Memory Clinic Study Finds Impaired Performance Prediction in Subjective Cognitive Decline

People with subjective cognitive decline (SCD) — individuals who report worsening memory or thinking abilities despite performing normally on standard neuropsychological tests — show a specific breakdown in how they predict their own performance, according to a study published in Aging Clinical and Experimental Research. The research, conducted with patients and volunteers from the Geneva Memory Center cohort, found that people with SCD were notably worse at anticipating how well they would do on a memory task before carrying it out, while their ability to judge their performance afterwards remained intact.

The study included 80 individuals with SCD and 59 volunteers, all cognitively unimpaired on formal testing. Participants made metacognitive judgments of learning (JoL) at two points: before the task, as a predictive judgment of how they would perform, and after the task, as a postdictive judgment of how they had actually done. The researchers also assessed awareness of cognitive change (ACC) using the Cognitive Change Index questionnaire, calculated as the discrepancy between self-reported and informant-reported cognitive deficits.

The results revealed a striking dissociation. On the memory tasks themselves, the two groups performed equally well — there were no differences in task accuracy for either the prospective or the retrospective condition. Yet when asked to predict their performance in advance, the SCD group gave significantly lower judgments than the volunteers, in both the prospective task (p = .005) and the retrospective task (p = .033). After completing the tasks, however, the groups’ postdictive judgments did not differ, suggesting that once people with SCD had actual experience of the task, their self-evaluations converged with those of healthy volunteers.

Metacognitive accuracy — how well judgments matched actual performance — showed the same pattern. Individuals with SCD demonstrated reduced predictive metacognitive accuracy in the prospective task (p = .034), but no differences emerged in any postdictive measures. In other words, the impairment was confined to anticipating performance on future-oriented memory tasks, not to evaluating performance that had already happened.

The correlation analysis added a further layer. Only predictive metacognitive accuracy was associated with awareness of cognitive change: it correlated negatively with Cognitive Change Index scores in both the prospective condition (R = −.21, p = .030) and the retrospective condition (R = −.26, p = .008). Postdictive measures showed no such relationship. This indicates that the more accurately a person with SCD could predict their own performance before acting, the more closely their self-assessment of cognitive change aligned with what informants reported about them.

The authors interpret these findings as evidence of reduced predictive metacognition in SCD, particularly for prospective memory, reflecting difficulty in accurately anticipating one’s own performance. The preservation of postdictive metacognition suggests that people with SCD retain a capacity to adjust their self-evaluation once they have actually executed a task. This partial overlap between metacognition and self-awareness may help explain why subjective complaints can arise even when objective test performance looks normal: the problem may lie not in memory itself but in the forward-looking monitoring system that generates expectations about cognitive ability.

SCD is considered a clinically meaningful condition because it is associated with an increased risk of cognitive impairment and dementia, which is why memory clinics track it closely. The perception of cognitive difficulty inherently involves self-awareness and metacognition, making these functions potential early markers. The study’s authors suggest that the findings support the development of metacognitive training to potentially enhance cognitive self-monitoring in people with SCD, though such interventions remain a direction for future work rather than an established treatment.

Several limitations frame the results. The study was conducted in a single memory clinic population, so it cannot establish whether reduced predictive metacognition predicts future cognitive decline in these individuals. The correlations between metacognitive accuracy and awareness of cognitive change were modest in size, and the reported p-value for one accuracy comparison in the retrospective condition was incomplete in the published abstract. As an open-access article shared early under Springer’s accepted-manuscript policy, the paper is citable with a permanent DOI but remains subject to further editorial edits before the final version of record is issued. Nonetheless, the dissociation between intact post-evaluation and impaired anticipation offers a technically specific target for future longitudinal research into how subjective memory complaints emerge.

Subject of Research: Metacognitive impairment in predictive performance judgments among individuals with subjective cognitive decline

Article Title: Metacognitive impairment in subjective cognitive decline: evidence from a memory clinic population

Article References: Volpara, G., Chicherio, C., Cappa, S. F., Kliegel, M., Frisoni, G. B., Ribaldi, F., & Mendes, A. J. (2026). Metacognitive impairment in subjective cognitive decline: evidence from a memory clinic population. Aging Clinical and Experimental Research. https://doi.org/10.1007/s40520-026-03540-y

Image Credits: AI Generated

DOI: 10.1007/s40520-026-03540-y

Keywords: subjective cognitive decline, metacognition, memory clinic, judgments of learning, prospective memory, self-awareness, Cognitive Change Index, cognitive aging, dementia risk, Geneva Memory Center, Metacognitive, impairment