Abstract: Objective: Based on the Symptom Experience Model (SEM), this study aimed to explore the symptom experiences of older adults with Subjective Cognitive Decline (SCD) at a specialized cognitive impairment outpatient clinic, in order to provide a reference for early identification, assessment, and support. Methods: A descriptive qualitative research design was adopted. Using purposive sampling, semi-structured interviews were conducted from September to December 2023 with 17 older adults experiencing SCD at a cognitive impairment outpatient clinic of a tertiary grade A hospital in Suzhou. The interview guide was developed based on the SEM. Data were analyzed using directed content analysis to extract themes. Results: A total of four themes and 11 sub-themes were identified: multi-dimensional experience of cognitive decline, multi-factorial attribution of cognitive decline, emotional responses and psychological adjustment related to dementia risk, and coping strategies characterized by the coexistence of passive avoidance and active management. Conclusion: The symptom experiences of older adults with SCD are multi-dimensional. Their symptom perception, attributional evaluation, emotional responses, and coping behaviors interact with each other. Healthcare professionals should based on memory complaint assessments, further focus on patients' attribution styles, emotional experiences, and coping patterns to provide individualized early support.

Key words: Subjective Cognitive Decline; older adult; symptom experience; symptom experience model; qualitative research; dementia