Older Adults With Subjective Cognitive Decline Worry About the Emotional Impact of Cognitive Test Results

Introduction: Older adults with subjective cognitive decline (SCD) would benefit from routine cognitive testing as they are twice as likely to develop dementia. Worries about concerning test results may diminish participation. The current study aimed to characterize the pattern of worries among older adults with and without SCD. Methods: Adults 50 years or above completed the Attitudes Around Cognitive Testing questionnaire on Mechanical Turk.com or in a primary care setting. Mechanical Turk.com is an online crowdsourcing site where requesters (eg, researchers) post jobs (eg, surveys or tasks) and workers (eg, respondents) choose which jobs to do for pay. Respondents were asked about perceived cognitive decline and about different types of worries they anticipated having if they received concerning test results. Results: We report data for 393 respondents (online: n=296, primary care: n=97), mean age of 63 years, age range of 50 to 91 years, and 60% endorsing SCD. Compared with No SCD, those with SCD anticipated a higher number of worries centered disproportionately on worries of becoming depressed, ashamed or embarrassed, feeling "stupid" and unable to do things, and being put in a nursing home. We observed this SCD pattern of worries in both samples. Discussion: Individuals with SCD worry about the emotional consequences of cognitive testing. This at-risk group would benefit from interventions focused on these concerns to increase patient engagement with cognitive tests.