Subjective cognitive decline (SCD) is defined as the subjective perception of cognitive difficulties prior to the onset of observable clinical impairments. SCD commonly occurs in older adults and can represent a risk state for future Alzheimer’s disease and related dementias (ADRDs). SCD is, however, a multifaceted construct, and many factors can affect its endorsement. Previous studies have shown that life stressors such as caregiver burden can lead to increased SCD. Similarly, measurement factors (e.g., how you ask about SCD) are known to impact the endorsement of SCD. For example, eliciting SCD relative to a past time can lead to greater endorsement of SCD compared to SCD with no reference framework (i.e., in general) or SCD compared to others of the same age. It is unknown whether measurement effects interact with individual factors such as life stressors. This study examined the main effects of measurement framework and caregiver status on SCD, as well as their interactive effect.

A total of 124 community-dwelling participants were included in this study (M age = 75.25, SD = 7.72; M years of education = 16.97, SD = 2.13). Measures included a 20-item SCD questionnaire administered in three counterbalanced measurement frameworks: Retrospective (compared to the participant’s own performance 5 years ago), Age-Anchored (compared to others one’s age), and General (no reference point). Caregiver status was assessed with items inquiring if participants were current caregivers of someone with a major illness, disability or dementia, Alzheimer’s disease, or another age-related disease that affects thinking abilities. A mixed-design ANOVA examined main effects of framework and caregiver status and their interaction on SCD. Analyses were reported as both unadjusted and adjusted for age, education, gender and depressive symptoms.

A total of 15 individuals (12%) indicated being current caregivers. The unadjusted ANOVA showed a main effect of caregiver status such that caregivers endorsed higher SCD than non-caregivers F(1,120) = 5.949, p = .016). A main effect of SCD measurement framework was also observed (F(2,240) = 9.057, p < .001). Pairwise comparisons revealed that retrospective-SCD was the highest endorsed type of SCD followed by standard- and age-anchored-SCD. The latter type of SCD was significantly lower than the others (Retrospective-age mean difference -5.5, p < .001; Standard-age mean difference -3.024, p = .029). Finally, an interaction effect between caregiver status and measurement framework was observed (F(2, 240) = 5.178, p = .006), wherein caregivers had a larger difference in the endorsement of retrospective SCD relative to standard- and age-anchored SCD, and relative to non-caregivers. Only the interaction effect remained significant after adjusting for covariates (F(2,208) = 6.357, p = .002).

As expected, caregivers endorsed higher levels of SCD than older adults who are not currently caring for someone. Additionally, age-anchored SCD was endorsed less frequently than SCD compared to 5 years ago, or SCD in general. Interestingly, this is the first study to show how caregiver status can moderate measurement effects on SCD, with caregivers endorsing differentially more SCD compared to 5 years ago. Findings add to growing evidence that age-anchored SCD is less susceptible to experiential factors (i.e., caregiving, COVID, age attitudes) than SCD in comparison to a previous point in time.