Factors associated with subjective cognitive decline in community-dwelling elderly individuals based on living area and living arrangement: A cross-sectional study

Abstract

We aimed to identify factors associated with subjective cognitive decline (SCD) among older adults, considering residential area (urban or rural) and living arrangement (alone or with others). Using multivariate logistic regression on data from 74,472 individuals aged ≥ 65 from the 2021 Community Health Survey, we found significant differences in SCD prevalence, with urban older adults living alone showing the highest rate. Age, subjective health status, subjective stress, and depression were associated with SCD across all groups. However, the SCD-related factors differed among these groups. Among urban older adults living with others, sex, employment, education, smoking, and lack of trust were associated with SCD. In rural areas, education was a risk factor for SCD among those living alone, while employment and education were risk factors for those living with others. These findings highlight the need for tailored health strategies based on residential area and living arrangement to effectively manage SCD. © 2025 The Author(s)