Subjective cognitive decline among older adults and its link to diabetes,cardiovascular diseases,and other comorbidities: A US population-based study

Abstract

Background

Subjective cognitive decline (SCD) is the self-reported occurrence of increasing confusion or memory loss. Accumulating evidence suggests that SCD may be a prodromal phase of progressed cognitive decline stages, particularly Alzheimer's disease. The risk factors, mainly comorbidities, associated with SCD are not well known.

Objective

This study aims to examine whether diabetes, cardiovascular disease (CVD), with a focus on stroke and coronary heart disease (CHD), and other comorbidities are associated with SCD.

Methods

We conducted a quantitative analysis employing weighted analyses on cross-sectional data adopted from the 2022 Behavioral Risk Factor Surveillance System.

Results

Our results showed that out of 60,492 adults aged 45 years and older, 6423 individuals (10.45%) reported experiencing SCD, 19.49% diabetes, 11.78% CHD, and 5.67% stroke. Among diabetics, 33.41% reported insulin use. Comorbidities that were significantly associated with SCD included stroke (OR: 1.61; 95%CI: 1.24–2.08), CHD (OR:1.56; 95% CI: 1.27,1.92), and diabetes (OR: 1.25; 95%CI: 1.02–1.55). Other significant comorbidities included depressive disorder (OR: 2.56; 95% CI: 2.18–3.02), kidney disease (OR: 1.89; 95% CI: 1.24–2.87), arthritis (OR: 1.31; 95%CI: 1.07–1.61), and asthma (OR: 1.27; 95%CI: 1.06–1.52). Age of diagnosis with diabetes was younger among participants with SCD. Insulin use was significantly associated with SCD, particularly among type 2 diabetes, accounting for duration of diabetes. (OR: 1.39; 95% CI:1.02- 1.92).

Conclusions

Given the importance of SCD as a precursor to progressed cognitive impairment, these findings highlight the need for awareness and proactive screening for cognitive dysfunction among high-risk individuals with CVDs, diabetes, depression, and other comorbidities.