An Overview of Subjective Cognitive Impairment

Subjective cognitive impairment is a self-observed decline in thinking processes, such as memory. It's subjective because others may not have observed any difficulty and you may score very well on cognitive tests designed to screen for dementia; however, you feel that there is a decline. For example, you may notice that your memory is not as good as it used to be, or that it's more difficult to recall the right word you want to use to describe something.

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Subjective cognitive impairment is also called subjective memory loss, subjective memory disorder, self-reported memory loss, and subjective cognitive decline.

Should You Worry About Subjective Cognitive Impairment?

You shouldn't ignore it but you shouldn't worry about it. People who have been diagnosed with Alzheimer's disease might not be very aware of their memory loss. The fact that you're able to identify your memory functioning as a concern indicates cognitive functioning that is fairly well intact, despite your identification of a problem.

Some research studies suggest that subjective cognitive impairment may be one of the earliest symptoms of Alzheimer's disease and dementia. But other research studies suggest that subjective cognitive impairment is not associated with Alzheimer's disease or any type of dementia.

What Does the Research Say?

For example, in one study, participants who reported subjective cognitive impairment were also more likely to show changes in their brains on imaging scans, specifically demonstrating higher levels of beta-amyloid protein. The concerns identified by individuals whose brains showed higher amounts of beta-amyloid protein included feeling that their memories were worse than their peers' memories and that organizing and prioritizing tasks (which utilizes executive function) was harder than it used to be.

Subjective cognitive impairment has also been correlated with brain changes such as atrophy (shrinkage due to cell death) in the hippocampus, an area of the brain that is associated with memory.

Other research concluded that subjective cognitive impairment is "predominantly a benign condition." In this study, researchers followed some individuals with subjective cognitive impairment and others with normal cognition for six years. They saw very little difference in the cognitive functioning of both groups by the end of the study.

Causes of Subjective Cognitive Impairment?

While subjective cognitive impairment might be the precursor of more significant memory loss later, it also has been connected to other conditions that may make cognitive functioning more difficult but are not actual impairments in cognition. These conditions include depression and anxiety, as well as other health problems and chronic diseases.

For example, a research study found that subjective cognitive impairment was significantly associated with mood, specifically depression and anxiety. The authors suggested that subjective cognitive impairment should not be considered indicative of any true cognitive decline, but rather felt that it pointed to a mood issue.

What Should You Do If You Have Subjective Cognitive Impairment?

First, don't panic. While it's understandable that you might be worried about your memory loss, remember that many cases of subjective cognitive impairment do not develop into dementia.

Some research suggests that people with subjective cognitive impairment who have a lower risk of cardiovascular issues and show less brain atrophy were less likely to develop Alzheimer's over time. Thus, living in a healthy manner to reduce cardiovascular risk factors may potentially be able to reduce the risk of subjective cognitive impairment progressing to a more serious issue.

Medical Screening and Evaluation

If you feel that you have subjective cognitive impairment, consider getting screened for depression and anxiety. Getting treatment for mental health issues could potentially ease your symptoms and improve your quality of life.

Early detection of Alzheimer's disease and other dementias is also critical for optimal treatment since some of the treatments may be more effective if they're started before cognitive abilities significantly decline.

Early detection also allows you to decide if you want to participate in a clinical trial.

Cognitive Training for Subjective Cognitive Impairment

Interventions designed to help your memory are emerging and can involve interactive therapies that can help improve your memory and executive functioning.

A study outlined in the Journal of Alzheimer's Disease involved people who had memory declines who participated in two months of cognitive training designed to target their episodic memory functioning. Following this training, the participants' memory functioning had improved and their brain gray matter volume had increased at a rate comparable to control subjects (other participants without memory concerns who also received the cognitive training). Greater brain volume has been shown to be correlated with higher cognitive functioning.

Other research has identified the MEND approach as somewhat effective in helping reverse symptoms of subjective cognitive impairment and MCI. The MEND approach is a multi-pronged treatment strategy that works to address several areas that could impact cognition, such as diet, vitamin supplementation, physical activity, adequate sleep, and more.

A Word From Verywell

Simply because you notice some decline in word-finding ability or memory doesn't mean you have Alzheimer's disease, or that you're going to develop dementia. Some people are far more likely to be aware of these changes or become concerned about them due to basic personality differences. There are also many different causes of memory loss, such as being too busy or not getting enough sleep. Others, such as vitamin B12 deficiency, may be reversible with treatment.

Memory loss is, however, something you should pay attention to and report to your physician. You can also do your part to maintain a healthy brain by eating healthy foods, exercising physically, and remaining mentally active, all of which have been associated with improved cognition.

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Additional Reading
  • Alzheimer's Association. In Brief for Healthcare Professionals. Research Highlights: Subjective Cognitive Concerns May Be an Early Clinical Indicator of Alzheimer’s Disease.

  • Cheng, Y., Chen, T. and Chiu, M. (2017). From mild cognitive impairment to subjective cognitive decline: conceptual and methodological evolution. Neuropsychiatric Disease and Treatment, Volume 13, pp.491-498.  doi:10.2147/NDT.S123428

  • Alzheimer’s Association International Conference (AAIC) 2013.  Abstracts F5-01-04,  P4-178, and  P4-206.