Metacognitive impairment in subjective cognitive decline: evidence from a memory clinic population

Abstract Background Subjective Cognitive Decline (SCD) is associated with an increased risk of cognitive impairment and dementia. They refer cognitive difficulties despite normal neuropsychological performance. This perception involves self-awareness and metacognition. This study aimed to examine both functions in cognitively unimpaired individuals with and without SCD. Methods 80 SCD and 59 volunteers from the Geneva Memory Center cohort completed a prospective-retrospective memory task. Metacognitive Judgments of Learning (JoL) were made before (predictive) and after (postdictive) the task performance. Awareness of cognitive change (ACC) was assessed using the Cognitive Change Index questionnaire, calculated as the discrepancy between self- and informant-reported cognitive deficits. Results No group differences were observed in task accuracy for either the prospective or retrospective ( p = .415). However, individuals with SCD had lower predictive JoL than volunteers in both prospective ( p = .005) and retrospective ( p = .033) tasks. No group differences were found in postdictive JoL. SCD also demonstrated reduced predictive metacognitive accuracy in the prospective task ( p = .034), while no differences in postdictive measures were observed. Lastly, only predictive metacognitive accuracy correlated with ACC (prospective: R = − .21, p = .030; retrospective: R = − .26, p = .008). Conclusion Individuals with SCD demonstrated reduced predictive metacognition, particularly in prospective memory, indicating difficulties in accurately anticipating their own performance. In contrast, preserved postdictive metacognition suggests a capacity to adjust self-evaluation following task execution. These findings highlight a partial overlap between metacognition and self-awareness and support the development of metacognitive training to potentially enhance cognitive self-monitoring in SCD.