Akbayrak Emine, Powell Philip A, Tunc Neslihan, Barnes Sarah
Sheffield Centre for Health and Related Research, School of Medicine and Population Health, University of Sheffield, Sheffield, UK.
Gerontologist. 2024 Dec 17;65(2). doi: 10.1093/geront/gnae176.
Subjective cognitive decline (SCD) is a common experience of self-perceived decline without objective cognitive impairment. It has been theorized that SCD is associated with participation in cognitive leisure activities (CLAs), but the evidence base is multifarious and unclear. The purpose of this systematic review was to synthesize current evidence to determine the association between SCD and CLA engagement.
Systematic searches were conducted in EMBASE, MEDLINE, PsycINFO, and Web of Science (last searched April 2023). Data were extracted against a priori inclusion criteria and synthesized narratively using Synthesis without Meta-Analysis guidelines. Risk of bias was assessed using the Newcastle-Ottawa Scale (NOS) and Mixed Methods Appraisal Tool (MMAT). Reporting follows PRISMA guidelines.
From 4,447 records, 11 articles were included. Due to study heterogeneity, evidence on SCD and CLA association is inconclusive. Although a modest correlation was found between greater engagement in CLA and fewer reports of SCD, the heterogeneity in study designs and outcomes, particularly in those addressing only perceived memory decline and CLA engagement, challenges definitive conclusions on this relationship. Evidence from mixed-method and qualitative studies indicated that perceived memory decline may cause negative feelings, such as shame and frustration, which may influence participating in CLA.
These findings suggest that participation in CLA is moderately associated with, and may act protectively against, SCD. However, establishing a directional or causal relationship between CLA participation and SCD outcomes requires further investigation through longitudinal and/or interventional studies.
主观认知衰退（SCD）是一种自我感知衰退但无客观认知障碍的常见体验。理论上认为SCD与参与认知休闲活动（CLA）有关，但证据基础繁杂且不明确。本系统评价的目的是综合现有证据，以确定SCD与CLA参与之间的关联。
在EMBASE、MEDLINE、PsycINFO和科学网（最后检索时间为2023年4月）中进行系统检索。根据预先设定的纳入标准提取数据，并按照非元分析的综合指南进行叙述性综合。使用纽卡斯尔-渥太华量表（NOS）和混合方法评价工具（MMAT）评估偏倚风险。报告遵循PRISMA指南。
从4447条记录中，纳入了11篇文章。由于研究的异质性，关于SCD与CLA关联的证据尚无定论。尽管发现CLA参与度越高，SCD报告越少之间存在适度相关性，但研究设计和结果的异质性，特别是那些仅涉及感知记忆衰退和CLA参与的研究，对这一关系的确定性结论提出了挑战。混合方法和定性研究的证据表明，感知记忆衰退可能会导致羞耻和沮丧等负面情绪，这可能会影响CLA的参与。
这些发现表明，参与CLA与SCD适度相关，且可能对SCD起到保护作用。然而，要确定CLA参与与SCD结果之间的方向性或因果关系，需要通过纵向和/或干预性研究进一步调查。
