Beyond WEIRD populations: Interpreting the gap between subjective cognitive complaints and objective impairment

Subjective cognitive complaints (SCC) are shifting from a quasi-diagnostic marker to a multidimensional clinical signal. Leniz et al. use the semi-rural Chilean MAUCO cohort to extend this debate beyond Western-dominated settings. They show a subjective-objective discrepancy: baseline objective performance did not predict incident SCC, whereas benzodiazepine use, and depressive symptoms did, highlighting affective and iatrogenic influences. Yet SCC predicted incident cognitive impairment. We argue that these findings are better interpreted by a model of SCC with at least two-components: affective/iatrogenic and degeneration-related components. In resource-limited contexts, SCC may aid risk-enrichment while prompting medication and mood review.