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

Pavankumar Kamat


August 27, 2021


  • 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%).


  • Heterogeneity among studies.

  • Lack of a standardised measure of SCD.


Desai R, Whitfield T, Said G, John A, Saunders R, Marchant NL, Stott J, Charlesworth G. Affective symptoms and risk of progression to mild cognitive impairment or dementia in subjective cognitive decline: A systematic review and meta-analysis. Ageing Res Rev. 2021 Aug 11 [Epub ahead of print]:101419. doi: 10.1016/j.arr.2021.101419. PMID: 34390850.  View abstract 

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


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