Subjective Cognitive Decline in Older Adults: An Overview of Self-Report Measures Used Across 19 International Research Studies

Abstract

Research increasingly suggests that subjective cognitive decline (SCD) in older adults, in the absence of objective cognitive dysfunction or depression, may be a harbinger of non-normative cognitive decline and eventual progression to dementia. Little is known, however, about the key features of self-report measures currently used to assess SCD. The Subjective Cognitive Decline Initiative (SCD-I) Working Group is an international consortium established to develop a conceptual framework and research criteria for SCD (Jessen et al., 2014, Alzheimers Dement 10, 844–852). In the current study we systematically compared cognitive self-report items used by 19 SCD-I Working Group studies, representing 8 countries and 5 languages. We identified 34 self-report measures comprising 640 cognitive self-report items. There was little overlap among measures—approximately 75% of measures were used by only one study. Wide variation existed in response options and item content. Items pertaining to the memory domain predominated, accounting for about 60% of items surveyed, followed by executive function and attention, with 16% and 11% of the items, respectively. Items relating to memory for the names of people and the placement of common objects were represented on the greatest percentage of measures (56% each). Working group members reported that instrument selection decisions were often based on practical considerations beyond the study of SCD specifically, such as availability and brevity of measures. Results document the heterogeneity of approaches across studies to the emerging construct of SCD. We offer preliminary recommendations for instrument selection and future research directions including identifying items and measure formats associated with important clinical outcomes.

Objective features of subjective cognitive decline in a United States national database

“…Many self-report measures have been used to assess SCD. One recent report indicated that 34 self-report measures are being used across 19 international studies of SCD [26]. At present, there is no “gold standard” method of SCD assessment [44].…”

“…Several methods have been used to investigate the presence of SCD [26]. In the present sample, SCD was assessed within the context of the standardized evaluation protocol used at all ADCs.…”

Assessing Error Awareness as a Mediator of the Relationship between Subjective Concerns and Cognitive Performance in Older Adults

“…Furthermore, there were no measures of insight or informant concerns included in this study, which could add further information about other factors that might mediate the relationship between SCD and objective cognitive performance. As many previous studies have shown, the influence of depressive symptomatology on subjective, metacognitive monitoring and self-reflective measures cannot be discounted [3, 25, 30]. It is possible that early signs of both depressive symptoms and greater SCD in cognitively-normal older adults may well be indicative of overall ‘illness’ due to a milieu of disease-related effects [31], and thus represent greater risk of progression to dementia.…”

Hippocampal hypometabolism in older adults with memory complaints and increased amyloid burden

“…First, to date, there is no consensus on how to assess SMCs. 36 Previous studies have used methods ranging from nonstandardized clinical interviews to well-validated scales, as well as having the complaints corroborated by an informant. In this study, we used the Memory Functioning Questionnaire to create a subjective memory score.…”