Unravelling the Association between Ongoing Financial Strain, Sleep Disorder, High Blood Pressure and Subjective Cognitive Decline Among Older Americans

Background and Purpose: Literature shows that 1.1 to 3.0 million diagnosed cases of dementia are preventable if discovered during the preclinical or early stages. In recent times, subjective cognitive decline (SCD) (self-reported cognitive decline) has gained scholarly attention as a critical early detection strategy for cognitive impairment and dementia. Evidence suggests that the accumulation of social adversity leads to weathering, which in turn results in accelerated aging and cognitive decline. There are no existing studies that have assessed the relationship between financial strain, sleep difficulties, high blood pressure and subjective cognitive decline. The current study expands the existing body of evidence by assessing how ongoing financial strain is associated with subjective cognitive decline.

Methods: Data was obtained from the RANDHRS 1992-2020 (waves 10-15) with an analytical sample of 34261 (13753 males and 20508 females). The study operationalized SCD as subjective reports of worse or increasing decline in present memory rating. A generalized mixed model using a binary logistic link was utilized to assess the relationship between subjective cognitive decline (self-reported memory) and other multiple predictors.

Findings: The study found a statistically significant association between ongoing financial strain and SCD, with those who reported financial issues as being very upsetting having 48.4% higher odds of reporting SCD (OR = 1.484, 95% Cl: 1.242-1.772, p < .0001). The study also found a statistically significant association between SCD and sleep difficulty (OR = 1.426, 95% CI: 1.298-1.566, p <.0001), depression (OR = 1.650, 95% CI: 1.448-1.880, p <.0001), and self-reported poor health (OR = 5.791, 95% Cl: 4.810-6.971, p <.0001).

Conclusions and Implications: Findings from the study underscore the need for the integration of financial literacy and economic well-being in cognitive health interventions. The findings also have implications for sleep quality promotion by screening sleep-related issues among older adults during memory visits, as well as holistic emotional and psychological interventions to mitigate SCD progression.