Subjective Cognitive Decline Questionnaire Research Articles

EXPLORING SUBJECTIVE COGNITIVE DECLINE IN OLDER ADULTS: A MIXED METHODS APPROACH

Abstract Objective This study aims to explore the cognitive health of older adults exhibiting SCD by using a mixed methods approach to identify the factors and implications of perceived cognitive decline, thereby contributing to early intervention strategies. Methods We employed a convergent parallel mixed-method design. Quantitative data were collected using the Dementia Assessment Sheet for Community-based Integrated Care System 21 items (DASC-21) and the 9-items Subjective Cognitive Decline Questionnaire (SCD-Q9) from 1,458 older adults without clinical dementia in Soochow, China. Qualitative data were gathered through semi-structured interviews to capture detailed narratives on cognitive complaints, their perceived causes, and impacts on daily life. Results Quantitative analysis revealed that 48.7% of participants experienced SCD, with significant associations found with advanced age, low education levels, underweight, diabetes, cataract/glaucoma, osteoporosis, hyperlipidemia, and ischemic heart disease. Qualitative thematic analysis identified three primary themes: cognitive complaints, multifactorial attributions of cognitive decline, and the effects on daily life. Conclusion Our findings underscore the importance of recognizing SCD in older adults as a possible precursor to more severe cognitive impairment. The mixed methods approach provided a comprehensive understanding, suggesting that both objective and subjective assessments are critical for early detection and intervention. These insights highlight the need for tailored interventions focusing on modifiable risk factors and enhancing quality of life for older adults with SCD.

Factors Affecting Medication Adherence in Middle-Aged and Elderly Patients in China: A Cross-Sectional Study.

BACKGROUND As the population ages, comorbidities among elderly patients are becoming a significant problem, due to associated risks and mortality. Medication adherence is crucial for controlling chronic diseases and improving patient outcomes; therefore, it is important to understand medication adherence among hospitalized patients. MATERIAL AND METHODS A cross-sectional study was conducted from June 2023 to April 2024 in 2 tertiary hospitals in Wuhu City, Anhui Province, China. Patients were divided into 2 age groups: 45 to 60 years and over 60 years. Data were collected using a self-designed sociodemographic questionnaire, the 4-item Morisky Medication Adherence Scale (MMAS-4), frailty scale, social frailty scale, and subjective cognitive decline questionnaire 9 (SCD-Q9). RESULTS A total of 963 inpatients were recruited, with 18.0% being middle-aged and 82.0%, elderly. The prevalence of medication adherence was 50.2%. Univariate analysis showed that medication adherence was significantly associated with place of residence, having relatives as medical personnel, physical frailty, social frailty, and subjective cognitive symptoms. Correlation analysis revealed that medication adherence was significantly negatively correlated with physical frailty, social frailty, and subjective cognitive symptoms. Binary logistic regression confirmed significant associations between medication adherence and physical frailty, social frailty, and subjective cognitive symptoms. CONCLUSIONS This study investigated medication adherence and its influencing factors among hospitalized patients with comorbidities in Anhui Province, China, identifying several influencing factors. Therefore, targeted interventions should be implemented by the government and relevant departments to improve patients' medication adherence.

Greater subjective cognitive decline is associated with higher plasma Alzheimer’s disease biomarkers in cognitively normal Hispanics living in Miami, FL

AbstractBackgroundSubjective cognitive decline (SCD), or a person’s perception of changes in their cognitive abilities, has been identified as a possible early marker of preclinical Alzheimer’s disease (AD) in non‐Hispanic Whites; however, research is lacking about the clinical utility of SCD in diverse populations. This study investigated the associations of self and informant reports of SCD, plasma biomarker profiles of AD, and objective cognitive performance in Hispanic older adults living in Miami.MethodHispanic participants enrolled in the 1Florida Alzheimer’s Disease Research Center who completed neuropsychological testing and blood draws for biomarker analysis were eligible. Plasma biomarkers included phosphorylated tau (p‐tau217 and p‐tau181), glial fibrillary acidic protein (GFAP), and neurofilament light chain (NfL). The Subjective Cognitive Decline Questionnaire self (MyCog) and informant (TheirCog) versions were used to assess SCD. Cognitive tests included the Montreal Cognitive Assessment (MoCA) and the Craft story 21 verbatim immediate (Craft‐Im) and delayed recall (Craft‐Del). Relationships between plasma biomarkers, cognitive performance, and SCD were explored using Spearman's rank correlation, with an uncorrected p‐value of 0.05.ResultThe cohort included 52 Hispanics (age 73.3±7.3 years; education 15.2±3.0 years; 63% female; 96% from Cuba or South America) with a consensus diagnosis of cognitively normal (CN, n=17) or mild cognitive impairment (MCI, n=35). Among CN participants (Tables 1 and 2), greater MyCog scores were significantly associated with higher p‐tau217 (rs=0.68), p‐tau181 (rs=0.58) and lower MoCA scores (rs=‐0.48). Greater TheirCog scores were significantly associated with higher p‐tau181 (rs=0.58) and lower MoCA scores (rs=‐0.52). Among MCI participants (Tables 1 and 2), greater MyCog scores were associated with lower p‐tau181 (rs=‐0.37). There were significant correlations between various cognitive test scores and p‐tau217 (MoCA, rs=‐0.50; CraftIm, rs=‐0.44) and NfL (CraftIm, rs=‐0.34; CraftDel, rs=‐0.33).ConclusionGreater self and informant reported SCD are related to higher AD plasma biomarker load and worse cognition in a small sample of CN Hispanics, suggesting potential clinical utility. Self‐reported SCD was inversely related to plasma biomarkers in those with MCI, suggesting loss of insight. Larger and more diverse longitudinal studies are needed to elucidate if CN Hispanics with elevated SCD and AD plasma biomarkers progress to MCI and AD.

Subjective Cognitive Decline Patterns in Patients with Migraine, with or without Depression, versus Non-depressed Older Adults

Purpose: Cognitive decline is a common complaint in young patients with migraine, especially those with depression. Independent of psychiatric factors such as depression, subjective cognitive decline (SCD) is associated with an elevated risk of progression to dementia. This study aimed to investigate patterns of subjective cognitive complaints between migraineurs with or without depression and non-depressed older adults.Methods: This retrospective study included 331 outpatients with SCD (293 from a headache clinic and 38 from a memory clinic). SCD was diagnosed as “yes” based on two questions about SCD. The Mini Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) were used to assess cognitive function. The SCD Questionnaire (SCD-Q) with three subdomains was analyzed to compare SCD between groups.Results: Among patients with SCD, significant differences in duration of education were found among the groups—specifically, migraineurs with depression (12.39 years) had longer education than non-depressed older adults (10.50 years) and shorter education than migraineurs without depression (14.28 years). The total MMSE and MoCA scores did not differ between migraineurs with and without depression. Regarding SCD-Q scores, migraineurs with depression showed higher scores overall and in all cognitive domains than migraineurs without depression, with no significant difference compared to non-depressed older adults. Conclusion: Although the depressed migraineurs with SCD were younger and more educated than the non-depressed older adults with SCD, both groups reported similarly high levels of SCD. Higher levels of surveillance for cognitive decline are warranted for migraineurs with depression who have SCD.

Development of a short version of the German subjective cognitive decline questionnaire (SCD-Q17): a principal component analysis approach to item reduction

Since it was shown that Alzheimer’s disease (AD) begins many years before the onset of symptoms with subjective cognitive decline (SCD), there has been increasing interest in the early clinical stages where disease-modifying drugs are expected to have the greatest benefit. However, at this early stage cognitive testing may yield unremarkable results, it is necessary to find a tool that can provide a simple and reliable indication of SCD as a part of a screening tool for AD in the general population. The German version of the 24-item Subjective Cognitive Decline Questionnaire (SCD-Q) with a dichotomous answer scale was tested, which then revealed some challenges. For this reason, an adaptation of the questionnaire was necessary. 360 participants completed the SCD-Q, all of whom were outpatients at a memory clinic. The most relevant subitems were identified by principal component analysis. This analysis focused on the self-perceived perspective of the decline. Results of the principal component analysis, consultations with experts and feedback from respondents were integrated into a short version of the SCD-Q with 17 items and a Likert scale – the SCD-Q17. The SCD-Q17 was sent to 100 participants of the original questionnaire for re-completion and, a new cut-off value was calculated by receiver operator characteristic (ROC) curves. The SCD-Q17 is a useful tool for the reliable detection of subjective symptoms, and thus may prompt more in-depth assessments of the underlying etiology. CogScreen has been retrospectively registered at clinical trials (NCT06191952).

Impaired glymphatic function as a biomarker for subjective cognitive decline: An exploratory dual cohort study.

Subjective cognitive decline (SCD) has been recognized as a potential risk stage for progression to Alzheimer's disease (AD), while glymphatic dysfunction is considered an important characteristic of AD. We hypothesize that glymphatic dysfunction occurs during the SCD stage, aiming to discover potential biomarkers for SCD. Participants from two independent studies, Sino Longitudinal Study on Cognitive Decline (SILCODE, n=654) and the Alzheimer's Disease Neuroimaging Initiative (ADNI, n=650), representing different ethnicities and disease stages, were included to assess glymphatic function using diffusion tensor image analysis along the perivascular space (DTI-ALPS). Abnormal glymphatic function occurs during the SCD stage, with the ALPS index demonstrating excellent classification performance for SCD and normal controls (area under the receiver operating characteristic curve [AUC]SILCODE=0.816, AUCADNI=0.797). Lower ALPS index indicates higher risk of cognitive progression, which is negatively correlated with Subjective Cognitive Decline Questionnaire 9 scores and amyloid positron emission tomography burden. Our study suggests the ALPS index has the potential to serve as a biomarker for SCD. Glymphatic function characterized by the analysis along the perivascular space (ALPS) index becomes abnormal in subjective cognitive decline (SCD), the earliest symptomatic manifestation and preclinical stage of Alzheimer's disease (AD). The ALPS index demonstrates excellent classification performance for SCD and normal controls in the East Asian and Western cohorts. Participants with a lower ALPS index show a higher risk of clinical progression. The ALPS index is closely associated with serval cognitive scales and amyloid beta burden.

The relationship between male and female endogenous reproductive hormones levels and subjective cognitive decline score: A cross-sectional analysis of the Pingyin cohort study.

Reproductive hormones might impact disease course in cognitive decline. We examined the association between male and female endogenous reproductive hormones and subjective cognitive decline (SCD) score. A cross-sectional study design was used with baseline data from the Pingyin cohort study, involving 1943 participants aged 45-70 years. Oestrogen (E2), testosterone, follicle stimulating hormone (FSH) and luteinizing hormone (LH) were measured in females and E2 and testosterone were measured in males. We categorised hormones into three levels of low, intermediate and high level. The 9-item subjective cognitive decline questionnaire (SCD-Q9) scores were collected to assess the symptoms of SCD. Multivariable logistic regression models were used to estimate odds ratios (ORs) and 95% confidence interval (CI) between categorised hormone levels and SCD status. Multivariable linear regression models were also used. Overall, 1943 participants were involved and 1285 (66.1%) were female. The mean age at baseline was 59.1 (standard deviation 7.1) years. Women with high testosterone levels had a higher probability of having SCD compared with those with low testosterone levels (OR 1.43, 95% CI 1.01-2.05). Men with a high level of testosterone (0.59, 0.35-0.98) and high testosterone/E2 ratio (0.55, 0.33-0.90) were related to decreased chances of having SCD. Each one-unit increase of testosterone was linked to reduced SCD score in males [(β: -.029, 95% CI (-0.052, -0.007)]. There was sex-specific relationship between hormone levels and SCD abnormal. Those with higher testosterone levels in females may increase likelihood of experiencing SCD. Males with higher testosterone levels and higher testosterone/E2 ratio may be associated with reduced likelihood of SCD. The roles of endogenous reproductive hormone levels and their dynamic changes in cognitive function need further investigation.

Subjective Cognitive Decline in Community-Dwelling Older Adults With Objectively Normal Cognition: Mediation by Depression and Instrumental Activities of Daily Living.

Subjective cognitive decline (SCD) refers to self-reported memory loss despite normal cognitive function and is considered a preclinical stage of Alzheimer's disease. This study aimed to examine the mediating effects of depression and Instrumental Activities of Daily Living (IADL) on the association between the scoring of Clinical Dementia Rating Scale-Sum of Boxes (CDR-SB) and Subjective Cognitive Decline Questionnaire (SCD-Q). A sample of 139 community-dwelling older adults aged 65-79 with normal cognitive function completed the SCD-Q, a comprehensive neuropsychological battery, and functional/psychiatric scales. We conducted 1) a correlation analysis between SCD-Q scores and other variables and 2) a path analysis to examine the mediating effects of depression and IADL on the relationship between CDR-SB and SCD-Q. CDR-SB was found to be indirectly associated with SCD-Q, with depressive symptoms mediating this relationship. However, no direct association was observed between SCD-Q and CDR-SB. Additionally, IADL was not associated with SCD-Q and did not mediate the relationship between CDR-SB and SCD-Q. The model fit was acceptable (minimum discrepancy function by degrees of freedom divided [CMIN/DF]=1.585, root mean square error of approximation [RMSEA]=0.065, comparative fit index [CFI]=0.955, Tucker-Lewis index [TLI]=0.939). Our results suggest that SCD-Q is influenced by depressive symptoms, but not by IADL. The role of depressive symptoms as a mediator between CDR-SB and SCD-Q indicates that psychological factors may contribute to the perception of SCD. Therefore, interventions targeting depression may mitigate the concerns associated with SCD and reduce feelings of worse performance compared to others of the same age group.

Validity of cognitive function assessed by a subjective cognitive decline questionnaire as compared with objective cognitive tests in community‐dwelling older adults in China

AbstractBackgroundSubjective cognitive decline (SCD) has been recognized as an early symptom of age‐related cognitive decline, but research on the validity of SCD questionnaire in the elderly population is limited. Thus, we aimed to evaluate the validity of a 7‐item SCD questionnaire in Chinese older adults.MethodThe study included 1585 participants (53.6% women; mean [SD] age: 78.7 [4.4] years) who completed the SCD questionnaire, Hasegawa Dementia Scale (HDS), and Mini‐Mental State Examination (MMSE) from the Rugao Longevity and Ageing Study (RuLAS) in 2019. MCI was defined according to established education‐specific cut‐off values of HDS and MMSE scores. We used sensitivity, specificity, Youden’s Index, and the receiver operating characteristic (ROC) curves to evaluate the discriminant ability of the SCD questionnaire. Spearman correlation coefficients were also used to measure the strength of correlation between SCD scores and objective cognitive function scores.ResultThe SCD score (range: 0‐7) with the cut‐off value of 4 displayed moderate‐to‐good sensitivity (Sen = 0.52) and specificity (Spec = 0.69), with Youden’s index of 0.21 and the area under the curve (AUC) of 0.62, in distinguishing cognitive impairment defined by objective cognitive tests. In addition, SCD scores have low‐to‐moderate correlations with overall scores of two cognitive tests (rHDS = ‐0.23; rMMSE = ‐0.28). Correlations between domain‐specific SCD and corresponding objective cognitive function scores ranged from ‐0.05 to ‐0.31.ConclusionOur study supported a reasonable discriminant ability of a 7‐item SCD questionnaire among Chinese older adults.

47 The Impact of COVID-19 Infection on Objective and Subjective Cognitive Functioning: Resilience as a Protective Factor

Objective:Growing evidence indicates that COVID-19 infection adversely impacts cognitive functioning, with COVID-19 patients demonstrating high rates of objective and subjective cognitive impairments (Daroische et al., 2020; Miskowiak et al., 2021). Given the prevalence and potentially debilitating nature of post-COVID-19 cognitive symptoms, understanding factors that mitigate the impact of COVID-19 infection on cognitive functioning is paramount to developing interventions that facilitate recovery. Resilience, the ability to cope with and grow from challenges, has been associated with improved cognitive performance in healthy adults and linked to decreased perceived cognitive difficulties in post-COVID-19 patients (Connor & Davidson, 2003; Deng et al., 2018; Jung et al., 2021). However, resilience has not yet been examined as a potential attenuator of the relationship between COVID-19 and either perceived or objective cognitive function. This study aims to investigate the role of resilience as a protective factor against experience of cognitive function difficulties in COVID-19 patients by probing the role of resilience as a moderator of the relationship between COVID-19 diagnosis and cognitive functioning (both perceived and objective).Participants and Methods:Participants (mean age=36.93, 30.10% male) were recruited from British Columbia and Ontario. The sample included 53 adults who had never been diagnosed with COVID-19 and 50 adults diagnosed with symptomatic COVID-19 at least three months prior and not ventilated. Participants completed online questionnaires (n=103) to assess depression (the Center for Epidemiological Studies Depression Scale), anxiety (7-item Generalized Anxiety Disorder Scale), subjective cognitive functioning (The Subjective Cognitive Decline Questionnaire), and resilience (2-item Connor-Davidson Resilience Scale). Participants then completed neuropsychological tests (n=82) measuring attention, processing speed, memory, language, visuospatial skills, and executive function via teleconference, with scores averaged to create a global objective cognition score. Moderated multiple regression was employed to assess the impact of resilience on the relationship between COVID-19 diagnosis and both objective and perceived cognition, controlling for gender, ethnicity, income, age, anxiety, and depression.Results:Average scores in the COVID-19 group exceeded diagnostic cut-offs for clinical depression (M=16.67, SD=10.77) and mild anxiety (M=5.27, SD=4.99), while the control group scored below diagnostic thresholds for depression (M=11.96, SD=9.76) and mild anxiety (M=4.48, SD=5.07). Controlling for sociodemographic and mental health characteristics, COVID-19 diagnosis was not associated with objective global cognitive functioning (b=-.07, se=1.71, p=.624) or subjective cognitive functioning (b=.16, se=1.32, p=.12), nor was resilience associated with objective global cognitive functioning (b=.19, se=1.50, p=.44) or subjective cognitive functioning (b=-.02, se=1.09, p=.89).Conclusions:Findings indicate that COVID-19 patients may be at risk for depression and anxiety. Results of this study fail to support a relationship between COVID-19 and cognitive functioning beyond the impact of sociodemographic and mental health variables. Thus, the role of resilience as a protective factor against COVID-19 related cognitive difficulties could not be fully explored. However, findings should be considered in the context of study limitations, including a small sample size. Future research should employ larger samples to further examine the relationship between COVID-19 infection and cognition, focusing on mental health characteristics and resilience as potential risk and protective factors.

52 Depressive Symptoms and Subjective Cognitive Decline in Individuals with COVID-19

Objective:Many individuals with COVID-19 develop mild to moderate physical symptoms that can last days to months. In addition to physical symptoms, individuals with COVID-19 have reported depressive symptoms and cognitive decline, posing a long-term threat to mental health and functional outcomes. Few studies have examined the presence of co-occurring depression and subjective cognitive decline in individuals who tested positive for COVID-19. The current study examined whether having COVID-19 is subsequently associated with greater depressive symptoms and subjective cognitive decline when compared to healthy individuals. Our study also examined differential associations between symptoms of depression and subjective cognitive decline between individuals who have and have never had COVID-19.Participants and Methods:Adults (N = 104; mean age = 37 years, 69% female) were recruited online from Ontario and British Columbia, Canada. Participants were categorized into two groups: (1) persons who tested positive for COVID-19 at least three months prior, had been symptomatic, and had not been ventilated (N = 50); and (2) persons who have never been suspected of having COVID-19 (N = 54). The Center for Epidemiological Studies Depression Scale (CES-D) and the Subjective Cognitive Decline Questionnaire (SCD-Q) were administered to both groups as part of a larger clinical neuropsychological evaluation. Two separate linear regression analyses were conducted to examine the association of COVID-19 with depressive symptoms and subjective cognitive decline. A moderation analysis was performed to examine whether depressive symptoms were associated with subjective cognitive decline and the extent to which this differed by group (COVID-19 and controls). Participants’ age, self-reported sex, and history of depression were included as covariates.Results:The first regression model explained 17.2% of the variance in CES-D scores. It was found that the COVID-19 group had significantly higher CES-D scores (ß = .20, p = .03). The second regression model explained 35.9% of the variance in SCD-Q scores. Similar to the previous model, it was found that the COVID-19 group had significantly higher SCD-Q scores compared to healthy controls (ß = .22 p = .01). Lastly, the moderation model indicated that higher CES-D scores were associated with higher SCD-Q scores (ß = .43, p < .01), but there was no statistically significant group X CES-D score interaction.Conclusions:These findings suggest that individuals who previously experienced a mild to moderate symptomatic COVID-19 infection report greater depressive symptom severity as well as greater subjective cognitive decline. Additionally, while more severe depressive symptoms predicted greater subjective cognitive decline in our sample, the magnitude of this association did not vary between those with and without a previous COVID-19 infection. While the underlying neurobiological and social mechanisms of cognitive difficulties and depressive symptoms in persons who have had COVID-19 have yet to be fully elucidated, our findings highlight treatment for depression and cognitive rehabilitation as potentially useful intervention targets for the post COVID-19 condition.

18 Which cognitive complaints among older adults are more concerning than others? Analysis of items in a Subjective Cognitive Decline Questionnaire

Objective:Subjective Cognitive Decline (SCD) is the self-reported experience of one’s own declining cognition prior to objective impairment on clinical neuropsychological testing. While SCD is a promising marker of preclinical Alzheimer’s disease (AD), information is needed to determine which cognitive complaints reflect typical aging versus prodromal degenerative disease. The objective of the current study was to examine the extent to which specific cognitive complaints were associated with two clinical outcomes including: 1) lower performance on cognitive tasks sensitive to preclinical AD; and 2) seeking help (i.e., medical attention) for cognitive difficulties.Participants and Methods:The current sample consisted of 175 healthy older adults (56 Male, 119 Female), aged 51 to 90 (M=72.67, SD=7.12) with a mean education of 16 years (SD=2.3 years) who performed > -1.5 SD on clinical neuropsychological testing. 26.8% of the sample self-reported as race/ethnic minorities (e.g., Hispanic or Non-Hispanic, Black, Asian, Other.) Participants completed a 20-item SCD questionnaire assessing perceived cognitive difficulties in comparison to same aged peers, and tests shown to be sensitive to preclinical AD including the Face Name Associative Learning Test and the Loewenstein-Acevedo Scales for Semantic Interference and Learning. Participants were coded as having sought help for SCD (39%) if they entered the current study from a clinical referral source, OR if they entered through a non-clinical referral stream but indicated that they had previously seen a doctor specifically for memory concerns or spoken to their doctor about memory concerns. Chi square tests were used to examine relationships between SCD item endorsement and help-seeking; ANOVAs were used to the extent to which item endorsement was associated with performance on cognitive tests. Results were considered significant at p < .05.Results:Three SCD items were associated with both lower cognitive test scores and having sought help for SCD (p values ranged from < .001 to .02). Items included difficulty remembering the date or day of the week and remembering a few shopping items without a list. One non-memory item was also associated with both outcomes including difficulty thinking ahead. In contrast, six items were not related to either outcome of interest. Such items included difficulty remembering appointments, remembering where you put things like keys, following a map to a new location, doing two things at once, understanding what you read, or understanding what people say to you. The remaining eleven items explore the extent to which selective associations exist with either help-seeking or cognitive performance.Conclusions:Patients and clinicians alike are often unsure about which cognitive difficulties are typical for aging and which may be the cause for further workup. Current results suggest that certain complaints among cognitively healthy older adults may be cause for more thorough evaluation or monitoring. These complaints include specific memory and nonmemory concerns. Future work is needed to determine if these complaints predict future cognitive decline or conversion to Mild Cognitive Impairment.

Association of subjective cognitive complaints with poor sleep quality: A cross-sectional study among Chinese elderly.

Subjective cognitive complaints (SCC) are the earliest symptom of Alzheimer's disease (AD) progression. Increasing evidence shows an association between poor sleep quality and SCC, but the current conclusions regarding the association between poor sleep quality and SCC in older adults are contradictory. Here, we aimed to explore the correlation of SCC with poor sleep quality among older adults without dementia living in nursing home and community in China. A cross-sectional survey on sleep and psychosomatic health of older adults was conducted in Guangdong, China, between November 2020 and March 2021. Socio-demographic, health-related information, psychological factors, sleep quality and SCC of participants were evaluated through a face-to-face interview. A 9-item Subjective Cognitive Decline Questionnaire (SCD-Q9) was used to measure SCC; SCD-Q9>3 was defined as SCC. The Chinese version of the Pittsburgh Sleep Quality Index (PSQI) was used to evaluate sleep quality; PSQI > 7 was defined as poor sleep quality. The relationship between SCC and sleep quality was evaluated using logistics regression analysis. The study involved 730 participants (mean age 74.14±8.246years). The total SCC prevalence was 59.59%. The SCC group had poor sleep quality than the reference group (p<0.05). Adjusted multiple logistic regression analysis revealed an association of poor sleep quality with SCC (OR=1.841; 95% CI, 1.267-2.647; p=0.001) after controlling for age, sex, residence, education level, marital status, income, smoking, alcohol consumption, tea drinking, multimorbidity, waist circumference, napping duration, anxiety symptoms, and depression symptoms. Hierarchical logistics regression analysis showed an association between sleep quality and SCC among community older adults (OR=2.872; 95% CI: 1.787-4.615; p<0.001), but not in nursing home residents (OR=0.845; 95% CI: 0.437-1.637; p=0.619). Poor sleep quality is associated with SCC in community older adults. Therefore, medical staff should take measures, such as earlier cognitive intervention, to postpone cognitive decline in older adults, in the meantime, earlier management and treatment of sleep disorders should be taken into consideration.

Psychometric Properties of the Subjective Cognitive Decline Questionnaire (SCD-Q) and Its Invariance across Age Groups.

Considering that a good sense of subjective cognitive decline seems to be crucial to prevent decline before clinical impairment, the interest in examining tools on this front were raised in the last decade. The aim of the present study is to examine the psychometric properties of the Subjective Cognitive Decline Questionnaire (SCD-Q) across age in its Spanish adaptation. It should be noted that two constructs were proposed in this context: mnestic processes and executive function factors. For this reason, a sample of 750 individuals aged from 18 to 82 years participated in the study. They were divided into three different groups: young, middle, and older adults. A confirmatory factor analysis (CFA) and invariance analysis were carried out. Moreover, a logistic regression was employed to address the role of age. The results support a good goodness of fit for both uni- and bifactorial models. The invariance analysis reached the structural covariances levels. Last, age did not predict the recognition of cognitive decline in the last two years, while the SCD-Q bifactorial model did. These results are of interest both on a theoretical level, to provide more information on models of cognitive impairment, and on a practical level, for screening.

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

AbstractBackgroundSubjective 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&lt;.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&lt;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.

The role of disability and depressive symptoms in the relation between objective cognitive performance and subjective cognitive decline.

Subjective cognitive decline (SCD) and subjective memory decline (SMD) are common among older people. Evidence linking SCD and SMD with cognitive and memory impairment is inconsistent. Moreover, little is known about the associations of SCD and SMD with disability. We aimed to explore the associations of SCD and SMD with objective cognitive and memory performance, disability, and depressive symptoms. In a cross-sectional study we conducted face to face interviews in a randomized sample of people aged ≥65 years living in the Canton of Ticino, southern Switzerland, between May 2021 and April 2022. We measured subjective cognitive decline with the MyCog, a subsection of the Subjective Cognitive Decline Questionnaire (SCD-Q); cognitive functioning with the Community Screening Instrument for Dementia; memory with the consortium to establish a registry for alzheimer's disease (CERAD) 10-word list learning task; and disability and depressive symptoms with the world health organization disability assessment schedule 2.0 (WHO-DAS 2.0) and the Euro-Depression (EURO-D) scales, respectively. Of the 250 participants 93.6% reported at least one cognitive difficulty, and 40.0% SMD. Both SCD and SMD were associated with poorer objective cognitive/memory performance, and independently with greater disability, and more depressive symptoms. But in participants with high disability and depressive symptoms subjective and objective cognition were no longer associated. Disability fully mediated the associations of poorer objective cognitive and memory performance with subjective cognitive and memory decline. Routine clinical assessments of cognitive function should include formal enquires about SCD and SMD, and also account for disability and depressive symptoms.

Plasma amyloid-beta oligomer is related to subjective cognitive decline and brain amyloid status

BackgroundSubjective cognitive decline (SCD) is a target for Alzheimer’s disease prediction. Plasma amyloid-beta oligomer (AβO), the pathogenic form of Aβ in blood, has recently been proposed as a novel blood-based biomarker of AD prediction by representing brain Aβ deposition. The relationship between plasma AβO, brain Aβ deposition, and SCD in individuals with normal objective cognition has not been investigated.MethodsIn this cross-sectional study, we analyzed 126 participants with normal objective cognition. More SCD symptoms were expressed as higher scores of the Subjective Cognitive Decline Questionnaire (SCDQ) and Memory Age-associated Complaint Questionnaire (MACQ). The plasma AβO level of each participant was measured twice for validation and expressed as a concentration (ng/mL) and a ratio relative to the mean value of two internal standards. Brain Aβ deposition was assessed by [18F] flutemetamol positron emission tomography (PET) and expressed as standard uptake value ratio (SUVR). Associations of SCDQ and MACQ with plasma AβO levels or SUVR were analyzed in multiple linear regression models. The association between plasma AβO level and flutemetamol PET positivity was assessed in logistic regression and receiver operative characteristic analyses.ResultsOverall, participants were 73.3 years old with female predominance (69.0%). After adjustment for confounders, high SCDQ and MACQ scores were associated with the high plasma AβO levels as both concentrations and ratios (ratios: standardized coefficient = 0.246 and p = 0.023 for SCDQ, standardized coefficient = 0.209 and p = 0.029 for MACQ; concentrations: standardized coefficient = 0.257 and p = 0.015 for SCDQ, standardized coefficient = 0.217 and p = 0.021 for MACQ). In contrast, SCDQ and MACQ were not significantly associated with SUVRs (p = 0.134 for SCDQ, p = 0.079 for MACQ). High plasma AβO levels were associated with flutemetamol PET (+) with an area under the curve of 0.694 (ratio) or 0.662 (concentration). Combined with APOE e4, plasma AβO presented area under the curves of 0.789 (ratio) and 0.783 (concentration).ConclusionsOur findings indicate that the high plasma AβO level could serve as a potential surrogate biomarker of severe SCD and the presence of brain Aβ deposition in individuals with normal objective cognition.

The relationship between depression and subjective cognitive decline in older adults of China: the mediating role of general self-efficacy

ABSTRACT Subjective cognitive decline (SCD) is common in older adults and may also be an early marker for future cognitive impairment. Depression is an important influencing factor for subjective cognitive decline in old age. However, the mediating effects of general self-efficacy in depression and subjective cognition are yet to be explored. This study included 308 participants who were ≥60 years. Participants were asked to complete the self-report measures of the Geriatric Depression Scale-15 (GDS-15), Subjective Cognitive Decline-Questionnaire (SCD-Q), and General Self-Efficacy Scale (GSES). We used correlations, regressions, and structural equation models for the analyses. The bootstrapping method was performed to confirm the mediation effect. The subjective cognitive decline was found to be significantly and positively correlated to depression. Bootstrapping mediation analyses indicated that depression could affect SCD not only directly but also indirectly through general self-efficacy. General self-efficacy partly played a mediating role between depression and SCD. Hence, community workers and clinicians should actively help the elderly experiencing low levels of general self-efficacy to reduce their SCD.

The reliability and validity test of subjective cognitive decline questionnaire 21 with population in a Chinese community.

BackgroundSubjective cognitive decline‐questionnaire 9 (SCD‐Q9) was developed to detect SCD complaints at risk of mild cognitive impairment (MCI). However, our previous findings indicated that its coverage might be insufficient. To test this hypothesis, we recently translated SCD‐Q21.ObjectiveTo examine the reliability and validity of this translated SCD‐Q21 and to explore its effectiveness for discriminating MCI from controls.MethodsItem analysis was performed to understand its item discrimination and homogeneity. The Cronbach's α and Spearman‐Brown's split‐half coefficients were calculated to test its reliability. The Kaiser–Meyer–Olkin (KMO) value, Bartlett's sphericity test, and exploratory factor analysis (EFA) were used to examine its construct validity. The content validity was evaluated using five‐grade Likert scale. Finally, the SCD‐Q21 scores in MCI and controls were compared.ResultsThe difference of each item between the extreme groups was significant. The Cronbach's α coefficient was .913 and Spearman‐Brown's split‐half coefficient was .894. When performing holding one‐out approach, the Cronbach's α coefficient ranged from .906 to .914. The KMO value was .929 and the difference of Bartlett's Sphericity test was significant. All experts scored 5 points when assessing its content. Finally, a significant difference of score was found between MCI and NC groups.ConclusionsThe reliability and validity of the SCD‐Q21 are good, which may pave a way for its application in a wider Chinese‐speaking population.

APOE ε4 Allele Distribution and Association With Scores of Subjective Cognitive Decline Questionnaire 9 in a Large Chinese Memory Clinic Cohort.

BackgroundPrevious reports on APOE ε4 allele distribution in different populations have been inconclusive. The Subjective Cognitive Decline-Questionnaire 9 (SCD-Q9) was developed to identify those at risk of objective cognitive impairment [OCI; including mild cognitive impairment (MCI) and dementia groups), but its association with APOE ε4 and discriminatory powers for SCDwith subtle cognitive decline (SCDs) and OCI in memory clinics are unclear.ObjectivesTo investigate demographic distribution of APOE ε4, its association with SCD-Q9 scores, and its ability to discriminate SCDs and OCI groups from normal control (NC).MethodsA total of 632 participants were recruited (NC = 243, SCDs = 298, OCI = 91). APOE ε4 allele distribution and association with SCD-Q9 scores were calculated and the effects on cognitive impairment were analyzed. Receiver operating characteristic (ROC) analysis was applied to identify discriminatory powers for NC, SCDs, and OCI.ResultsTotal APOE ε4 frequency was 13.1%. This did not vary by demography but was higher in patients with OCI. The SCD-Q9 scores were higher in APOE ε4 carriers than non-carriers in the OCI group. The area under the curve (AUC) for discriminating from OCI using APOE ε4 were 0.587 and 0.575, using SCD-Q9 scores were 0.738 and 0.571 for NC and SCDs groups, respectively. When we combined APOE ε4 and SCD-Q9 scores into the model, the AUC increased to 0.747 for discriminating OCI from NC. However, when OCI group was split into MCI and dementia groups, only total SCD-Q9 score was the independent affecting factor of MCI.ConclusionThis study demonstrated that the distribution of APOE ε4 alleles did not vary with different demographic characteristics in a large-scale cohort from a memory clinic. APOE ε4 alleles may be associated with scores of SCD-Q9 reflecting the degree of cognitive complaints but their additional contribution to SCD-Q9 scores is marginal in discriminating between NC, SCDs, and OCI.