Abstract

Background: Chronic diseases are common worldwide and are closely associated with cognitive decline. Subjective cognitive decline (SCD) refers to self-perceived worsening of memory or cognitive ability. Individuals with SCD have a two-fold higher risk of developing dementia and often experience reduced physical function, emotional problems, lower quality of life, and an increased risk of falls. However, research on cognitive function and related factors among older adults with chronic diseases who report SCD remains limited.

Purpose: To compare cognitive and executive function in older adults with chronic diseases with and without SCD, and to identify factors associated with cognitive and executive performance among those with SCD.

Methods: A cross-sectional, two-group comparative study was conducted following the STROBE guidelines. A convenience sample of 313 older adults with chronic diseases was recruited from northern Taiwan. Participants completed questionnaires; neuropsychological tests of global cognition and executive function; and clinical data were collected from medical records. Data were analyzed using t tests, chi-square tests, ANCOVA, Pearson correlations, and multiple linear regression.

Results: Of the 313 participants, 130 (41.5%) had SCD. Compared with those without SCD, participants with SCD demonstrated significantly poorer executive function, while global cognition was lower but did not reach statistical significance. Among participants with SCD, older age, fewer years of education, higher HbA1c levels, and higher systolic blood pressure were associated with lower global cognitive scores. Older participants with fewer years of education, higher HbA1c, living alone, and poorer instrumental activities of daily living had significantly poorer executive function.

Conclusions: Older adults with chronic diseases who report SCD show reduced executive functioning. Early cognitive screening is crucial to identify at-risk individuals and provide timely intervention to prevent cognitive deterioration.

Implications for Nursing/Clinical Practice: Healthcare professionals should routinely assess cognitive function in older adults with chronic diseases for those at risk, such as individuals who are older, have lower education, poor glycemic or blood pressure control, live alone, or have impaired daily functioning. Targeted interventions should be provided to mitigate cognitive decline and improve functional outcomes.

Notes

References:

Jessen F, Amariglio RE, Buckley RF, et al. The characterisation of subjective cognitive decline. The Lancet Neurology. 2020/03/01/ 2020;19(3):271-278. doi:https://doi.org/10.1016/S1474-4422(19)30368-0

Parfenov VA, Zakharov VV, Kabaeva AR, Vakhnina NV. Subjective cognitive decline as a predictor of future cognitive decline: a systematic review. Dement Neuropsychol. Jul-Sep 2020;14(3):248-257. doi:10.1590/1980-57642020dn14-030007

Pavel A, Paun R, Matei V, Rosca A, Tudose C. Quality of Life in People With Subjective Cognitive Decline. Alpha Psychiatry. Mar 2023;24(2):60-64. doi:10.5152/alphapsychiatry.2023.221007

Kim JH, Song JH, Wee JH, Lee JW, Choi HG. Depressive Symptoms, Subjective Cognitive Decline, and Subjective Sleep Quality Are Associated with Slips and Falls: Data from the Community Health Survey in Korean Adults. Gerontology. 2022;68(5):518-528. doi:10.1159/000518007

Chen, H. F., Jiang, J. Y., Chen, M. H., Lin, R., Jerence, S. W. O., Chang, C. H., & Chou, C. C. (2023). Gender differences in cognitive function and its associated factors among older adults with type 2 diabetes. Geriatric Nursing, 52, 165-171. https://doi.org/10.1016/j.gerinurse.2023.05.017

Description

Older adults with chronic diseases who have subjective cognitive decline (SCD) demonstrated poorer executive function compared with those without SCD. This study supports the importance of routine cognitive screening for older adults with chronic diseases, particularly those with SCD, to enable early detection and timely intervention to prevent cognitive deterioration.

Author Details

Cheng-Chen Chou, PhD, RN; Yuan-Mei Liao, PhD, RN; Jong-Ni Lin, PhD, RN

Sigma Membership

Lambda Beta at-Large

Type

Poster

Format Type

Text-based Document

Study Design/Type

Cross-Sectional

Research Approach

Quantitative Research

Keywords:

Primary Care, Public and Community Health, Cognitive Disorders, Cognitive Disorders--Complications, Executive Function, Executive Function--In Old Age, Chronic Disease, Chronic Disease-In Old Age

Conference Name

37th International Nursing Research Congress

Conference Host

Sigma Theta Tau International

Conference Location

Toronto, Ontario, Canada

Conference Year

2026

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

Date of Issue

2026-07-27

Funder

Far Eastern Memorial Hospital, Taiwan

Second Funder

National Yang Ming Chiao Tung University

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Reduced Executive Function in Older Adults with Chronic Diseases and Subjective Cognitive Decline

Toronto, Ontario, Canada

Background: Chronic diseases are common worldwide and are closely associated with cognitive decline. Subjective cognitive decline (SCD) refers to self-perceived worsening of memory or cognitive ability. Individuals with SCD have a two-fold higher risk of developing dementia and often experience reduced physical function, emotional problems, lower quality of life, and an increased risk of falls. However, research on cognitive function and related factors among older adults with chronic diseases who report SCD remains limited.

Purpose: To compare cognitive and executive function in older adults with chronic diseases with and without SCD, and to identify factors associated with cognitive and executive performance among those with SCD.

Methods: A cross-sectional, two-group comparative study was conducted following the STROBE guidelines. A convenience sample of 313 older adults with chronic diseases was recruited from northern Taiwan. Participants completed questionnaires; neuropsychological tests of global cognition and executive function; and clinical data were collected from medical records. Data were analyzed using t tests, chi-square tests, ANCOVA, Pearson correlations, and multiple linear regression.

Results: Of the 313 participants, 130 (41.5%) had SCD. Compared with those without SCD, participants with SCD demonstrated significantly poorer executive function, while global cognition was lower but did not reach statistical significance. Among participants with SCD, older age, fewer years of education, higher HbA1c levels, and higher systolic blood pressure were associated with lower global cognitive scores. Older participants with fewer years of education, higher HbA1c, living alone, and poorer instrumental activities of daily living had significantly poorer executive function.

Conclusions: Older adults with chronic diseases who report SCD show reduced executive functioning. Early cognitive screening is crucial to identify at-risk individuals and provide timely intervention to prevent cognitive deterioration.

Implications for Nursing/Clinical Practice: Healthcare professionals should routinely assess cognitive function in older adults with chronic diseases for those at risk, such as individuals who are older, have lower education, poor glycemic or blood pressure control, live alone, or have impaired daily functioning. Targeted interventions should be provided to mitigate cognitive decline and improve functional outcomes.