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

Desai, R; Whitfield, T; Said, G; John, A; Saunders, R; Marchant, NL; Stott, J; (2021) Affective symptoms and risk of progression to mild cognitive impairment or dementia in subjective cognitive decline: A systematic review and meta-analysis. Ageing Research Reviews , Article 101419. 10.1016/j.arr.2021.101419. (In press).

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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.

Type: Article
Title: Affective symptoms and risk of progression to mild cognitive impairment or dementia in subjective cognitive decline: A systematic review and meta-analysis
DOI: 10.1016/j.arr.2021.101419
Publisher version: https://doi.org/10.1016/j.arr.2021.101419
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Subjective cognitive decline, MCI, dementia, depression, anxiety, worry
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences > Clinical, Edu and Hlth Psychology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry
URI: https://discovery.ucl.ac.uk/id/eprint/10132861
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