Identifying the Components of Cognitive Decline from Older Adults’ Perspectives: A Qualitative Study
Keywords:
Cognitive decline, Older adults, Aging, Qualitative research, Thematic analysisAbstract
Purpose: This study aimed to identify and conceptualize the components of cognitive decline from the perspectives and lived experiences of older adults.
Methods and Materials: This applied qualitative study was conducted among older adults living in Districts 1 and 3 of Tehran, Iran. Participants were selected through theoretical sampling, and data collection continued until theoretical saturation was achieved with 17 older adults. Data were collected using in-depth, semi-structured interviews focused on participants’ perceptions, experiences, and interpretations of age-related cognitive decline. The interviews were transcribed and subjected to qualitative coding and thematic analysis. The extracted codes were reviewed, compared, categorized, and integrated to identify the principal dimensions of cognitive decline. The identified components were subsequently used to develop a preliminary cognitive decline questionnaire. Ten items were proposed for each component. The content validity of the questionnaire was assessed by a panel of nine university professors and subject-matter experts. To assess the reliability of the qualitative coding and the stability of the developed framework, the interview data were coded twice at a one-month interval.
Findings: The qualitative analysis generated 20 initial codes, which were organized into nine subthemes and ultimately consolidated into nine principal themes representing the components of cognitive decline from older adults’ perspectives. These findings indicated that older adults perceive cognitive decline as a multidimensional phenomenon that cannot be adequately represented by a single cognitive indicator. The nine identified components provided the conceptual foundation for developing a 90-item preliminary questionnaire, with ten items assigned to each component. Expert evaluation yielded an overall content validity index of 0.78, indicating acceptable agreement regarding the relevance and representativeness of the questionnaire items. Furthermore, the agreement between the two coding stages conducted one month apart was 85%, demonstrating satisfactory coding stability and reliability.
Conclusion: The findings support a multidimensional conceptualization of cognitive decline grounded in older adults’ experiences and suggest that the resulting questionnaire has acceptable preliminary content validity and reliability for assessing perceived cognitive decline in older populations.
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Copyright (c) 2026 Maryam Barghi Irani (Author); Ahmad Alipour; Ziba Barghi Irani , Parvaneh Ghodsi (Author)
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