Affective symptoms and risk of progression to mild cognitive impairment or dementia in subjective cognitive decline: A systematic review and meta-analysis

Roopal Desai; Tim Whitfield; Glorianne Said; Amber John; Rob Saunders; Natalie L Marchant; Joshua Stott; Georgina Charlesworth

doi:10.1016/j.arr.2021.101419

Affective symptoms and risk of progression to mild cognitive impairment or dementia in subjective cognitive decline: A systematic review and meta-analysis

Ageing Res Rev. 2021 Nov:71:101419. doi: 10.1016/j.arr.2021.101419. Epub 2021 Aug 11.

Authors

Roopal Desai¹, Tim Whitfield², Glorianne Said³, Amber John³, Rob Saunders⁴, Natalie L Marchant², Joshua Stott³, Georgina Charlesworth³

Affiliations

¹ University College London, Department of Clinical Educational and Health Psychology, 1-19 Torrington Place, London, WC1E 7HB, UK. Electronic address: roopal.desai.15@ucl.ac.uk.
² Division of Psychiatry, University College London, UK.
³ University College London, Department of Clinical Educational and Health Psychology, 1-19 Torrington Place, London, WC1E 7HB, UK.
⁴ Centre for Outcomes Research and Effectiveness, University College London, UK.

PMID: 34390850
DOI: 10.1016/j.arr.2021.101419

Abstract

Aims: To 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.

Methods: Five 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.

Results: Twelve 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).

Conclusions: Affective 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.

Keywords: Anxiety; Dementia; Depression; MCI; Subjective cognitive decline; Worry.

Publication types

Meta-Analysis
Research Support, Non-U.S. Gov't
Review
Systematic Review

MeSH terms

Affective Symptoms
Aged
Cognitive Dysfunction* / epidemiology
Cognitive Dysfunction* / etiology
Dementia* / diagnosis
Dementia* / epidemiology
Dementia* / etiology
Disease Progression
Humans
Longitudinal Studies