Subjective Memory Decline Predicts Incident Cognitive Impairment among White -- but Not Black or Hispanic -- Older Adults

Background and objectives: This study investigates whether subjective memory decline in a racially diverse sample of older adults without cognitive impairment at baseline is associated with incident cognitive impairment during a 12-year follow-up period. Research design and methods: With panel data from a national sample (N=9,244) of cognitively-intact Black, White, and Hispanic Americans 65 years or older in 2004, we examine if subjective memory decline is associated with the loss of normal cognition by 2016. Cognitive status was assessed every two years with a modified version of the Telephone Interview for Cognitive Status to identify the transition from normal cognition to cognitive impairment. Results: Estimates from Weibull accelerated failure-time models reveal that subjective memory decline is associated with earlier incident cognitive impairment (time ratio = 0.96, p<.05). In subsequent models stratified by race-ethnicity, this association was evident among White respondents (time ratio = 0.95, p<.01) but not among Black, US-born Hispanic, or foreign-born Hispanic respondents. Discussion and implications: Given that the prognostic validity of subjective memory decline differs by race and ethnicity, caution is warranted when using it as a screening or clinical tool in diverse populations.