Sex and racial/ethnic patterns in subjective cognitive concerns-related functional difficulties among middle-aged and older adults: A multi-year cross-sectional analysis of a population-based U.S. adult sample in 2015–2022

BackgroundExperiencing subjective cognitive concerns (SCC) marks a potential risk stage for Alzheimer's disease.ObjectiveThis study examined sex and racial/ethnic patterns in the prevalence of functional difficulties among U.S. adults with SCC.MethodsData for 32,105 adults aged ≥45 years who experienced SCC in the past year were sourced from the Behavioral Risk Factor Surveillance System in 2015-2022. Individuals reporting SCC-related functional difficulties in daily or social life activities always/usually/sometimes (versus rarely/never) in the past year were considered having each of the functional difficulties. Weighted binomial logistic regression analyses were conducted to examine the association of sex (male or female) and race/ethnicity (non-Hispanic White [NHW], non-Hispanic Black [NHB], Hispanic, or non-Hispanic Other [NHO]) with SCC-related daily and social life difficulties, adjusting for all covariates.ResultsOverall, a decreasing trend in SCC-related functional difficulties was observed in both sexes, while female adults had higher prevalence. Trends in these functional difficulties varied by race/ethnicity, with NHW adults exhibiting the most stable and lowest prevalence. Female adults had significantly higher odds of experiencing SCC-related daily life (adjusted odds ratio [AOR] = 1.28, 95% confidence interval [CI] = 1.15, 1.41) and social life difficulties (AOR = 1.12, 95% CI = 1.01, 1.24) than male adults. NHB, Hispanic, and NHO groups had higher odds of experiencing SCC-related daily and social life difficulties compared to NHW participants.ConclusionsFemale and racial/ethnic minority individuals experienced higher levels of SCC-related functional difficulties. Public health interventions are warranted to alleviate such challenges for vulnerable populations.