An analysis of minimal depressive symptoms and minimal anxiety symptoms in patients with subjective cognitive decline

Abstract

Objective To investigate the characteristics of minimal depressive symptoms (MDS) and minimal anxiety symptoms (MAS) in patients with subjective cognitive decline (SCD), and to provide a basis for early prevention and treatment of Alzheimer’s disease. Methods From the Chinese Alzheimer’s Biomarker and LifestylE (CABLE) study cohort, a total of 1 982 participants were included. Based on the criteria established by the international SCD initiative workgroup, the participants were divided into non-SCD group and SCD group (further divided into SCD-nonplus group and SCD-plus group by the severity of SCD assessed using a Likert scale). All the participants were evaluated for MDS and MAS status using the Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA). Multiple linear regression and logistic regression models were employed to analyze the relationships between SCD status and HAMD and HAMA scores as well as MDS and MAS status. One-way analysis of variance was performed to compare HAMD and HAMA scores between the non-SCD group, SCD-nonplus group, and SCD-plus group. A mediation model was utilized to analyze the mediating effects of HAMD and HAMA scores on the relationship between SCD severity and Chinese Modified Mini-Mental State Examination (CM-MMSE) score. Results The multiple linear regression analysis showed that SCD status was positively associated with HAMD and HAMA scores (β=0.045, 0.057,t=4.528,5.832,P<0.05). The logistic regression analysis revealed that SCD status was positively associated with MDS and MAS status (β=0.579,0.741,Z=4.242,5.329,P<0.05). The HAMD and HAMA scores in the SCD-plus group were significantly higher than those in the non-SCD group and the SCD-nonplus group (t=-7.058--2.321,P<0.05). The mediation analysis indicated that HAMD score partially mediated the relationship between SCD severity and CM-MMSE score. Conclusion Patients with SCD, particularly those with SCD-plus, present with more severe MDS and MAS, suggesting that MDS and MAS may have potential value in the early identification and prevention of Alzheimer’s disease.

Keywords

• cognitive dysfunction|depression|anxiety|psychiatric status rating scales|alzheimer disease