A needed revision for the definition of subjective cognitive decline

Subjective cognitive decline (SCD) as defined by the SCD-initiative (2014/2020) is now nearly universally accepted. In this framework, conditions characterized by objective cognitive impairment are distinct from SCD, and SCD is not a diagnostic category. The criteria prevent the straightforward linguistic expression, 'subjective cognitive decline', from being applied to someone with objective cognitive impairment. However, individuals with objective impairment can, of course, experience of subjective decline. The definition thus operates as a quasi-diagnostic category, precluding description of subjective experience for some individuals. Here I propose a simple solution: preclinical and clinical SCD (P-SCD/C-SCD) for objectively unimpaired and impaired individuals, respectively.

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Publication Details

Journal
Journal of Alzheimer s Disease
Published
2026-06-24
DOI
https://doi.org/10.1177/13872877261461255
Primary Topic
Dementia and Cognitive Impairment Research
Type
article
Field-Weighted Citation Impact
0.00

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article

A needed revision for the definition of subjective cognitive decline

William S. Kremen
Journal of Alzheimer s Disease
Dementia and Cognitive Impairment Research
article

A needed revision for the definition of subjective cognitive decline

William S. Kremen
article en

Abstract

Subjective cognitive decline (SCD) as defined by the SCD-initiative (2014/2020) is now nearly universally accepted. In this framework, conditions characterized by objective cognitive impairment are distinct from SCD, and SCD is not a diagnostic category. The criteria prevent the straightforward linguistic expression, 'subjective cognitive decline', from being applied to someone with objective cognitive impairment. However, individuals with objective impairment can, of course, experience of subjective decline. The definition thus operates as a quasi-diagnostic category, precluding description of subjective experience for some individuals. Here I propose a simple solution: preclinical and clinical SCD (P-SCD/C-SCD) for objectively unimpaired and impaired individuals, respectively.

Journal of Alzheimer s Disease
University of California System (US)
National Institute on Aging
Reduced inequalities
Openalex Percentile: Top 7%
Dementia and Cognitive Impairment Research
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