Subjective Cognitive Decline And Its Behavioral And Psychological Symptoms In Community-dwelling Elderly

[Purpose] The purpose of this study is 1)to test the reliability and validity of the Chinese-version of subjective cognitive decline questionnaire(SCD-Q).2)to investigate the prevalence of SCD in Chinese community-dwelling elderly;and 3)to analyze the BPSs of SCD and explore whether SCD is associated with sleep disorders and mental symptoms.[Methods]This study was a cross-sectional questionnaire survey.From March to June2019,convenient sampling was conducted.337 community elderlies were recruited and assessed with SCD-Q in Wuhan.From March to July 2019,community elderlies were recruited at five communities in Wuhan.The Montreal Cognitive Assessment was used to exclude the elderlies with cognitive impairment.The elderlies without cognitive impairment were inclusion.We collected demographic data,SCD-Q,Pittsburgh Sleep Quality Index(PSQI),Morningness-Eveningness Questionnaire(MEQ),Epworth Sleepiness Scale(ESS),Modified Berlin Questionnaire(MBQ),Geriatric Depression Scale-15(GDS-15),Geriatric Anxiety Inventory(GAI),Apathy evaluation Scale-self(AESs).The SPSS 24.0 and Amos 21.0 statistical software were used to analyze data.[Results](1)There were significant differences between the high and the low scoring groups of each item in SCD-Q(P < 0.05).All items were positively correlated with the total score(r > 0.3).All items can be retained.The Cronbach’s alpha coefficient was0.862 and the Cronbach’s alpha coefficients were ranging from 0.852 to 0.861 after excluding one item.The half-split reliability was 0.813.The average content validity index of the SCD-Q was 0.958.Exploratory factor analysis showed that SCD-Q was composed of four factors(Episodic Memory(6 items),Information Processing Speed(5 items),Working Memory(6 items),Attention & Executive Function(7 items)).The cumulative variance contribution rate was 43.652%.(2)211 community recruited elders without cognitive impairment,aged 71.0(IQR = 8.0)years old,were included in this study.48.5% of the participants were women.The median score of SCD-Q was 6.0(IQR = 7.0),with 49.8% of the participants scoring higher than 7.The median scores of PSQI,ESS,and MEQ was 6.0(IQR = 5.0),5.0(IQR = 6.0),and 67.0(IQR = 10.0),respectively.Participants scored higher than the cutoff of the PSQI,ESS,and MEQ was 33.6%,12.8%,and31.8%,respectively.The median scores of GDS-15,GAI,and AES-s was 3.0(IQR = 5.0),2.0(IQR = 5.0),and29.0(IQR = 12.0),respectively.Participants scored higher than the cutoff of GDS-15,GAI,and AES-s was11.4%,5.7%,and 16.1%.(3)Multiple linear regression analysis showed that age,sleep quality,depression,anxiety,and apathy were the influencing factors of SCD(adjusted R 2 = 0.334,F = 22.061,P < 0.001).The structural equation model of the BPS factors of SCD showed that the direct BPS factors of SCD-Q were depression(0.240),apathy(0.183),sleep quality(0.183),and anxiety(0.160).[Conclusions] The Chinese-versions of SCD-Q has good reliability and validity.The SCD-Q is a useful and convenient tool for primary care nurses to measure SCD in the Chinese community-dwelling elderly.It can help to prepare for the health education of the high-risk population with cognitive impairment and promote healthy aging in China.The prevalence of SCD is high in the community-dwelling elderly without cognitive impairment.The direct BPS factors of SCD are sleep quality,depression,anxiety,and apathy.And depression is the greatest BPS factor on SCD.Primary medical staff should pay more attention to SCD,and combine its BPSs to implement the intervention.