ABSTRACT
CONTEXT: Early-stage cognitive decline occurs when an individual experiences memory loss or other cognitive impairment but does not meet the criteria for Alzheimer's disease (AD) or other dementias. After diagnosis of mild cognitive impairment (MCI), approximately 5-15â¯% of cases progress to dementia per year. AD and many other causes of dementia are presently incurable. Early recognition of cognitive decline can allow healthcare providers to reduce the risk of disease progression. Literature is scarce on factors that can increase the incidence of cognitive decline, especially in early ages; this is further exacerbated by difficulty tracking the prevalence of mild cognitive symptoms. OBJECTIVES: This analysis aims to determine demographic and comorbid factors that predispose individuals to higher rates of early-stage subjective cognitive impairment in order to determine which individuals should be screened at earlier stages. METHODS: We conducted a cross-sectional analysis of data from the Subjective Cognitive Decline module of the 2017-2021 Behavioral Risk Factor Surveillance System (BRFSS). Applying survey design and sampling weights, we constructed binary logistic regression models to assess associations, via odds ratios (OR), between comorbidities and subjective cognitive decline (SCD). Alpha was set at 0.05 and confidence intervals (CIs) are reported at 95â¯%. RESULTS: Our sample included 110,305 participants representing 13.4 million US adults aged 45-64 years. Results showed that individuals with diabetes (OR: 2.29, CI: 2.09-2.51), hypertension (OR: 1.98, CI: 1.81-2.17), stroke (OR: 4.61, CI: 4.07-5.22), myocardial infarction (MI [OR: 3.09, CI: 2.73-3.49]), coronary heart disease (CHD [OR: 3.26, CI: 2.88-3.69]), depression (OR: 5.65, CI: 5.21-6.11), and chronic kidney disease (CKD [OR: 3.08, CI: 2.66-3.58]) experienced higher rates of SCD. Further, there were higher rates of SCD among individuals who identified as American Indian/Alaskan Native (AI/AN), those with low educational attainment, and those with lower incomes. CONCLUSIONS: Our findings show that all comorbidities listed were correlated with higher rates of memory loss or confusion. Investigation of factors that are associated with an increased risk of developing new or worsening cognitive decline allows healthcare professionals to properly screen and treat these individuals early, before progressing to conditions that are currently incurable. Future studies into the mechanisms of these diseases in contributing to cognitive decline can illuminate specific effective treatment options.
