Semester

Spring

Date of Graduation

2024

Document Type

Thesis

Degree Type

MS

College

Eberly College of Arts and Sciences

Department

Psychology

Committee Chair

Julie Hicks Patrick

Committee Member

Elisa Krackow

Committee Member

Nicholas Turiano

Abstract

Subjective cognitive decline is one’s awareness of their own consistent memory loss or confusion that interrupts their day-to-day activities (CDC, 2022; Roehr et al., 2017). Several risk factors for subjective cognitive decline, such as demographic social determinants of health (SDOH) and adverse childhood experiences (ACEs) have been identified through previous research (Alzheimer’s Association, 2016; Dening & Sandilyan, 2015); however, less is known about the interaction between demographic SDOH and ACEs on subjective cognitive decline. The current study sought to examine how demographic SDOH (i.e., age, sex, race, and education) (research question 1) and ACEs (i.e., physical abuse, sexual abuse, and household dysfunction) (research question 2) influenced subjective cognitive decline among middle-aged and older adults (M = 67 years old). Additionally, we aimed to better understand the interaction between demographic SDOH and ACEs on subjective cognitive decline (research question 3). Using the 2020 Behavioral Risk Factor Surveillance System (BRFSS) data (CDC, 2020), a two- step hierarchical logistic regression was conducted, with demographic SDOH included in the first step and ACEs included in the second step. Both Step 1 (F(3, 1905) = 36.92, p < .001, R2 = .087) and Step 2 (F(3, 1902) = 9.36, p < .001, R2D = .013) were significant, where SDOH and ACEs uniquely contributed to the variance explained in subjective cognitive decline (F(8, 1902) = 26.49, p < .001, R2 = .096) . It was expected that older adults would report experiencing more subjective cognitive decline; however, our first hypothesis was not supported. Younger age was associated with more subjective cognitive decline, which is not consistent with previous research. The remaining hypotheses for our first research question were supported, where identifying as female, identifying as a member of a marginalized racial group, and having lower educational attainment were associated with more subjective cognitive decline, which is similar to previous findings. Our results also revealed that experiencing more ACEs was associated with more subjective cognitive decline, which supported our second hypothesis. To assess whether the effects of SDOH moderate the influence of ACEs on subjective cognitive decline, a series of moderated regression analyses were conducted. Although main effects emerged for individual SDOH and ACEs, no significant interactions among the two variables emerged. None of our hypotheses regarding the moderation of SDOH on ACEs and subjective cognitive decline were supported. Overall, our results revealed that both SDOH and ACEs uniquely contributed to the variance explained in subjective cognitive decline. Future research would benefit from examining the effects of demographic SDOH and ACEs on subjective cognitive decline by implementing longitudinal designs to better understand the lingering effects of childhood adversity and other sociodemographic influences on subjective cognitive decline at mid and late life.

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