The Interplay between Cognitive and Psychological Factors in Subjective Cognitive Decline: Contribution to the validation of a screening battery for Subjective Cognitive Decline

Marina Maffoni^1*Annalisa Magnani²Antonia Pierobon¹Alessandra Mafferra³Fabrizio Pasotti^3,4Carlo Dallocchio³Pierluigi Chimento⁵Valeria Torlaschi¹Giuseppe Trifirò⁶Cira Fundarò⁵

• ¹Istituti Clinici Scientifici Maugeri IRCCS, Psychology Unit, Montescano Institute, Italy, Montescano, Italy
• ²Università Cattolica del Sacro Cuore, Department of Psychology, Milan, Italy, Milan, Italy
• ³Department of Medical Area, Neurology Unit, ASST di Pavia, Italy, Pavia, Italy
• ⁴Department of Rehabilitation ASST Pavia, Voghera, Pavia, Italy, Voghera, Italy
• ⁵Istituti Clinici Scientifici Maugeri IRCCS, Neurophysiopathology Unit, Montescano Institute, Italy, Montescano, Italy
• ⁶Istituti Clinici Scientifici Maugeri IRCCS, Nuclear Medicine Unit of Pavia Institute, Pavia, Italy, Pavia, Italy

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. Conclusions 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.