Subjective cognitive decline and cognitive leisure activity engagement in older adults: a mixed-methods study

Background and Objectives

Subjective cognitive decline (SCD), self-perceived worsening in cognitive abilities without objective impairment, is an early marker of dementia linked to poorer mental health and reduced quality of life. Cognitive leisure activities (CLA) are low-cost, accessible behaviours that support cognitive functioning and well-being. However, evidence remains limited regarding the directionality, mechanisms, and domain-specific nature of the SCD–CLA relationship. This study provides novel mixed-methods evidence to inform early, person-centred intervention strategies.

Research Design and Methods

A sequential explanatory mixed-methods design combined a cross-sectional survey of 255 older adults and semi-structured interviews with 20 individuals living with SCD in the United Kingdom. Quantitative data were analysed using regression analyses, and qualitative data through thematic analysis. Results were integrated via a joint display.

Results

Quantitative analyses showed higher SCD concerns were associated with lower CLA engagement, with specific activity types linked to distinct cognitive domains. Qualitative findings highlighted motivations, barriers, and strategies shaping engagement, including enjoyment, social connection, and emotional or health-related challenges. Integrated findings indicated potential reciprocal influences: cognitive concerns could motivate CLA engagement to maintain cognitive health, but SCD-related emotional distress and reduced confidence constrained participation. CLA did not statistically moderate the age–SCD association, yet participants reported perceived cognitive and emotional benefits.

Discussion and Implications

These findings highlight the need for interventions that move beyond simple activity promotion to address emotional ambivalence, stigma, and contextual barriers to participation. Tailoring CLA opportunities to individual preferences and capacities may enhance engagement, cognitive wellbeing, and emotional resilience in later life.