Subjective Cognitive Decline: Level of Risk for Future Dementia and Mild Cognitive Impairment, a Meta-Analysis of Longitudinal Studies

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Pike, Kerryn E
Cavuoto, Marina G
Li, Lily
Wright, Bradley J
Kinsella, Glynda J
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Subjective Cognitive Decline (SCD) in older adults has been identified as a risk factor for dementia, although the literature is inconsistent, and it is unclear which factors moderate progression from SCD to dementia. Through separate meta-analyses, we aimed to determine if SCD increased the risk of developing dementia or mild cognitive impairment (MCI). Furthermore, we examined several possible moderators. Longitudinal studies of participants with SCD at baseline, with data regarding incident dementia or MCI, were extracted from MEDLINE and PsycINFO. Articles were excluded if SCD occurred solely in the context of dementia, MCI, or as part of a specific disease. Pooled estimates were calculated using a random-effects model, with moderator analyses examining whether risk varied according to SCD definition, demographics, genetics, recruitment source, and follow-up duration. Risk of study bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS)-2 tool. 46 studies with more than 74,000 unique participants were included. SCD was associated with increased risk of developing dementia (HR = 1.90, 95% CI 1.52–2.36; OR = 2.48, 95% CI 1.97–3.14) and MCI (HR = 1.73, 95% CI 1.18–2.52; OR = 1.83, 95% CI 1.56–2.16). None of the potential moderating factors examined influenced the HR or OR of developing dementia. In contrast, including worry in the definition of SCD, younger age, and recruitment source impacted the OR of developing MCI, with clinic samples demonstrating highest risk. SCD thus represents an at-risk phase, ideal for early intervention, with further research required to identify effective interventions for risk reduction, and cognitive-behavioural interventions for cognitive management. PROSPERO, protocol number: CRD42016037993

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Neuropsychology Review

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© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2021. This is an electronic version of an article published in Neuropsychology Review, 2021. Neuropsychology Reviewis available online at: with the open URL of your article.

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Clinical neuropsychology

Psychology of ageing

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Life Sciences & Biomedicine

Psychology, Clinical


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Pike, KE; Cavuoto, MG; Li, L; Wright, BJ; Kinsella, GJ, Subjective Cognitive Decline: Level of Risk for Future Dementia and Mild Cognitive Impairment, a Meta-Analysis of Longitudinal Studies, Neuropsychology Review, 2021