An approach to classifying subjective cognitive decline in community‐dwelling elders

INTRODUCTION: Subjective cognitive decline (SCD) may be an early symptomatic manifestation of Alzheimer's disease, though published research largely neglects how to classify SCD in community‐based studies. METHODS: In neuropsychologically intact Einstein Aging Study participants (n = 1115; mean age = 78; 63% female; 30% non‐White), we used Cox models to examine the association between self‐perceived cognitive functioning at baseline (using three different approaches) and incident amnestic mild cognitive impairment (aMCI) with covariates of age, sex, education, race/ethnicity, general (objective) cognition, depressive symptoms, and four other SCD‐related features. RESULTS: After a median of 3 years, 198 participants developed aMCI. In models that included all the variables, self‐perceived cognitive functioning was consistently associated with incident aMCI as were age, general cognition, and perceived control; apolipoprotein E (APOE) ε4 allele status was significant in one model. We set cut points that optimized the diagnostic accuracy of SCD at various time frames. DISCUSSION: We provide an approach to SCD classification and discuss implications for cognitive aging studies.