Increased Worry Associated with Self-Reported, but Not Informant-Reported, Subjective Cognitive Decline Predicts...

Background: Subjective cognitive complaints (SCC) have emerged as an important predictor of future dementia, with the SCD-plus framework emphasizing the prognostic value of cognitive concern and informant corroboration. Most research has focused on the presence or persistence of concern rather than examining trajectories of change over time. Objective: To determine if baseline levels and longitudinal trajectories of SCC concern from both participants and informants independently predict incident dementia over 10 years. Methods: Data were from 873 community-dwelling older adults (mean age 78.65 years) in the Sydney Memory and Ageing Study. Employing latent growth curve modelling, we analyzed binary SCC and concern variables. Cox proportional hazards models examined the association between concern trajectories and incident dementia over a 10-year follow-up, controlling for demographic and clinical factors. Results: Both participant-reported (Hazard Ratio [HR] = 1.21) and informant-reported (HR = 1.32) SCC concern at baseline independently predicted dementia risk. Notably, increasing participant SCC concern over time conferred substantial additional risk (HR = 10.23), while changes in informant concern did not significantly improve dementia risk prediction. Conclusions: Both participant and informant reports of SCC concern provide valuable but distinct prognostic information for dementia risk. The substantial predictive value of increasing participant concern over time highlights the importance of monitoring subjective cognitive experiences longitudinally. These findings support the clinical utility of tracking concern trajectories and suggest that the patient's evolving perspective may be particularly sensitive to underlying pathological processes.