Distress symptoms of old age and mild cognitive impairment are two distinct dimensions in older adults without major depression: effects of adverse childhood experiences and negative life events

Abstract

AbstractBackgroundStudies in old adults showed bidirectional interconnections between amnestic mild cognitive impairment (aMCI) and affective symptoms and that adverse childhood experiences (ACE) may affect both factors. Nevertheless, these associations may be confined to older adults with clinical depression.AimsTo delineate the relationship between clinical symptoms of aMCI and affective symptoms in older adults without major depression (MDD) or dysfunctions in activities of daily living (ADL).MethodsThis case-control study recruited 61 participants with aMCI (diagnosed using Petersen’s criteria) and 59 older adults without aMCI and excluded subjects with MDD and ADL dysfunctions.ResultsWe uncovered 2 distinct dimensions, namely distress symptoms of old age (DSOA) comprising anxiety, depression, perceived stress and neuroticism scores, and mild cognitive dysfunctions (mCoDy) comprising episodic memory test scores, and the total Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) scores. A large part of the variance (37.9%) in DSOA scores was explained by ACE, negative life events (health and financial problems), a subjective feeling of cognitive decline, and education (all positively). While ACE and NLE have a highly significant impact on the DSOA, they are not associated with the mCoDy scores. Cluster analysis showed that the diagnosis of aMCI is overinclusive because some subjects with DSOA symptoms may be incorrectly classified as aMCI.ConclusionsThe clinical impact is that clinicians should carefully screen older adults for DSOA after excluding MDD. DSOA might be misinterpreted as aMCI.