Everyday functioning among older adults with subjective cognitive decline: a scoping review

Disabil Rehabil. 2024 Feb 10:1-10. doi: 10.1080/09638288.2024.2313127. Online ahead of print.

Abstract

Purpose: Older adults with subjective cognitive decline (SCD) experience cognitive difficulties without objectively measurable cognitive impairments but which may affect their everyday functioning. However, everyday functioning in this population has not yet been characterized. We sought to describe the empirical literature on the everyday functioning of community-dwelling older adults with SCD, their recruitment methods, and the measurements used.

Methods: A scoping review was conducted for primary research articles including at least one measure of everyday functioning. Retrieved records were independently screened. Data were extracted then analyzed using descriptive statistics and summative content analysis.

Results: 6544 studies were screened; 21 studies were included. All were observational analytic studies. Most compared an SCD group with a group of healthy control (47.6%), mild cognitive impairment (71.5%), and/or dementia (33.3%). Subjective cognition was measured via interview (28.6%) or clinical question(s) (14.3%). Normal cognition was determined by a wide variety of cognitive tests. The most studied everyday functioning domain was instrumental activities of daily living (90.5%). Most studies used questionnaires (81.0%), and measured ability to do an everyday life task (76.2%).

Conclusions: More research is needed on everyday functioning other than IADL, with greater focus on measures that consider an individual's real-life participation.

Keywords: Scoping review; activities of daily living; aging; cognition; everyday functioning; mild cognitive impairment; subjective cognitive decline.

Plain language summary

These is heterogeneity in the operational definitions and reporting of subjective cognitive decline in the empirical literature.Assessment of everyday functioning in the empirical literature on people with subjective cognitive decline is focused on the individual’s ability to do instrumental activities of daily living.There is a need for consensus on: (1) standards to assess subjective and objective cognition in determining subjective cognitive decline; and (2) best practice in assessing changes in everyday functioning in people with subjective cognitive decline.Clinical and research assessment of older adults with subjective cognitive decline should be expanded to functional domains other than instrumental activities of daily living.