한국노년학 · Oct 13, 2026
Biopsychosocial and Health Behavioral Factors Associated with Subjective Cognitive Decline among Older Adults
By Ko H, Cho Y
This study aimed to identify biological, psychological, social, and health behavioral factors associated with subjective cognitive decline among community-dwelling older adults based on the biopsychosocial model. This study was a secondary data analysis using raw data from the Korea Disease Control and Prevention Agency's 2025 Community Health Survey. The study included 84,261 older adults aged 65 years or older, and individual weights, stratification variables, and cluster variables were applied to account for the complex sampling design; differences according to the presence of subjective cognitive decline were analyzed using the Rao-Scott χ² test and the complex-sample t test. Hierarchical complex-sample logistic regression analysis was performed to identify factors associated with subjective cognitive decline. The weighted proportion of subjective cognitive decline was 28.1%. In the final model, increasing age, female sex, fair/poor self-rated health, depression, high stress, low health-related quality of life, low educational attainment, reduced frequency of contact with relatives and neighbors, and short or long sleep duration were significantly associated with subjective cognitive decline. In contrast, obesity and current smoking showed inverse associations with subjective cognitive decline. The hierarchical analysis showed that explanatory power increased the most in Model 2, which added psychological factors. Subjective cognitive decline among community-dwelling older adults was associated not only with biological factors but also with psychological factors, social relationships, and health behaviors. In particular, given that the largest increase in model explanatory power occurred at the step that added psychological factors, an integrated approach that includes depression and stress management, improvement in health-related quality of life, strengthening of social networks, and improvement in health behaviors is needed to promote cognitive health among community-dwelling older adults.