Predictors of Subjective Cognitive Impairment in Help-Seekers With and Without Symptoms of a Major Depression

Abstract

Abstract. Previous studies related subjective cognitive impairment (SCI) in the absence of objectifiable cognitive deficits to a prodromal stage of neurodegenerative diseases. However, there is also evidence that the expression of SCI in older people is primarily determined by the psychoaffective state and is markedly increased in depression. This study provides a better estimation of the impact of a major depression on the SCI level. Our sample comprised 70 participants visiting a memory clinic, 30 whom fulfilled the criteria of a major depressive disorder according to ICD-10 criteria. Using the CPI questionnaire (Complainer Profile Identification), we assessed the level of SCI and its expression in the three cognitive domains of memory, attention, and executive functions. These scores were related in turn to the psychoaffective state (GDS, Geriatric Depression Scale) and the cognitive performance on neuropsychological standard tests. Comparing help-seekers with (HS+) and without (HS−) major depression, we observed that negative mood and SCI level were significantly higher in HS+. Although within a normal performance range, memory and executive functions were also slightly reduced in HS+ compared to HS−. Linear regression analysis revealed that the psychoaffective state predicted the SCI level in HS−, while the cognitive performance did not contribute ( R2: 28.3%). In contrast, both factors significantly contributed to the SCI level in HS+ ( R2: 56.3%). This pattern was also observed for the level of subjective impairment in the memory and executive domain. The results indicate that, when assessing SCI in patients, it is necessary to inquire about the affective state, as patients with a major depression are more likely to suffer from cognitive impairment. Longitudinal research can help to determine whether help-seeking behavior in patients without a depression results from dementia worry or genuinely higher risk of a neurodegenerative disease.