Relationship between Anxiety, Depressive Symptoms and Mild Neurocognitive Disorder in Older Adults: A Systematic Review

Abstract

Background: Neurocognitive disorder (NCD) presents its highest prevalence in older adults, with the rate of diagnoses expected to triple in the next two decades due to the accelerated aging of the population. The etiology of this disorder is diverse, with notable comorbidity with anxiety and/or depressive symptoms, and there are modifiable risk factors that highlight significant prevention potential. Objective: This systematic review aimed to examine the current scientific literature findings to answer the research question: What is the relationship between anxiety and depressive symptoms and mild cognitive impairment? Methodology: The search was conducted in the Web of Science and Scopus databases in March 2024, using the search equation: ("depressive symptoms" OR "anxiety symptoms") AND ("older person" OR elderly OR aging) AND ("cognitive decline" OR "cognitive performance" OR "mild cognitive impairment"), with a date range from January 2020 to March 2024. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed, and the results were uploaded to the Tree of Science platform. Results: The resulting articles were organized into three perspectives: Anxiety and depression in mild Neurocognitive disorder, Functional and structural neuroanatomy of mild NCD in relation to anxiety and depressive symptoms, and Predictors and psychosocial profile of mild NCD. Conclusion: Research confirms a significant relationship between both anxiety and depressive symptoms and mild NCD, though the nature of this relationship is still unclear. Establishing the psychosocial profile of older adults, as a characterization tool, promises to be very helpful for the clinical management of mild NCD and preventing its progression to major neurocognitive disorder (major NCD). The percentage of modifiable risk factors in mild NCD is 40%, presenting a substantial opportunity to reduce the prevalence of neurocognitive disorders in adulthood.

Keywords

• anxiety
• clinical psychology
• depression
• neurocognitive disorder
• psychosocial profile.