The interplay between cognitive and psychological factors in subjective cognitive decline: contribution to the validation of a new screening battery

认知因素和心理因素在主观认知衰退中的相互作用:对一套新的筛查工具的验证

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Abstract

BACKGROUND: Subjective Cognitive Decline (SCD) is increasingly recognized as a potential early indicator of neurodegenerative disorders, yet its heterogeneous nature and lack of standardized screening tools complicate early detection and clinical management. This study aimed to comprehensively characterize a clinical SCD population and provide a preliminary contribution to the validation of a novel multidimensional screening battery, called MASCoD (Multidimensional Assessment of Subjective Cognitive Decline). METHODS: A total of 59 individuals (69.36 ± 8.66, female: 71,2%) with self-reported SCD without objective cognitive impairment was recruited within two Centers for Cognitive Disorders and Dementia (CCDDs) in Northern Italy. Participants underwent a comprehensive assessment, including neurological assessment, neuropsychological testing, psychological screening, and administration of MASCoD. Convergent validity was assessed using the Cognitive Function Instrument (CFI), and internal consistency was evaluated too. Correlations between MASCoD subscales, depressive and anxious symptoms, and cognitive performance were examined, alongside comparisons between short and long forms of anxiety and depression measures (GAD and PHQ). RESULTS: The sample showed preserved cognitive performance across all domains, consistent with SCD diagnostic criteria. Mild depressive symptoms were present and significantly associated with SCD, explaining up to around 10% of the variance in SCD measures. MASCoD Section B demonstrated good internal consistency (KR-20 = 0.782) and the entire tool shows moderate-to-strong convergent validity with the CFI. Notably, comparisons between PHQ-2/GAD-2 and their full-length versions indicated the brief tools may underestimate affective symptoms in this population. CONCLUSION: This study offers a detailed clinical and cognitive profile of an older SCD population, emphasizing the psychological dimensions of subjective complaints which should be evaluated into routine cognitive screening to proposed targeted preventive and rehabilitation interventions. The preliminary validation of MASCoD supports its potential as a reliable and multidimensional screening tool for early SCD detection. However, limitations such as small sample size, cross-sectional design, and cultural specificity necessitate further validation studies.

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