Subjective Cognitive Decline from a Phenomenological Perspective: A Review of the Qualitative Literature

BACKGROUND: Subjective cognitive decline is related to greater risk of dementia and biological markers of Alzheimer's disease (AD), but researchers are yet to characterize the phenomenological perspective of cognitive decline in those with and without a diagnosis of AD. OBJECTIVE: To collate and synthesize studies measuring the subjective experience of cognitive change or decline in healthy older adults and those with mild cognitive impairment and AD. METHODS: We reviewed 58 peer-reviewed articles that were found to directly or indirectly refer to the subjective experience of cognitive decline. RESULTS: We extracted eight central themes, dealing with cognitive changes experienced by each diagnostic group, and also related to issues of changing self-identity, the causal attribution of cognitive decline, the anxiety and concern related to perceived decline, the negative perceptions attached to a diagnosis of dementia, changing levels of insight, and perception of well-being in aging. CONCLUSION: This review is the first step toward characterizing phenomenological profiles of cognitive change in both non-demented and demented older adults. Developing a clearer understanding of subjective cognitive decline, particularly at the earliest stages of AD, will augment the sensitivity of detection of individuals at greater risk of future dementia