Subjective Cognitive Decline: Exploring Neuropsychological Testing, Personal Perspectives and Affective Factors on Cognitive Function Overtime.

Leventhall, Rebecca (2026) Subjective Cognitive Decline: Exploring Neuropsychological Testing, Personal Perspectives and Affective Factors on Cognitive Function Overtime. Doctoral thesis, University of East Anglia.

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Abstract

Subjective cognitive decline (SCD) involves self-perceived cognitive deterioration and may represent an early stage of mild cognitive impairment (MCI). This thesis presents three papers examining mood-related risks; longitudinal change using online neuropsychological testing; and lived experiences of SCD.

This portfolio introduces current knowledge of SCD, outlining research gaps, leading to a systematic review on SCD in older adults, with mood as longitudinal risk factors. Depression was found to increase the risk of developing MCI or Alzheimer's Disease (HR = 1.45, 95% C.I. [1.25, 1.68], p <.001). However, findings are impacted by fewer longitudinal studies focusing on older adults with depression and anxiety as predictors.

While the review explored SCD longitudinally, it did not focus on online neuropsychological testing. This thesis presents a study with older adults who completed online testing in 2023, with reassessment six-months later and then again 2025. This study aimed to identify whether SCD progressed into MCI in a two-year period, and the utility of online testing. Participants also completed the Verbal Associative Learning Memory Test (VALMT). No participants reported having MCI, though all reported SCD. Testing scores remained unchanged across timepoints, possibly reflecting stability in SCD presentation, or indicate online tests lacked sensitivity. VALMT scores showed a significant reduction in learned word-pairs after 55-minutes and 24-hours.

Additionally, this portfolio explored personal experiences of living with SCD, identifying four themes. Participants described attentional, multi-tasking and word-finding difficulties, and cited these as “memory” decline, indicating this is how they interpreted living with SCD.

This portfolio supports the view that SCD may reflect an early stage in the cognitive decline trajectory. Findings of the SR highlight older adults with SCD, and depression may be at increased risk of further cognitive decline over time. Findings of the quantitative empirical paper highlight that SCD may remain stable for several years, particularly when examined via online testing. This highlights areas for future research regarding practicality and sensitivity of online neuropsychological testing. Furthermore, the qualitative study indicates how people with SCD articulate their cognitive concerns. They may cite memory difficulties, while describing attentional, working memory, multitasking and word-finding difficulties alongside physical health decline. These findings have implications for the assessment and management of people presenting with SCD, alongside affective symptoms.

Item Type:	Thesis (Doctoral)
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User:	Chris White
Date Deposited:	10 Nov 2026 08:57
Last Modified:	10 Nov 2026 08:57
URI:	https://ueaeprints.uea.ac.uk/id/eprint/105030
DOI:

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