Please use this identifier to cite or link to this item: https://doi.org/10.1186/s13195-020-00673-8
Title: Subjective cognitive decline, anxiety symptoms, and the risk of mild cognitive impairment and dementia
Authors: Liew, T.M. 
Keywords: Anxiety
Cox regression
Longitudinal study
Neurocognitive disorders
Subjective memory complaints
Issue Date: 2020
Publisher: BioMed Central Ltd
Citation: Liew, T.M. (2020). Subjective cognitive decline, anxiety symptoms, and the risk of mild cognitive impairment and dementia. Alzheimer's Research and Therapy 12 (1) : 107. ScholarBank@NUS Repository. https://doi.org/10.1186/s13195-020-00673-8
Rights: Attribution 4.0 International
Abstract: Background: Subjective cognitive decline (SCD) and anxiety symptoms both predict neurocognitive disorders, but the two correlate strongly with each other. It is unclear whether they reflect two independent disease processes in the development of neurocognitive disorders and hence deserve separate attention. This cohort study examined whether SCD and anxiety symptoms demonstrate independent risks of mild cognitive disorder and dementia (MCI/dementia). Methods: The study included 14,066 participants aged ? 50 years and diagnosed with normal cognition at baseline, recruited from Alzheimer's Disease Centers across the USA. The participants were evaluated for SCD and anxiety symptoms at baseline and followed up almost annually for incident MCI/dementia (median follow-up 4.5 years; interquartile range 2.2-7.7 years). SCD and anxiety symptoms were included in Cox regression to investigate their independent risks of MCI/dementia. Results: SCD and anxiety symptoms demonstrated independent risks of MCI/dementia, with HR 1.9 (95% CI 1.7-2.1) and 1.3 (95% CI 1.2-1.5), respectively. Co-occurring SCD and anxiety symptoms demonstrated the highest risk (HR 2.4, 95% CI 1.9-2.9) - participants in this group had a 25% probability of developing MCI/dementia by 3.1 years (95% 2.4-3.7), compared to 8.2 years among those without SCD or anxiety (95% CI 7.9-8.6). The results remained robust even in the sensitivity analyses that took into account symptom severity and consistency of symptoms in the first 2 annual visits. Conclusions: The findings suggest that clinicians should not dismiss one over the other when patients present with both SCD and anxiety and that both constructs may potentially be useful to identify high-risk populations for preventive interventions and trials. The findings also point to the need for further research to clarify on the neurobiological distinctions between SCD and anxiety symptoms, which may potentially enrich our understanding on the pathogenesis of neurocognitive disorders. © 2020 The Author(s).
Source Title: Alzheimer's Research and Therapy
URI: https://scholarbank.nus.edu.sg/handle/10635/199706
ISSN: 1758-9193
DOI: 10.1186/s13195-020-00673-8
Rights: Attribution 4.0 International
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