Subjective Cognitive Decline in Older Adults
Summary
Subjective cognitive decline (SCD) refers to the self-experienced perception of worsening cognitive abilities—most often memory—despite performance within normal limits on standard neuropsychological tests. Affecting roughly one quarter of community-dwelling older adults, SCD has emerged as a potential preclinical stage of Alzheimer’s disease and other dementias. Individuals with SCD present a heterogeneous profile: for some, concerns reflect normal ageing or mood disturbances, whereas for others they herald underlying neurodegeneration. Features associated with elevated risk include recent onset of decline, corroboration by a knowledgeable informant and accompanying worry. Multimodal research has revealed subtle structural and functional brain changes in hippocampal and default-mode network regions, while genetic factors such as carriage of the APOE ɛ4 allele and fluid biomarkers like glial fibrillary acidic protein further aid stratification. Variability in prevalence across countries and assessment methods underscores the need for harmonised criteria. Clinically, recognising SCD offers a critical window for early intervention and for enrolling at-risk individuals into prevention trials at a stage when disease-modifying approaches may be most efficacious.
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Subjective Cognitive Decline in Older Adults publication trend
The graph below shows the total number of articles in subjective cognitive decline in older adults across all publications each year (not limited to Nature Index journals).
Technical terms
Subjective cognitive decline (SCD): Self-perceived persistent decline in cognitive capacity without detectable deficits on objective testing.
APOE ɛ4 allele: Genetic variant of apolipoprotein E associated with higher risk of amyloid accumulation and Alzheimer’s disease.
Glial fibrillary acidic protein (GFAP): Astrocyte-derived intermediate filament protein measurable in blood, elevated in neurodegenerative processes.
Mild cognitive impairment (MCI): Objective cognitive decline greater than expected for age and education but not meeting dementia criteria.
Biomarker: Biological measurement indicating normal or pathological processes or responses to therapeutic interventions.
References
- Self- and interviewer-reported cognitive problems in relation to cognitive decline and dementia: results from two prospective studies. BMC Medicine (2024).
- Subjective cognitive complaints and blood biomarkers of neurodegenerative diseases: a longitudinal cohort study. Alzheimer's Research & Therapy (2023).
- The influence of APOE status on rate of cognitive decline. GeroScience (2024).
- Neuroimaging advances regarding subjective cognitive decline in preclinical Alzheimer’s disease. Molecular Neurodegeneration (2020).
- Estimating prevalence of subjective cognitive decline in and across international cohort studies of aging: a COSMIC study. Alzheimer's Research & Therapy (2020).
- Which features of subjective cognitive decline are related to amyloid pathology? Findings from the DELCODE study. Alzheimer's Research & Therapy (2019).
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