I’m the one who used to be ‘on the ball’: a qualitative study on older adults’ experience and interpretation of subjective cognitive decline

Objectives: Subjective cognitive decline (SCD) refers to self-perceived cognitive difficulties without objective impairment, and is associated with increased dementia risk, poorer mental health, and reduced quality of life. As research has largely relied on quantitative methods, little is known abouth how older adults interpret and respond to cognitive changes. This study explored how older adults with SCD notice, interpret, and respond to cognitive changes.

Methods: Twenty community-dwelling adults aged ≥60 were purposively sampled using the Subjective Cognitive Decline Questionnaire. Semi-structured interviews were analysed thematically. Rigour was ensured through collaborative coding, audit trails, reflexivity, and adherence to qualitative reporting standards.

Results: Participants described SCD as gradual and shaped by life transitions, social context, and health events. Fear and frustration were common,often contributing to social withdrawal, particularly among lonely participants. Media portrayals and ageist narratives amplified worry and stigma. Participants’ metacognitive beliefs, informed by personal experiences and dementia exposure, influenced how cognitive changes were interpretedand managed. Coping strategies included peer comparison, cognitively stimulating activities, external aids, and adaptive attitudes.

Conclusion: Self-perceived cognitive changes may influence emotional and social functioning. Findings support interventions incorporating cognitive training, memory strategies, group-based activities, and metacognitive approaches to address ageist beliefs and dementia-related fears shaped by media and personal experience.