Subjective Cognitive Decline and Mild Cognitive Impairment: Inter-group Differences and Correlation Analysis of Clinical Neuropsychological Scales

Shanghai American School Pudong, Shanghai, China

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Abstract

Alzheimer’s Disease (AD) progresses from normal cognition (NC), subjective cognitive decline (SCD), mild cognitive impairment (MCI) to AD dementia. SCD is crucial for primary AD prevention. However, single neuropsychological scales lack sensitivity for early SCD and MCI identification, and research on multi-scale assessment differences and correlations is limited. A cross-sectional study with 110 participants (18 NC, 53 SCD, 39 MCI) used eight clinical neuropsychological scales and demographic indicators. One-way ANOVA or Kruskal-Wallis tests analyzed inter-group differences, Pearson or Spearman analysis investigated scale correlations, and boxplots and heatmaps visualized results. Baseline characteristics: The MCI group (64.05±8.42 years) was older than the SCD group (59.67±9.64 years, p = 0.021) and the NC group (44.33±17.77 years, p < 0.001). There were no significant gender or educational duration differences among groups. Inter-group scale differences: All scale scores differed significantly across groups (p < 0.05). Emotional scale scores (HAMD, HAMA) were MCI > SCD > NC; cognitive scale scores (MMSE, MOCA) and dementia - related scale scores (AFT, BNT) were NC > SCD > MCI. Only the MCI group had a Clinical Dementia Rating (CDR) score > 0 (mean = 0.5). Correlations: HAMD and HAMA had a strong positive correlation (r = 0.81, p < 0.001); MMSE and MOCA had a strong positive correlation (r = 0.71, p < 0.001); age was weakly negatively correlated with MMSE (r = - 0.31, p = 0.002) and MOCA (r = - 0.33, p = 0.001). Multi - domain neuropsychological scales can differentiate NC, SCD, and MCI populations. Scale correlations provide a quantitative basis for early cognitive impairment screening, and combining MOCA and AFT improves SCD identification sensitivity.