Prediction of one-year cognitive decline via self-perceived memory in older adults during the COVID-19 pandemic.

Background: Subjective memory complaints (SMC) are associated with increased risk of cognitive decline and dementia. SMCs are also influenced by mood and anxiety symptoms, which increased among older adults during the COVID-19 pandemic. Objective: We investigated whether a single-item SMC measure predicts one-year cognitive decline and whether this predictive relationship remained stable during the early COVID-19 period (2020). Methods: We analyzed longitudinal data (2011-2023) from the National Health And Aging Trends Study (NHATS), an annual survey of Medicare beneficiaries in the United States. Mixed-effects models assessed the association between self-perceived memory worsening and next-year cognitive outcomes, and tested whether this association differed in 2020. Results: A total of 33,244 observations from 6676 elderly individuals were included. Higher age, male sex, non-white race, education at or below high school level, lower scores on basic and instrumental activities of daily living, poorer social activity, anxiety symptoms, lower annual income, and self-perceived memory decline each predicted worse cognitive function one year later. However, the interaction between self-perceived memory decline and the COVID-19 pandemic (in 2020) was not significant. Discussion: A single-item measure of self-perceived memory decline effectively predicts next-year cognitive decline in older adults, independent of the broader social impacts observed during the 2020 COVID-19 pandemic.