Relationships Among Neurocognition, Social Cognition, Anxiety, and Depression in Patients With Mild Cognitive Impairment: A Network Analysis

This study describes the symptom structure in patients with mild cognitive impairment (MCI), focusing on neurocognition, social cognition, anxiety, and depression. It also explored the direct and indirect symptoms that affect the quality of life (QoL) of patients with MCI.

A cross-sectional study.

This study was conducted from October 2024 to January 2025 at a tertiary hospital, involving 332 patients with MCI. Neurocognition, social cognition, anxiety, and depression were assessed using standardized tools, including the Mini-Mental State Examination, Faces Emotion Recognition Test, Reading the Mind in the Eyes Test, Inter-personal Sensitivity Measure and Hamilton Anxiety and Depression Scales. Network analysis was employed to examine symptom interrelationships, identify central and bridge symptoms, and assess their impact on QoL.

The symptom network revealed that central symptoms included theory of mind (expected influence, EI = 0.250) and social perception (EI = 0.252), while orientation (bridge expected influence, BEI = 0.214) and language (BEI = 0.133) were identified as bridge symptoms. Depression had the strongest negative association with QoL (edge weight = -0.137). The network demonstrated high adequate edge-weight accuracy (bootstrapped CIs) and centrality stability (CS-coefficients: 0.593 for EI; 0.672 for BEI).

This study clarified the centrality of "theory of mind" and "social perception" in the MCI symptom network and further identified "orientation" and "language" as key bridge symptoms, which together may provide novel entry points for clinical intervention to improve patient outcomes. Addressing depression symptoms could be a viable approach to enhance QoL in MCI.