Centre for Innovative Ageing, Swansea University, Wales, UK.
Department of Psychology, Swansea University, Wales, UK.
J Alzheimers Dis. 2021;80(3):1231-1242. doi: 10.3233/JAD-200882.
Subjective cognitive decline (SCD) is increasingly recognized in both the clinical and research arenas as a risk factor for mild cognitive impairment (MCI) and dementia. Although SCD is etiologically heterogeneous and potentially treatable, in comparison to MCI and Alzheimer's disease, SCD remains poorly characterized with its clinical relevance often questioned.
This study's aim was to improve the characterization of SCD within the general public.
Individuals with SCD were compared to those without via a battery of measures.
Both the SCD and the non-SCD group correlational analysis identified significant relationships between worse SCD, worse metacognitive dysfunction, negative affective symptoms, and greater levels of stress. The SCD group displayed additional correlational relationships between Cognitive Change Index (Self report) (CCI-S) scores, higher neuroticism scores, and poorer quality of life (QoL). Partial correlation analysis in the SCD group suggests CCI-S scores, anxiety, depression, and metacognition are intercorrelated. Ad hoc analyses using metacognition as the grouping variable found that those experiencing worse metacognitive dysfunction were significantly more likely to experience poorer SCD, psychological and social QoL, greater levels of anxiety, depression, stress, and neuroticism.
The emerging pattern from the analysis indicates that SCD appears associated with sub-clinical negative affective difficulties, metacognitive, and other psycho-social issues, and poorer QoL. Dysfunctional cognitive control at a meta-level may impact someone's ability to rationally identify cognitive changes, increase worry about cognitive changes, and allow such changes to impact their lives more than those with superior metacognitive control. Findings could impact SCD assessment, monitoring, early intervention, and ultimately reducing risk of further decline.
主观认知衰退(SCD)在临床和研究领域中越来越被认为是轻度认知障碍(MCI)和痴呆的危险因素。尽管 SCD 在病因学上是异质的,并且可能具有治疗潜力,但与 MCI 和阿尔茨海默病相比,SCD 的特征仍然很差,其临床相关性经常受到质疑。
本研究旨在提高公众对 SCD 的认识。
通过一系列测试将 SCD 患者与非 SCD 患者进行比较。
SCD 组和非 SCD 组的相关性分析均表明,SCD 越严重、元认知功能越差、负面情绪症状越严重、压力水平越高。SCD 组的认知变化指数(自我报告)(CCI-S)评分、神经质性评分越高、生活质量(QoL)越差之间还存在额外的相关性。SCD 组的偏相关分析表明,CCI-S 评分、焦虑、抑郁和元认知相互关联。使用元认知作为分组变量的特定分析发现,元认知功能越差的患者发生 SCD 的可能性显著更高,心理和社会 QoL 更差,焦虑、抑郁、压力和神经质性评分更高。
分析结果表明,SCD 似乎与亚临床负面情绪困难、元认知和其他心理社会问题以及较差的 QoL 有关。元认知层面的认知控制功能障碍可能会影响人们理性识别认知变化的能力,增加对认知变化的担忧,并使这些变化对生活的影响大于具有优越元认知控制的人。研究结果可能会影响 SCD 的评估、监测、早期干预,并最终降低进一步下降的风险。