Affective symptoms and risk of progression to mild cognitive impairment or dementia in subjective cognitive decline: A systematic review and meta-analysis |
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| Institution: | 1. Regional Institute for Mental Health Care in Outpatients, RIAGG Maastricht, Maastricht, The Netherlands;2. Department of Psychiatry and Psychology / MUMC, School for Mental Health and Neuroscience (MHeNS) / Alzheimer Centre Limburg, Maastricht University Medical Center, Maastricht, The Netherlands;3. Center for Psychiatry & Interdisciplinary Center of Psychopathology of Emotion Regulation (ICPE), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands;1. Department of Radiology, University of Bonn, Germany;2. German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany;3. Department of Psychiatry, University of Bonn, Germany;4. German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany;5. Department of Nuclear Medicine, University of Bonn, Germany;6. Department of Psychosomatic Medicine, University of Rostock, Rostock, Germany;7. Department of Psychiatry, Medical Faculty, University of Cologne, Germany |
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| Abstract: | AimsTo systematically review the literature on outcomes for individuals with subjective cognitive decline (SCD) with concurrent affective symptoms. To conduct a meta-analysis to establish whether either higher depressive symptoms or higher levels of anxiety increased the risk of progression SCD to mild cognitive impairment (MCI) or dementia.MethodsFive databases were searched from inception to February 2021 for longitudinal studies of older adults with SCD, reporting depressive and anxiety symptoms at baseline and risk of MCI or dementia at follow-up. Data were extracted and pooled using a random-effects meta-analysis.ResultsTwelve studies were identified. Pooled effect sizes indicated higher depressive symptoms did not increase risk of clinical progression to either MCI (RR = 0.98; 95 % CI: 0.75–1.26) or dementia (RR = 0.69; 95 % CI: 0.27–1.79). However, presence of anxiety or SCD-related worry did significantly increase risk of progression from subjective to objective cognitive impairment by 40 % (RR = 1.40; 95 % CI:1.20 – 1.63).ConclusionsAffective symptoms in the form of anxiety, but not depressive symptoms, increase the risk of progression to objective cognitive impairment in individuals with SCD. Further research should focus on establishing whether psychological interventions aimed at reducing anxiety and worry also reduce the risk of clinical progression. |
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| Keywords: | Subjective cognitive decline MCI Dementia Depression Anxiety Worry |
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