Associations between higher-order executive planning and subjective cognitive decline in middle-aged individuals

BackgroundSubjective cognitive decline (SCD) is a recognized risk factor for future objective cognitive impairment and dementia. Although widely studied in older adults, SCD during midlife remains underexplored, despite this period representing a critical window for early detection. Higher-order executive functions, particularly cognitive planning, may be especially sensitive to subtle cognitive changes at this stage.ObjectiveTo examine the association between higher-order executive function performance and subjective cognitive decline in middle-aged individuals.MethodsThis cross-sectional study included 167 community-dwelling middle-aged adults (45-60 years) with SCD and normal global cognition. Participants completed the Subjective Cognitive Decline Questionnaire (SCDq), mood and sleepiness measures, structured executive function tests, and the Zoo Map Test (ZMT) to assess higher-order executive planning. Group comparisons, correlation analyses, and hierarchical linear regressions were performed.ResultsHigher SCD levels were associated with longer planning times and more planning errors on the ZMT. No associations were observed between SCD and global cognitive performance or structured executive function measures. In the hierarchical regression model, mood symptoms and daytime sleepiness explained 23% of SCD variance, while higher-order executive planning measures accounted for an additional 8.4%, yielding a final hierarchical model explaining 33.6% of the variance. Fully adjusted simultaneous model showed the same pattern.ConclusionsSCD in midlife is associated with subtle differences in higher-order executive functioning that emerge under high cognitive demand. Ecologically valid executive tasks may improve early detection of individuals at risk for future objective cognitive decline beyond traditional neuropsychological measures.