The Relationship Between Subjective Cognitive Decline and Cognitive Leisure Activities in Older Adults: A Mixed Methods Study

Background: Subjective cognitive decline (SCD), defined as self-perceived worsening in
cognitive abilities in the absence of objective impairment, is recognised as an early marker of dementia and is associated with poorer mental health and reduced quality of life, making it a critical target for early intervention. Cognitive leisure activity (CLA), such as reading, enhances cognitive functioning and mental wellbeing, offering a low-cost, accessible approach to brain health. However, evidence on the relationship between SCD and CLA remains limited and inconsistent, with gaps concerning non-memory cognitive domains and experiential factors shaping engagement. Thus, this research aimed to examine the SCD–CLA relationship and factors influencing CLA participation among older adults.
Method: This PhD comprised a systematic review and empirical research using a sequential explanatory mixed methods design. The review informed the empirical investigation. The quantitative phase involved a cross-sectional survey of 255 community-dwelling older adults in the United Kingdom, assessing SCD concerns, CLA engagement, and sociodemographic characteristics. Correlation and regression analyses were conducted. The qualitative phase included semi-structured interviews with 20 older adults with SCD, analysed using thematic analysis. Quantitative and qualitative findings were integrated through a joint display approach.
Results: Quantitative analyses showed that higher SCD concerns were associated with lower CLA engagement, and that specific activity types were linked to distinct cognitive domains. Qualitative findings illustrated multidomain cognitive difficulties, accompanied by emotional and social challenges. Integrated findings indicated a bidirectional relationship between SCD and CLA: while cognitive concerns could motivate engagement in CLA for maintaining cognitive health, SCD-related emotional distress and reduced confidence constrained participation. CLA did not statistically moderate the age–SCD association, yet participants emphasised perceived emotional and cognitive benefits.
Conclusion: Fostering activity engagement in older adults with SCD requires addressing
emotional, social, and contextual barriers while providing guidance, accessibility, and support to maintain cognitive and psychosocial wellbeing.