were observed in sociodemographic, health, cognitive reserve, behavioral and attentional measures. Identification of these factors are critical to analyze the transcultural validity of cognitive complaints in predicting progression to AD.Table 1Between group (control, SCD) and Between study (CIMA-Q, CompAS) differences in sociodemographic, health, and cognitive measuresCIMA-QCompASBetween-studies differencesBetween-group differencesBetween-group differencesControlSCDSociodemographicsAgeNSNSCIMA-Q&gt;CompAS; F(1,124)=22.78; p&lt;.001CIMA-Q&gt;CompAS; F(1,172)=36.97; p&lt;.001GenderNSNSNSNSSchooling (years)NSNSNSCIMA-Q&gt;CompAS; F(1,172)=20.74; p&lt;.001Prof. qualificationNSNSCIMA-Q&gt;CompAS; χ24=18.18; p=001CIMA-Q&gt;CompAS; χ24=33.95; p&lt;001Cognitive reserve (quartiles)NSNSCIMA-Q&gt;CompAS; χ23=13.57; p=004CIMA-Q&gt;CompAS;χ23==42.56; p&lt;001Memory familiar antecedentsNSNSNSCIMA-Q&gt;CompAS; χ21==15.03; p&lt;001NeuropsychologySubjective complaints*SCD&gt;Control; F(1,119)=147.17, p&lt;.001)SCD&gt;Control; F(1,177)=192.87, p&lt;.001NSNSCharlson Index*SCD&gt;Control; F(1,115)=5.29, p=.023NSCIMA-Q&gt;CompAS; F(1,123)=394.96; p&lt;.001CIMA-Q&gt;CompAS; F(1,168)=335.98; p&lt;.001General cognitionNS (MoCA)NS (CAMCOG-R)----GDS-15*SCD&gt;Control; F(1,119)=8.60, p=.004SCD&gt;Control; F(1,176)=11.97, p&lt;.001NSNSTMT-A (secs.)*NSNSNSNSTMT-B (secs.)*NSNSCompAS&gt;CIMA-Q; F(1,118)=12.56; p&lt;.001CompAS&gt;CIMA-Q; F(1,163)=21.74; p&lt;.001Verbal fluencyNSNSNSNSSemantic fluencyNSNSNSNSBoston testNSNSNSNSNPI-QNSNSCompAS&gt;CIMA-Q; F(1,119)=16.68; p&lt;.001CompAS&gt; CIMA-Q; F(1,162)=24.46; p&lt;.001Immediate recall (RAVL test)NSNSNSNSShort delay (RAVL test)NSNSNSNSLong delay(RAVL test)NSNSNSNSIntrusions (RAVL test)NSNSNSNSIAVD*NSNSNSNSNote: *On these measures, higher scores denote worse cognition or health condition. TMT: Trail Making Test (A and B forms); NPI-Q: Neuropsychiatric Inventory-Questionnaire; RAVL: Rey Auditory Verbal Learning; IAVD: Instrumental Activity of Daily Living.

Inadequate sleep associated with increased odds of subjective cognitive decline among transgender and gender nonbinary adults in the U.S., 2016‐2018

AbstractBackgroundInadequate sleep (&lt;7 hours/night) and subjective cognitive decline (SCD), a self‐reported experience of worsening memory or thinking, are independently associated with an increased risk for Alzheimer’s disease and related dementias (ADRD) and cognitive impairment. Transgender and nonbinary (TNB) adults report significantly poorer sleep quality and are more likely to report SCD compared to cisgender adults. However, little is known about ADRD risk or how inadequate sleep is associated with SCD among TNB adults.Method2016‐2018 Behavioral Risk Factor Surveillance System data, representing 14 U.S. states that assessed sleep duration, SCD, and TNB status from adults ages 45+, were analyzed to examine differences in inadequate sleep prevalence and SCD among TNB adults (n = 394) and cisgender adults (n = 120,688). Odds ratios (OR) along with 95% confidence intervals (CI) were calculated to investigate group differences in inadequate sleep prevalence. A separate analysis compared the prevalence of SCD among TNB and cisgender adults with inadequate sleep.ResultInadequate sleep was highest among TNB adults (37.9%) compared to cisgender adults (31.34%). TNB adults were 34% more likely to report inadequate sleep compared to cisgender adults (95% CI: 1.1‐1.7, p = 0.0180). Inadequate sleep significantly increases the likelihood of SCD by 1.3 times (95% CL: 1.2, 1.3) compared to sleeping ≥7 hours/night. Among those with inadequate sleep, TNB adults were 2.3 times more likely to report SCD compared to cisgender adults (95% CI: 1.2‐3.6, p = &lt;0.0001).ConclusionInadequate sleep and its relationship with SCD is not uniformly experienced among TNB and cisgender adults. It is important to explore and address modifiable risk factors affecting sleep duration among TNB adults. Given the literature linking sleep duration, SCD, and ADRD risk, these data highlight the need for additional research focused on better understanding TNB cognitive health. The use of objective measures to assess sleep and cognition will provide more precision, which is needed to develop tailored interventions for TNB adults.

Prevalence and Progression of Subjective Cognitive Decline Among Rural Chinese Older Adults: A Population-Based Study.

Few community-based studies have examined occurrence and progression of subjective cognitive decline (SCD). To investigate prevalence and progression of SCD among rural-dwelling Chinese elderly people. This cohort study included 2,488 cognitively unimpaired adults (age≥65 years) who were examined at baseline (2014-2015) and followed in 2018. Demographic, epidemiological, clinical, and neuropsychological data were collected via in-person interviews and clinical examinations following a structured questionnaire. At baseline, SCD was assessed using the self-rated Ascertain Dementia 8-item Questionnaire. At follow-up, Alzheimer's disease (AD) and vascular dementia (VaD) were clinically diagnosed following the international criteria. Data were analyzed using logistic regression models. The prevalence of SCD was 40.07%. SCD at baseline was associated with the multivariable-adjusted odds ratio (OR) of 1.51 (95% confidence interval 1.10-2.07) for incident cognitive impairment, no dementia (CIND) and 3.11 (1.64-5.93) for incident AD. Among people with SCD at baseline, the multivariable-adjusted OR of incident CIND was 0.55(0.32-0.96) for hyperlipidemia; the multivariable-adjusted OR of incident AD was 1.21 (1.14-1.30) for older age, 0.32 (0.12-0.88) for high education, 2.60 (1.11-6.08) for carrying APOEɛ4 allele, and 0.34 (0.13-0.86) for high social support, whereas the multivariable-adjusted OR of incident VaD was 6.30 (1.71-23.18) for obesity. SCD affects over 40% of rural-dwelling cognitively unimpaired older adults in China. SCD is associated with accelerated progression to CIND and AD. Older age, lack of school education, APOEɛ4 allele, and low social support are associated with an increased risk of progression from SCD to AD, whereas obesity is related to accelerated progression to VaD.

Prevalence and progression of subjective cognitive decline among rural Chinese older adults: A Population‐based follow‐up study

AbstractBackgroundFew studies have examined occurrence and progression of subjective cognitive decline (SCD) in rural China. We aimed to investigate the prevalence of SCD and explore factors associated with progression from SCD to cognitive impairment, no dementia (CIND) and Alzheimer’s disease (AD).MethodThis community‐based study included 2488 cognitively unimpaired participants (age ≥65 years; 55.18% women; and 39.87% illiterate) in the Shandong Yanggu Study of Aging and Dementia who were examined at baseline (2014‐2015), of these, 1843 were followed in 2018. Demographic, epidemiological, clinical, and neuropsychological data were collected following a structured questionnaire. SCD was defined based on the Chinese version of the self‐rated Ascertain Dementia 8‐item Questionnaire (AD8) score. CIND and AD were diagnosed following the international criteria. Data were analyzed with the multivariate logistic regression models.ResultAt baseline, 997 of the 2488 participants were defined to have SCD. The prevalence of SCD was 40.07%, and the prevalence was increased with age. Of the 1843 participants in the follow‐up examination in 2018, 189 were diagnosed with CIND and 58 with AD. Having SCD at baseline was significantly associated with the multi‐adjusted odds ratio (OR) of 1.55 (95% confidence interval = 1.14‐2.12) for incident CIND and 2.91 (1.56‐5.42) for incident AD. Of 745 participants with SCD at baseline, 97 progressed to CIND and 43 to AD during the average 3.79 years of follow‐up. Multivariable logistic regressions showed that the multi‐adjusted OR of incident CIND was 0.51 (0.26‐0.98) for high social support, whereas the multi‐adjusted OR of incident AD was 1.22 (1.14‐1.31) for older age (per 1‐year increment), 0.31 (0.11‐0.85) for high education, 2.77 (1.17‐6.57) for carrying the apolipoprotein E (APOE) ε4 allele, 0.29 (0.11‐0.75) for high social support, and 3.98 (1.37‐11.52) for mild depressive symptoms.ConclusionSCD affects over 40% of rural‐dwelling older adults in China who are free of cognitive impairment. Older people with SCD are more likely to develop CIND and AD. Older age, illiteracy, APOE ε4 allele, low social support, and depressive symptoms are associated with accelerated progression from SCD to CIND or AD.

Subjective cognitive decline and unmet care needs highest among transgender women: A comparison of subjective cognitive decline and related limitations among transgender communities in the U.S.

AbstractBackgroundThe transgender population is composed of subgroups that are diverse in gender identity (e.g., transgender women [TW], transgender men [TM], nonbinary [NB] individuals). Research investigating Alzheimer’s disease and related dementias (ADRD) among transgender adults is limited and no study has delineated the factors associated with the brain health of TW, TM, or NB adults. Compared to their cisgender peers, transgender adults are more likely to report subjective cognitive decline (SCD), which may be one of the first clinical manifestations of ADRD. It remains unclear if SCD prevalence and related limitations vary by transgender subgroups.Method2015‐2020 Behavioral Risk Factor Surveillance System data, representing 39 U.S. states that assessed SCD (confusion/memory loss happening more often/getting work over previous 12 months) and self‐reported gender identity were used to examine differences in SCD prevalence and SCD‐related limitations (activities of daily/independent living) by transgender subgroups, TW (n = 442), TM (n = 298), and NB (n = 183). Age‐adjusted odds ratios (OR) along with 95% confidence intervals (CI) were calculated to investigate group differences in prevalence of SCD. Separate analyses compared SCD‐associated limitations, demographics, and health characteristics across study groups among participants reporting SCD.ResultSCD prevalence was highest among NB (21.3%), followed by TW (16.3%) and TM (14.1%). After accounting for age, subgroup differences remained; the odds of SCD were 1.6 times higher among TW compared to TM (95% CI: 1.1‐2.4, p = 0.012). Among those with SCD, TW were less likely to receive help they needed with day‐to‐day activities when compared to TM (OR = 7.9; 95% CI: 0.1–0.2, p&lt;0.001) and NB (OR = 5.0; 95% CI: 0.1–0.4, p = 0.001); and TW were more likely to be deaf (OR = 4.2; 95% CI: 1.7‐10.1, p = 0.002) and have asthma (OR = 2.8; 95% CI: 1.4‐5.7, p = 0.005) when compared to NB adults. No other SCD‐related limitation, demographic, or health differences were found.ConclusionHealth and social inequities are not uniformly experienced across transgender subgroups, and it is important to understand how these factors uniquely impact the brain health of TW, TM, and NB adults. There is an urgent need for ADRD and cognitive aging studies in this population.

Prevalence and risk factors for subjective cognitive decline and the correlation with objective cognition among community-dwelling older adults in China: Results from the Hubei memory and aging cohort study.

The prevalence and risk factors for subjective cognitive decline (SCD) and its correlation with objective cognition decline (OCD) among community-dwelling older adults is inconsistent. Older adults underwent neuropsychological and clinical evaluations to reach a consensus on diagnoses. This study included 7486 adults without mild cognitive impairment and dementia (mean age: 71.35 years [standard deviation = 5.40]). The sex-, age-, and residence-adjusted SCD prevalence was 58.33% overall (95% confidence interval: 58.29% to 58.37%), with higher rates of 61.25% and 59.87% in rural and female subgroups, respectively. SCD global and OCD language, SCD memory and OCD global, SCD and OCD memory, and SCD and OCD language were negatively correlated in fully adjusted models. Seven health and lifestyle factors were associated with an increased risk for SCD. SCD affected 58.33% of older adults and may indicate concurrent OCD, which should prompt the initiation of preventative intervention for dementia. SCD affects 58.33% of older adults in China. SCD may indicate concurrent objective cognitive decline. Difficulty finding words and memory impairments may indicate a risk for AD. The presence of SCD may prompt preventative treatment initiation of MCI or dementia. Social network factors may be initial targets for the early prevention of SCD.

Racial and Ethnic Differences in Subjective Cognitive Decline - United States, 2015-2020.

Subjective cognitive decline (SCD), the self-reported experience of worsening or more frequent memory loss or confusion, might be a symptom of early-stage dementia or future serious cognitive decline such as Alzheimer disease* or a related dementia (ADRD) (1). Established modifiable risk factors for ADRD include high blood pressure, inadequate physical activity, obesity, diabetes, depression, current cigarette smoking, and hearing loss (2). An estimated 6.5 million persons aged ≥65 years in the United States live with Alzheimer disease, the most common dementia (1). This number is projected to double by 2060, with the largest increase among non-Hispanic Black or African American (Black), and Hispanic or Latino (Hispanic) adults (1,3). Using data from the Behavioral Risk Factor Surveillance System (BRFSS), CDC assessed racial and ethnic, select demographic, and geographical differences in SCD prevalence, and prevalence of health care professional conversations among those reporting SCD. The age-adjusted prevalence of SCD during 2015-2020 was 9.6% among adults aged ≥45 years (5.0% of Asian or Pacific Islander [A/PI] adults, 9.3% of non-Hispanic White [White] adults, 10.1% of Black adults, 11.4% of Hispanic adults, and 16.7% of non-Hispanic American Indian or Alaska Native [AI/AN] adults). College education was associated with a lower prevalence of SCD among all racial and ethnic groups. Only 47.3% of adults with SCD reported that they had discussed confusion or memory loss with a health care professional. Discussing changes in cognition with a physician can allow for the identification of potentially treatable conditions, early detection of dementia, promotion of dementia risk reduction behaviors, and establishing a treatment or care plan to help adults remain healthy and independent for as long as possible.

Transgender Adults From Minoritized Ethnoracial Groups in the U.S. Report Greater Subjective Cognitive Decline.

Investigate subjective cognitive decline (SCD) among 4 study groups consisting of cisgender and transgender adults who are from minoritized ethnoracial groups (i.e., minoritized ethnoracial transgender, minoritized ethnoracial cisgender) and White cisgender and transgender adults aged 45+ (i.e., White transgender, White cisgender) to determine the odds of SCD by group and to test for group differences. Data from the 2015-2020 Behavioral Risk Factor Surveillance System were used in a modified case-control approach to perform an intercategorical intersectional study. Each transgender participant was matched to 2 cisgender men and 2 cisgender women, on state, ethnoracial identity, and age. Multivariable logistic regressions modeled SCD odds by group and post hoc contrasts estimated pairwise odds ratios comparing the SCD odds for each combination of groups. SCD prevalence was highest among minoritized ethnoracial transgender (21.6%), followed by White transgender (15.0%), minoritized ethnoracial cisgender (12.0%), and White cisgender (9.0%). After accounting for age, education, and survey year, the odds of SCD were higher in minoritized ethnoracial transgender when compared to White cisgender (adjusted odds ratio [aOR] = 2.51, 95% confidence interval [CI]: 1.59-3.96) and minoritized ethnoracial cisgender (aOR = 1.89, 95% CI: 1.16-3.09). The odds of SCD were higher in White transgender compared to White cisgender (aOR = 1.66, 95% CI: 1.20-2.30). When considering the intersection of transgender and ethnoracial identities, we found that transgender adults from minoritized ethnoracial groups reported higher odds of SCD when compared to cisgender adults from minoritized ethnoracial groups. Additional studies are needed to understand the relationship between racialized and gendered inequities in cognitive impairment and how specific mechanisms of systemic transphobia and racism may contribute to this inequity.

Relation Between Smoking Status and Subjective Cognitive Decline in Middle Age and Older Adults: A Cross-Sectional Analysis of 2019 Behavioral Risk Factor Surveillance System Data.

Smoking status may influence subjective cognitive decline (SCD); however, few studies have evaluated this association. To assess whether smoking status is associated with SCD among middle age and older adults, and to determine if this association is modified by sex at birth. A cross-sectional analysis was conducted using data from the 2019 Behavioral Risk Factor Surveillance System (BRFSS) survey to analyze the relationship between SCD and smoking status (current, recent former, and remote former). Eligible respondents included participants 45 years of age or older who responded to the SCD and tobacco questions of interest. Survey-weighted Poisson regression models were employed to estimate the crude and adjusted prevalence ratios (cPR/aPR) and corresponding 95% confidence intervals (CI) of the association between smoking status and SCD. A Wald test was computed to determine the significance of the interaction term between smoking status and sex (α= 0.05). There were 136,018 eligible respondents, of which approximately 10% had SCD. There was a graded association between smoking and SCD, with the greatest prevalence of SCD among current smokers (aPR = 1.87; CI: 1.54, 2.28), followed by recent former smokers (aPR = 1.47; 95% CI: 1.02, 2.12), and remote former smokers (aPR = 1.11; 95% CI: 0.93, 1.33) each compared to never smokers. There was no evidence of effect modification by sex (p interaction = 0.73). The consistency of smoking as a risk factor for objective and subjective cognitive decline supports the need for future studies to further the evidence on whether changes to smoking status impacts cognition in middle age.