'Worried Well' Patients Have a Higher Risk of Progression to Mild Cognitive Impairment or Dementia

Takeaway

• Anxiety and subjective cognitive decline (SCD)-related worry, but not depressive symptoms, were associated with an increased risk of clinical progression to mild cognitive impairment (MCI) or dementia in patients with SCD.

Why this matters

• Findings suggest that psychological interventions aimed at reducing anxiety or worry may benefit a group of patients with SCD and related worry traditionally referred to as the ‘worried well,’ who are at an increased risk of clinical progression to MCI or dementia.

Study design

• UK researchers performed a meta-analysis of 12 longitudinal studies, identified through a literature search across Medline, PubMed, PsycInfo, Embase and Web of Science databases.
• Funding: None.

Key results

• Patients with higher levels of anxiety or SCD-related worry were at a significantly increased risk of cognitive progression to either MCI or dementia (RR, 1.40; 95% CI, 1.20-1.63; P=.14; I², 52.55%).
• In patients with SCD, higher depressive symptoms were not significantly associated with an increased risk of MCI (relative risk [RR], 0.98; 95% CI, 0.75-1.26; P=.35) and dementia (RR, 0.69; 95% CI, 0.27-1.79; P=.10; I², 62.35%).

Limitations

• Heterogeneity among studies.
• Lack of a standardised measure of SCD.

This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.