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Exploring Subjective Cognitive Decline and Ageism: At-Risk Older Adults' Lived Experience

Williams, Randal Lawrence
http://orcid.org/0009-0000-4593-3339
http://rave.ohiolink.edu/etdc/view?acc_num=antioch1743782304691055

Abstract Details

2025, Psy. D., Antioch University, Antioch New England: Clinical Psychology.
Subjective Cognitive Decline (SCD), the self-perceived decline in cognitive abilities, is recognized as a preclinical marker for neurocognitive disorders (Jessen et al., 2014). Understanding the contextual factors informing SCD experience remains a research priority in this domain. At-risk older adults have heritable markers associated with dementia. Chronic exposure to embedded ageism burdens allostatic load (AL) and exacerbates epigenetic risk for cognitive decline (Levy, 2022; McEwen, 2020; Miller et al., 2021). The current qualitative study explored how ageism shapes the lived experience of SCD among at-risk older adults. Semi-structured interviews were conducted with 12 participants, all doctoral level clinical practitioners, aged 60 to 79 and analyzed using thematic analysis, guided by the Transactional Model of Stress and Coping (TMSC). Findings revealed that ageism pervades three ecological domains—intrapersonal, interpersonal, and systemic—¬contributing to emotional distress, behavioral restriction, and reduced healthcare engagement. The present study extends the current literature on this topic by identifying ageism as a socio-cultural determinant of perceived cognitive health, shaping the outcome trajectory. The findings underscore the need to address ageism through clinical interventions and systemic reforms. Such strategies to reduce AL burden, through reduction of stigma and promotion of preventive healthcare engagement, may delay or even prevent onset of dementia among at-risk older adults. This dissertation is available in open access at AURA (https://aura.antioch.edu) and Ohio LINK ETD Center (https://etd.ohiolink.edu).
Katherine Evarts, PsyD (Committee Chair)
Gina Pasquale, PsyD (Committee Member)
Casey Culligan-Benoit, PsyD (Committee Member)
116 p.
Clinical Psychology; Gerontology; Mental Health; Psychotherapy; Social Psychology
Subjective Cognitive Decline (SCD); cognitive health; dementia prevention; ageism; allostatic load (AL); aging and clinical psychology; stress and coping; thematic analysis

Recommended Citations

Citations

  • Williams, R. L. (2025). Exploring Subjective Cognitive Decline and Ageism: At-Risk Older Adults' Lived Experience [Doctoral dissertation, Antioch University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=antioch1743782304691055

    APA Style (7th edition)

  • Williams, Randal. Exploring Subjective Cognitive Decline and Ageism: At-Risk Older Adults' Lived Experience . 2025. Antioch University, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=antioch1743782304691055.

    MLA Style (8th edition)

  • Williams, Randal. "Exploring Subjective Cognitive Decline and Ageism: At-Risk Older Adults' Lived Experience ." Doctoral dissertation, Antioch University, 2025. http://rave.ohiolink.edu/etdc/view?acc_num=antioch1743782304691055

    Chicago Manual of Style (17th edition)

antioch1743782304691055
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© 2025, all rights reserved.
This open access ETD is published by Antioch University and OhioLINK.