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Introduction: Subjective cognitive decline (SCD) may be an early symptomatic man- ifestation 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; meanage=78;63%female;30%non-White),weusedCoxmodelstoexaminetheasso- ciation 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 symp- toms, 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 asso- ciated 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.


This work was originally published in Diagnosis, Assessment & Disease Monitoring, available at DOI: 10.1002/dad2.12103

his is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License (CC BY-NC-ND 4.0), which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made



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