title: Ascertaining Subjective Cognitive Decline: A Comparison of Approaches and Evidence for Using an Age-Anchored Reference Group.
abstract: BACKGROUND
  Subjective cognitive decline (SCD) is increasingly considered promising to detect preclinical Alzheimer's disease. How SCD is ascertained is critical for determining its potential utility in identifying at-risk individuals, yet SCD measures differ along several dimensions.
  
  
  OBJECTIVE
  We aimed to examine the extent to which reports of SCD in healthy elderly may be influenced by the characteristics of the SCD measures. We investigated variations in rates of SCD endorsement across different measures, including an open-ended question. We also examined the association of responses across measures, and the degree to which specific SCD items were associated with objective memory performance.
  
  
  METHODS
  99 healthy elderly completed a series of questionnaires from which 10 items examining SCD for memory and other aspects of cognition were drawn. We applied Cochran's Q tests to assess differences in rates of SCD, correlation analyses to examine association of SCD responses, and regression models to determine the association between SCD items and delayed verbal memory.
  
  
  RESULTS
  Rates of SCD varied as a function of the assessment format, ranging from 1 to 7% for memory and 5 to 20% for concentration. SCD was lower for memory versus non-memory domains. SCD items were associated both within and across domains. The most accurate predictor of memory was memory-related SCD in comparison to others the same age.
  
  
  CONCLUSIONS
  Characteristics of SCD items influence rates of endorsement. Querying SCD using an "age-anchored" question may provide the most accurate reflection of actual cognitive performance.
authors.affiliation: Cognitive Neuroscience Division of The Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, New York, NY, USA.
authors.forename: Caroline
authors.initials: C
authors.lastname: Tandetnik
authors.affiliation: Cognitive Neuroscience Division of The Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, New York, NY, USA.
authors.forename: Meagan T
authors.initials: MT
authors.lastname: Farrell
authors.affiliation: Departments of Medicine and Medical Ethics, Alzheimer's Disease Center, Institute on Aging, and Center for Health Incentives, The University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Mark S
authors.initials: MS
authors.lastname: Cary
authors.affiliation: Cognitive Neuroscience Division of The Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, New York, NY, USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Cines
authors.affiliation: Cognitive Neuroscience Division of The Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, New York, NY, USA.
authors.forename: Sheina
authors.initials: S
authors.lastname: Emrani
authors.affiliation: Departments of Medicine and Medical Ethics, Alzheimer's Disease Center, Institute on Aging, and Center for Health Incentives, The University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Jason
authors.initials: J
authors.lastname: Karlawish
authors.affiliation: Cognitive Neuroscience Division of The Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, New York, NY, USA.|G.H. Sergievsky Center, Columbia University Medical Center, New York, NY, USA.|Department of Neurology, Columbia University Medical Center, New York, NY, USA.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Cosentino
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D003072:Cognition Disorders / Q000150:complications / Q000175:diagnosis* / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008569:Memory Disorders / Q000175:diagnosis / Q000209:etiology; D008875:Middle Aged; D009483:Neuropsychological Tests; D012016:Reference Values; D014706:Verbal Learning
keywords: Aging; cognitive complaints; early detection; metacognition; subjective cognitive decline; subjective memory complaints