Rumination , stress coping , and quality of life in subjective cognitive decline

Background: Subjective cognitive decline (SCD) is consistently associated with adverse affects, such as subclinical depression, anxiety, along with poor psychological well-being. However, detailed aspects of psychological stress, a potential predictor of brain alteration and cognitive decline, have rarely been studied in this group. We aimed to further characterize the affective profile of SCD by assessing rumination, stress coping, and psychological quality of life in this at-risk cohort. Methods: In total 60 individuals, 30 SCDs (70.665.4 years) and 30 healthy older adults (HO) (70.767.3), underwent cognitive evaluation and filled out self-reported questionnaires. We examined associations of global cognitive complaints (Every Day Cognition, ECog), global cognition (neuropsychological composite), cognitive response styles of rumination and distraction (Response Style Questionnaire RSQ), negative and positive stress coping (Stress Coping Questionnaire SVF-78), and quality of life (WHO Quality of Life WHoQol). Correlation and mediation analyses were conducted to highlight relationships between cognitive and affective variables. Results: In the total sample, cognitive complaints were significantly associated with higher symptom rumination, negative coping, and lower quality of life in the psychological domain (Table 1); with SCD reporting higher symptom rumination and lower quality of life when compared to HO. Mediation models corroborated a significant indirect effect of cognitive complaints on quality of life through symptom rumination (b1⁄4-5.9, CI: -13.06, -1.17) Similar relationships were not found for global cognition in the total sample. However, in the SCD group, lower global cognition was associated with negative coping strategies(r1⁄4-.40). Additionally, negative coping mediated the adverse impact of lower cognition on psychological well-being (b1⁄45.03 CI: .08, .75). Conclusions:Our findings suggest that symptom rumination and negative stress coping help form the psychological profile of SCD. In addition, these factors play a central role on how complaints and cognition compromise psychological well-being. Rumination and stress are associated with cognitive debt [1], which may increase the vulnerability of the brain and cognitive function to pathological changes. Interventions that target these specific affective factors may increase quality of life and reduce risk of future