Epidemiological studies have revealed that behavioral and psychological (or non-cognitive) symptoms are risk factors for cognitive decline in older adults. This study aimed to systematically review the literature and determine which behavioral and psychological symptoms are most predictive of future cognitive decline among individuals with no pre-existing cognitive impairments. The selected studies included middle-aged or older adults without cognitive impairments. The predictors were assessed using behavioral and psychological questionnaires, or diagnostic interviews, to identify non-cognitive symptoms or psychiatric clinical conditions. The follow-up period was at least one year, and the design of the selected studies was either retrospective or prospective. This study compared individuals with and without non-cognitive manifestations and resulted in one of three outcomes: (a) a score change on a cognitive measure, (b) a diagnosis of mild cognitive impairment, or (c) a diagnosis of Alzheimer's disease or dementia. Four online databases were searched for eligible studies from the database inception to January 17, 2017: MEDLINE (PubMed), Embase (OVID), PsycINFO, and Web of Science. Pooled effect sizes were estimated using a random-effect model. Higgins I2, the Q statistic, and tau-squared were used to quantify the observed heterogeneity between the studies. Results indicate that depression and sleep duration (long and short) were the most consistent associations between behavioral or psychological symptoms and cognitive decline. This meta-analysis supports the need to assess behavioral and psychological symptoms in cognitively intact older adults to identify those who are at risk for cognitive decline.

中文翻译：

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预测认知正常的中年或老年人认知衰退或损害的行为和心理症状：元分析。

流行病学研究表明，行为和心理（或非认知）症状是老年人认知能力下降的危险因素。本研究旨在系统地回顾文献，并确定哪些行为和心理症状最能预测没有预先存在认知障碍的个体未来的认知能力下降。选定的研究包括没有认知障碍的中年或老年人。使用行为和心理问卷或诊断性访谈来评估预测因子，以识别非认知症状或精神病临床状况。随访期至少为一年，所选研究的设计要么是回顾性的，要么是前瞻性的。本研究比较了有和没有非认知表现的个体，并得出了以下三种结果之一：(a) 认知测量的分数变化，(b) 轻度认知障碍的诊断，或 (c) 阿尔茨海默病的诊断或痴呆。从数据库成立到 2017 年 1 月 17 日，在四个在线数据库中搜索了符合条件的研究：MEDLINE (PubMed)、Embase (OVID)、PsycINFO 和 Web of Science。使用随机效应模型估计合并效应大小。Higgins I2、Q 统计量和 tau 平方用于量化研究之间观察到的异质性。结果表明，抑郁和睡眠持续时间（长和短）是行为或心理症状与认知能力下降之间最一致的关联。