Comparison of two measures of cognitive impairment on the 2015 Behavioral Risk Factor Surveillance System

Only selected states have used an optional module to address subjective cognitive decline (SCD) on the Behavioral Risk Factor Surveillance System (BRFSS). This study compares SCD with a core measure of cognitive disability (CDis) that has been included on the BRFSS since 2013. Using 2015 BRFSS data from 35 states that asked the module we report the weighted prevalence of SCD and CDis by demographics, chronic conditions, and risk factors among 150,981 respondents ages 45 years or older. We also compare adults with SCD only, CDis only, both, or neither, plus all those reporting either measure on similar health related measures. In addition, results of logistic regression are presented. Weighted prevalence rates and 95% confidence intervals were 11.5% (11.1%-12.0%) for SCD and 10.6% (10.2%-11.0%) for CDis. Approximately half of those reporting one measure reported the other and about one-third of those reporting either fell into each of the 3 mutually exclusive groups. Comparisons indicated a consistent progression from SCD only, to CDis only, to those with both, for measures of chronic conditions, number of SCD-related risk factors, and poorer health status. Logistic regression results for CDis were more like those for adults with SCD who also reported functional difficulties than for all adults with SCD. Conclusion: Although it does not include a timeframe or capture the exact same respondents as SCD, the core measure of CDis appears to be a useful measure of cognitive impairment and may represent adults more adversely affected than those reporting SCD.