Abstract
Subjective cognitive decline (SCD), a measure of self-rated health, compares subjective and objective cognitive decline (CD). Since health care professionals are under time constraints during consultations, SCD may serve as a brief screening tool for cognitive impairment. The Behavioral Risk Factor Surveillance System surveys Americans at the state level annually and includes fifteen core and twenty-five optional modules, including self-reported CD, and in 2015, 122,487 participants age 45 or older completed the core and CD modules. Approximately 11% endorsed CD, and of those, 54% had not discussed CD with a health care professional. Logistic regression analysis assessed effects of age, sex, race, ethnicity, education, household income, and health care access with SCD. Participants’ SCD odds increased with age (OR=1.08; 95%CI:1.07–1.09). Men had higher SCD odds compared to women (OR=1.44; 95%CI:1.38–1.49). Nonwhites had higher SCD odds compared to non-Hispanic whites (OR=1.22; 95%CI:1.16–1.29). Non-Hispanics/Non-Latinos had higher SCD odds compared to Hispanics/Latinos (OR=1.56; 95%CI:1.42–1.70). Respondents with 12 years of education or less had higher SCD odds compared to participants with one or more years of college or technical school (OR=1.16; 95%CI:1.11–1.21). Participants with household incomes <$25,000/year had higher SCD odds compared to other participants (OR=1.88; 95%CI:1.80–1.96). Respondents without health care coverage had higher SCD odds compared to respondents with health care coverage (OR=1.09; 95%CI:1.00–1.19). Health care professionals can utilize SCD to initiate conversations about CD with at-risk populations, especially men, Nonwhites, Hispanics/Latinos, less educated, or impoverished individuals. Fostering physician-patient conversations about SCD could support earlier interventions for symptom reduction.