Subjective cognitive decline and anxious/depressive symptoms during the COVID-19 pandemic: what is the role of stress perception, stress resilience, and β-amyloid?

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• dc.contributor.author Akinci, Muge
• dc.contributor.author Sánchez Benavides, Gonzalo
• dc.contributor.author Brugulat Serrat, Anna, 1986-
• dc.contributor.author Peña-Gómez, Cleofé
• dc.contributor.author Palpatzis, Eleni
• dc.contributor.author Shekari, Mahnaz
• dc.contributor.author Deulofeu, Carme
• dc.contributor.author Fuentes-Julian, Sherezade
• dc.contributor.author Salvadó, Gemma
• dc.contributor.author González de Echávarri, José Maria
• dc.contributor.author Suárez-Calvet, Marc
• dc.contributor.author Minguillón, Carolina
• dc.contributor.author Fauria, Karine
• dc.contributor.author Molinuevo, José Luis
• dc.contributor.author Domingo Gispert, Juan
• dc.contributor.author Grau-Rivera, Oriol
• dc.contributor.author Arenaza Urquijo, Eider M.
• dc.contributor.author ALFA Study
• dc.date.accessioned 2023-01-12T07:52:23Z
• dc.date.available 2023-01-12T07:52:23Z
• dc.date.issued 2022
• dc.description.abstract Background: the COVID-19 pandemic may worsen the mental health of people reporting subjective cognitive decline (SCD) and therefore their clinical prognosis. We aimed to investigate the association between the intensity of SCD and anxious/depressive symptoms during confinement and the underlying mechanisms. Methods: two hundred fifty cognitively unimpaired participants completed the Hospital Anxiety and Depression Scale (HADS) and SCD-Questionnaire (SCD-Q) and underwent amyloid-β positron emission tomography imaging with [18F] flutemetamol (N = 205) on average 2.4 (± 0.8) years before the COVID-19 confinement. During the confinement, participants completed the HADS, Perceived Stress Scale (PSS), Brief Resilience Scale (BRS), and an ad hoc questionnaire on worries (access to primary products, self-protection materials, economic situation) and lifestyle changes (sleep duration, sleep quality, eating habits). We investigated stress-related measurements, worries, and lifestyle changes in relation to SCD. We then conducted an analysis of covariance to investigate the association of SCD-Q with HADS scores during the confinement while controlling for pre-confinement anxiety/depression scores and demographics. Furthermore, we introduced amyloid-β positivity, PSS, and BRS in the models and performed mediation analyses to explore the mechanisms explaining the association between SCD and anxiety/depression. Results: in the whole sample, the average SCD-Q score was 4.1 (± 4.4); 70 (28%) participants were classified as SCD, and 26 (12.7%) were amyloid-β-positive. During the confinement, participants reporting SCD showed higher PSS (p = 0.035) but not BRS scores (p = 0.65) than those that did not report SCD. No differences in worries or lifestyle changes were observed. Higher SCD-Q scores showed an association with greater anxiety/depression scores irrespective of pre-confinement anxiety/depression levels (p = 0.002). This association was not significant after introducing amyloid-β positivity and stress-related variables in the model (p = 0.069). Amyloid-β positivity and PSS were associated with greater HADS irrespective of pre-confinement anxiety/depression scores (p = 0.023; p < 0.001). The association of SCD-Q with HADS was mediated by PSS (p = 0.01). Conclusions: higher intensity of SCD, amyloid-β positivity, and stress perception showed independent associations with anxious/depressive symptoms during the COVID-19 confinement irrespective of pre-confinement anxiety/depression levels. The association of SCD intensity with anxiety/depression was mediated by stress perception, suggesting stress regulation as a potential intervention to reduce affective symptomatology in the SCD population in the face of stressors.
• dc.description.sponsorship This research was supported by Alzheimer’s Association research grants (AARG 2019-AARG-644641, AARG 2019-AARG-644641-RAPID) to EMAU. EMAU holds a “Ramón y Cajal” fellowship (RYC2018-026053-I). EMAU holds a grant from the Ministry of Science and Innovation (PID2019-111514RA-I00). The research leading to these results has received funding from the “la Caixa” Foundation (LCF/PR/GN17/10300004), the Alzheimer’s Association, and an international anonymous charity foundation through the TriBEKa Imaging Platform project. Additional support has been received from the Universities and Research Secretariat, Ministry of Business and Knowledge of the Catalan Government under grant 2017-SGR-892. MSC receives funding from the European Research Council (ERC) under the European Union’s Horizon 2020 research and innovation programme (Grant Agreement No. 948677) and the Instituto de Salud Carlos III (PI19/00155) and a fellowship from “la Caixa” Foundation (ID 100010434) and the European Union’s Horizon 2020 research and innovation programme under the Marie Skłodowska-Curie grant agreement no. 847648 (LCF/BQ/PR21/11840004).
• dc.format.mimetype application/pdf
• dc.identifier.citation Akinci M, Sánchez-Benavides G, Brugulat-Serrat A, Peña-Gómez C, Palpatzis E, Shekari M, et al. Subjective cognitive decline and anxious/depressive symptoms during the COVID-19 pandemic: what is the role of stress perception, stress resilience, and β-amyloid?. Alzheimers Res Ther. 2022 Sep 6;14(1): 126. DOI: 10.1186/s13195-022-01068-7
• dc.identifier.doi http://dx.doi.org/10.1186/s13195-022-01068-7
• dc.identifier.issn 1758-9193
• dc.identifier.uri http://hdl.handle.net/10230/55257
• dc.language.iso eng
• dc.publisher BioMed Central
• dc.relation.projectID info:eu-repo/grantAgreement/EC/H2020/847648
• dc.relation.projectID info:eu-repo/grantAgreement/ES/2PE/PID2019-111514RA-I00
• dc.relation.projectID info:eu-repo/grantAgreement/EC/H2020/948677
• dc.rights Copyright © Akinci M, Sánchez-Benavides G, Brugulat-Serrat A, Peña-Gómez C, Palpatzis E, Shekari M, 2022. Open Access. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri http://creativecommons.org/licenses/by/4.0/
• dc.subject.keyword Alzheimer’s disease
• dc.subject.keyword Anxiety
• dc.subject.keyword COVID-19 confinement
• dc.subject.keyword Depression
• dc.subject.keyword Stress
• dc.subject.keyword Subjective cognitive decline
• dc.title Subjective cognitive decline and anxious/depressive symptoms during the COVID-19 pandemic: what is the role of stress perception, stress resilience, and β-amyloid?
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion