This study aimed to understand subjective cognitive decline (SCD) and functional difficulties in older age cohorts with depressive symptoms, using one scoping review and two empirical studies. We implemented the six steps of Arksey and O'Malley's procedure for the scoping review. We used the population, concept, and context (PCC) inclusion and exclusion criteria in the literature search across MEDLINE via Ebscohost, PubMed, and PsycINFO for articles published on ADL/IADL indicators of SCD in older adults with depressive symptoms and that published in English language journals from January 2011 to November 2021. The two empirical studies used the 2019 wave of the Behavioral Risk Factor Surveillance Survey dataset of older adults aged 65 and ≥ 80 from the Centers for Disease Control and Prevention. We used multiple regression and the bias-corrected percentile bootstrap with 5000 samples using standard path-analytic approaches for the moderated mediation for the two empirical studies. Findings supported that instrumental activities of daily living (IADLs) presented more difficulties for older adults with SCD than the basic activities of daily living (B-ADLs), given that IADLs require more cognitive capabilities than B-ADLs. Environmental factors like healthcare access and subjective functional difficulties predicted SCD by mentally unhealthy day (MUD) mediation and age cohort moderation. The middle age cohort (70–74) had the most pronounced effects of the MUDs mediation in the relationship between healthcare access and IADLs in older adults with SCD. The younger-old (65–69) showed more substantial MUD mediation effects in the relationship between subjective functional difficulties and SCD. Worse SCD was associated with being Asians, female older adults, and at lower education years and income levels. Findings profiled SCD indicators in daily living activities across age cohorts and the mentally unhealthy days presentation. We extend the chronic stress theory predictions on accentuated emotional vulnerability from increased functional difficulties, compounding SCD.
| Identifer | oai:union.ndltd.org:unt.edu/info:ark/67531/metadc2137567 |
| Date | 05 1900 |
| Creators | Komalasari, Renata |
| Contributors | Mpofu, Elias, Prybutok, Gayle, Ingman, Stan, Catalano, Denise |
| Publisher | University of North Texas |
| Source Sets | University of North Texas |
| Language | English |
| Detected Language | English |
| Type | Thesis or Dissertation |
| Format | Text |
| Rights | Public, Komalasari, Renata, Copyright, Copyright is held by the author, unless otherwise noted. All rights Reserved. |
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