Invest Clin 65(1): 37 - 47, 2024 https://doi.org/10.54817/IC.v65n1a04

Corresponding author: Fanlin Xia. School of Health and Social Care, Shanghai Urban Construction Vocation Co-

llege, Shanghai, China. E-mail: dr.bojielin1@gmail.com

Correlation between the degree of cognitive

impairment and emotional state in patients

with Alzheimer’s disease.

Zhichao Qiu, Jingjing Cai and Fanlin Xia

School of Health and Social Care, Shanghai Urban Construction Vocation College,

Shanghai, China.

Keywords: Alzheimer’s disease; cognitive dysfunction; positive emotion; negative

emotion.

Abstract. This study aimed to investigate the correlation between cogni-

tive dysfunction and emotional state in patients with Alzheimer’s disease and

then propose intervention strategies. One hundred twenty-five patients with

Alzheimer’s disease from June 2019 to May 2022 were selected as the study

subjects and divided into two groups based on the degree of cognitive impair-

ment, both receiving routine drug treatment and cognitive rehabilitation in-

tervention. The Montreal Cognitive Assessment (MoCA) and the Positive and

Negative Affect Scale (PANAS) were used to evaluate the cognitive function

and emotional status of two groups of patients before the intervention and

four and eight weeks of intervention and to analyze the correlations between

the two. The results showed statistically significant differences between the

two groups MoCA and PANAS scores (P<0.05). Before the intervention, the

patient’s MoCA score was positively correlated with the PANAS positive emo-

tion score and negatively correlated with the PANAS negative emotion score

(P<0.05). After four and eight weeks of intervention, the patient’s MoCA score

was positively correlated with the PANAS positive emotion score (P<0.05) and

negatively correlated with the PANAS negative emotion score (P<0.05).

38 Qiu et al.

Investigación Clínica 65(1): 2024

Correlación entre disfunción cognitiva y estado emocional

en pacientes con enfermedad de Alzheimer y su intervención.

Invest Clin 2024; 65 (1): 37 – 47

Palabras clave: enfermedad de Alzheimer; disfunción congnitiva; emoción positiva;

emoción negativa.

Resumen. El objetivo de este estudio fue explorar la correlaciónón entre

la disfunciónón cognitiva y el estado emocional en pacientes con enfermedad

de Alzheimer. Se seleccionaron 125 pacientes diagnosticados con enfermedad

de Alzheimer entre junio de 2019 y mayo de 2022 como sujetos de investi-

gaciónón, divididos en dos grupos según el grado de disfunción cognitiva, y

ambos recibieron tratamiento farmacológico convencional e intervenciónón de

rehabilitaciónón cognitiva. La función cognitiva y el estado emocional de los

pacientes antes de la intervención, a las 4 semanas de intervención y a las 8 se-

manas de intervención se evaluaron utilizando la escala de evaluación de la fun-

ción cognitiva de Montreal (MoCA) y la escala de emociones positivas y negati-

vas (PANAS), respectivamente. Los resultados del análisis de la prueba repetida

ANOVA mostraron diferencias estadísticas significativas en la puntuación de la

dimensión emocional PANAS entre los dos grupos de pacientes (p<0,05). Los

resultados del análisis de correlación de Pearson mostraron que después de 4 y

8 semanas de intervencion, la puntuación MoCA del paciente se relacionó posi-

tivamente con el estado de ánimo positivo de PANAS (p<0,05) y negativamente

con el estado de ánimo negativo de PANAS (p>0,05). En conclusión, el grado

de disfunción cognitiva en pacientes con enfermedad de Alzheimer está es-

trechamente relacionado con el estado emocional. Una intervención cognitiva

razonable ayuda a eliminar las emociones negativas de los pacientes y tiene un

impacto positivo en la aceleración de la progresión del tratamiento y la mejora

de la calidad de vida.

Received: 15-03-2023 Accepted: 19-11-2023

INTRODUCTION

Alzheimer’s disease is a progressive de-

generative neurological disease with mem-

ory impairment, aphasia, and agnosia as

typical manifestations. According to statis-

tics, by the end of 2019 1, China had more

than 6 million cases of Alzheimer’s disease,

and with the prolongation of age, the preva-

lence rate gradually grew. The disease has

become one of the major diseases threaten-

ing the health and life quality of the elderly

population. Clinical studies have shown that

the disease triggers motor symptoms such

as static tremor, motor retardation and ab-

normal gait, as well as non-motor symptoms

such as cognitive dysfunction, memory loss

and complicated social interaction 1. In most

patients are usually accompanied by abnor-

mal emotional states, who show emotional

depression and occasional irritation at the

initial stage of the disease, but will evolve

into impatience and restlessness as the dis-

ease progresses, hindering the treatment

Cognitive impairment and emotional state in Alzheimer’s disease 39

Vol. 65(1): 37 - 47, 2024

of the disease. Other studies have shown 2

that patients with Alzheimer’s disease de-

velop both cognitive dysfunction and abnor-

mal emotional states, which may exist inde-

pendently or interact with each other, but

the specific association between the two is

not yet clear. Hence, in order to further ex-

plore the relationship between the two, this

study conducted research and analysis on

the correlation between cognitive dysfunc-

tion degree and emotional state in patients

with Alzheimer’s disease. Relevant interven-

tion strategies were formulated accordingly,

which are now reported below.

Patients and methods

General data: One hundred twenty-five

patients with Alzheimer’s were selected as

the study subjects from June 2019 to May

2022. Inclusion criteria: (1) With symptoms

such as memory loss, decreased judgment

ability, and abnormal emotional changes,

the results of neuropsychological tests, thin

layer CT scans, and positron scans comply

with the diagnostic criteria for Alzheim-

er’s disease according to the 2018 Chinese

Guidelines for the Diagnosis and Treat-

ment of Dementia and Cognitive Disorders:

Guidelines for the Diagnosis and Treatment

of Alzheimer’s Disease 3; (2) MoCA scale

score <26 points; (3) Age ≤ 75 years old;

(4) The condition was stable. Furthermore,

the family members knew the research con-

tent, voluntarily participated and signed a

consent form. Exclusion criteria: (1) Alco-

holic dementia and vascular dementia, with

Hachinski Ischemia Index Scale score >4

points 4; (2) Management of drug-resistant

epilepsy; (3) Complicated with severe heart,

liver, kidney, or lung dysfunction diseases;

(4) Concomitant severe anxiety disorder,

depression, schizophrenia and other men-

tal and psychological disorders; (5) Weight

<40kg, blood pressure <90/60mmHg or

>160/100mmHg, blood pressure fluctua-

tion >30mmHg; (6) Combined with other

central nervous system disease; (7) Clinical

data missing >10%.

METHODS

Intervention Methods

After enrollment, both groups of pa-

tients received routine medication treat-

ment and underwent cognitive function

intervention under the guidance of rehabili-

tation therapists and specialized nurses. The

intervention included: (1) Aerobic exercise:

Before exercise, the patient’s heart rate at

maximum exercise load was determined

through cardiopulmonary exercise test eval-

uation and maximal exercise test using an

improved Bruce scheme. The aerobic exer-

cise intensity was set at 70% of the maximum

exercise load heart rate. The training items

could include aerobic exercise, cycling,

treadmill exercise, etc. Aerobic exercise was

conducted for one hour after breakfast and

two hours after dinner, with each exercise

time controlled between 60 to 90 minutes.

During the exercise, the patient could rest

for 5 to 10 minutes, 3-5 times per week,

performing continuous aerobic exercise for

eight weeks. (2) Targeted cognitive training:

Targeted cognitive training usually consisted

of five parts: orientation and reality training,

memory, computation and language func-

tion training. Directional training mainly

involves repeatedly asking the patient about

the season, date, time, city, etc., every three

minutes, six times a day; memory function

training mainly involved informing the pa-

tient of the name of a particular item, im-

mediately asking the patient the name of the

item, and then asking once every three min-

utes, six times a day; computation function

training mainly involved designing simple

addition, subtraction, multiplication, and

division test questions for patients, guid-

ing them to calculate test questions based

on specific daily life events; language func-

tion training mainly aims to extend the com-

munication time between family members

and patients as much as possible, focusing

on familiar things in daily life, and allowing

patients to execute some simple commands

with the assistance of family members; real-

40 Qiu et al.

Investigación Clínica 65(1): 2024

ity training requires patients to plan their

daily activities and gradually develop a good

lifestyle pattern day after day.

Survey tool: (1) Cognitive function. The

MoCA scale was used to evaluate patients’

cognitive function. The scale consists of eight

cognitive domains: visual space and execu-

tive function (5 points), naming (3 points),

memory/delayed recall (5 points), attention

(3 points), calculation (3 points), language

(3 points), abstract thinking (2 points), and

directional ability (6 points). The total score

is 30 points, and a score <26 indicated the

patient had cognitive impairment. The low-

er the score, the more severe the cognitive

impairment. The Cronbach scale coefficient

α was 0.818 5. (2) Emotional state. The PA-

NAS scale is used to evaluate the emotional

state of patients. The scale consists of two

emotional dimensions: positive and negative

emotions, each containing ten emotional ad-

jectives. After each emotional adjective, five

options are set, ranging from “almost no”

to “extremely many”, and each is assigned a

score of 1-5 points. The total score for a sin-

gle domain is 10-50 points. The higher the

score, the more positive/negative the patient

emotions. The scale Cronbach coefficient α

ranged from 0.800 to 0.820.

Survey method: Before the patient in-

tervention, at four weeks and eight weeks of

intervention, two nurses with uniform pro-

fessional training were instructed to fill out

the MoCA scale (completed within 10 min-

utes) and PANAS scale in a quiet room with

the same guidance language. Once complet-

ed, they were immediately collected.

Statistical method: SPSS 27.0 software

was used to process and analyze the data, with

the mean value ± standard deviation (X±SD)

representing the measurement data (t-test)

and the percentage representing counting data

(χ2test); Pearson correlation analysis was per-

formed on the correlation between the degree

of cognitive impairment and emotional state of

patients; GraphPad Prism 9 software was used

to draw line chart and heat map. P<0.05 was

considered statistically significant.

RESULTS

Comparison of general information

of patients

Out of 125 patients included in this

study, two withdrew from the study mid-

way, three had missing clinical data >10%,

and one had poor intervention compliance

and did not receive effective improvement

through psychological support, all of which

were excluded. Finally, 119 valid data were

ultimately collected, with a questionnaire

response effectiveness rate of 95.20%. Ac-

cording to the patient’s MoCA score, they

were divided into two groups, with 73 cas-

es in the mild disorder group and 46 cases

in the moderate to severe disorder group.

There was no statistically significant differ-

ence in gender, family genetic history, and

presence or absence of hearing loss between

the two groups of patients (p>0.05). There

was a statistically significant difference in

age, course of disease, and head CT between

the two groups of patients (p<0.05). Please

refer to Table 1 for details.

Comparison of patient cognitive function

The overall analysis found that there

were statistically significant differences in

MoCA scores and total scores between the

two groups of patients (p<0.05), and only

memory/delayed recall and attention inter-

action differences between the two groups

of patients were statistically significant

(p<0.05). Compared within the group, the

MoCA cognitive domain scores and total

scores of the two groups of patients at four

weeks and eight weeks of intervention were

higher than before intervention (p<0.05),

while the MoCA cognitive domain scores

and total scores of the two groups of pa-

tients at eight weeks of intervention were

higher than those at four weeks of interven-

tion (p<0.05). Compared between groups,

the MoCA cognitive domain scores and total

scores of patients in the mild disorder group

before intervention, four weeks of interven-

Cognitive impairment and emotional state in Alzheimer’s disease 41

Vol. 65(1): 37 - 47, 2024

tion, and eight weeks of intervention were

higher than those in the moderate to severe

disorder group (P<0.05). Please refer to Ta-

ble 2 for details.

Comparison of patient emotional states

The overall analysis found that there

were statistically significant differences in

the scores of various emotional dimensions

of PANAS between the two groups of patients

(p<0.05), and the interactive differences in

PANAS negative emotional scores between

the two groups of patients were statistically

significant (p<0.05). Compared within the

group, the positive emotional scores of the

two groups of patients at eight weeks and

four weeks of intervention were higher than

before intervention, while the negative emo-

tional scores were lower than before inter-

vention (p<0.05). The positive emotional

scores of both groups of patients after eight

weeks of intervention were higher than

those after four weeks of intervention, while

the negative emotional scores were lower

than those after four weeks of intervention

(p<0.05). Comparing the groups, the posi-

tive emotional scores of patients in the mild

disorder group before intervention, four

weeks of intervention, and eight weeks of

intervention were higher than those in the

moderate to severe disorder group. In con-

trast, the negative emotional scores were

lower than those in the moderate to severe

disorder group (p<0.05). Please refer to Ta-

ble 3 and Fig. 1 for details.

Correlation between the degree

of cognitive impairment and emotional

state of patients

The Pearson correlation analysis results

showed that before intervention, except for

the calculation dimension, the scores of each

cognitive domain dimension of the patient’s

MoCA were positively correlated with the PA-

NAS positive emotion score (p<0.05), while

the scores of each cognitive domain dimen-

sion of the patient’s MoCA were negatively

correlated with the PANAS negative emotion

score (p<0.05). After four weeks of inter-

vention and eight weeks of intervention, the

MoCA scores of patients showed a positive

Table 1

Comparison of general information between the two groups of patients.

Items Mild impairment

group (n=73)

Moderate to severe

disorder group (n=46) χ2/t/Z p

Gender Female 30(41.10) 18(39.13) 0.045 0.831

Male 43(58.90) 28(60.87)

Age 61.19±8.47 68.65±6.86 -5.023 <0.001

Course of disease

Years (mean±SD)

4.01±1.35 8.24±2.17 13.103 <0.001

Family genetic

history

No 61(83.56) 38(82.61) 0.018 0.892

Ye s 12(16.44) 8(17.39)

Hearing loss No 67(91.78) 42(91.30) 0.000 1.000

Ye s 6(8.22) 4(8.70)

Head CT Normal 9(12.33) 3(6.52) -4.961 <0.001

Mild atrophy 45(61.64) 9(19.57)

Moderate atrophy 14(19.18) 17(36.96)

Severe atrophy 5(6.85) 17(36.96)

Values are expressed as n (%).

42 Qiu et al.

Investigación Clínica 65(1): 2024

Table 2

Comparison of MoCA Cognitive Domain Scores and Total Scores between two groups of patients.

Cognitive

domain

Time Mild

impairment

group (n=73)

Moderate to severe

disorder group

(n=46)

t p

Visual space

and executive

function

Before intervention 3.32±0.47 1.46±0.50 20.489 <0.001

Intervention for four weeks 3.67±0.47 1.78±0.42 22.181 <0.001

Intervention for eight

weeks

4.00±0.37 2.07±0.33 28.893 <0.001

Name Before intervention 1.97±0.23 1.76±0.43 3.467 0.001

Intervention for four weeks 2.05±0.23 1.89±0.31 3.273 0.001

Intervention for eight

weeks

2.11±0.31 1.98±0.26 2.374 0.019

Memory/delayed

recall

Before intervention 3.22±0.45 1.78±0.42 17.472 <0.001

Intervention for four weeks 3.73±0.48 2.00±0.21 23.045 <0.001

Intervention for eight

weeks

4.04±0.31 2.37±0.49 22.898 <0.001

Attention Before intervention 1.97±0.16 1.22±0.42 13.882 <0.001

Intervention for four weeks 2.08±0.28 1.67±0.47 5.937 <0.001

Intervention for eight

weeks

2.19±0.40 1.89±0.31 4.347 <0.001

Calculation Before intervention 1.96±0.31 1.83±0.38 2.078 0.040

Intervention for four weeks 2.15±0.36 1.89±0.31 4.012 <0.001

Intervention for eight

weeks

2.32±0.47 2.15±0.36 2.010 0.047

Language Before intervention 2.00±0.24 1.80±0.40 3.353 0.001

Intervention for four weeks 2.04±0.20 1.91±0.28 2.880 0.005

Intervention for eight

weeks

2.19±0.40 2.00±0.30 2.816 0.006

Abstraction Before intervention 0.93±0.25 0.74±0.44 3.005 0.003

Intervention for four weeks 1.03±0.16 0.85±0.36 3.676 <0.001

Intervention for eight

weeks

1.11±0.31 0.98±0.33 2.169 0.032

Directive force Before intervention 2.89±0.36 1.85±0.42 14.505 <0.001

Intervention for four weeks 2.97±0.16 1.91±0.55 15.416 <0.001

Intervention for eight

weeks

3.10±0.93 2.13±0.54 6.382 <0.001

Total score Before intervention 18.26±0.50 12.43±2.83 17.231 <0.001

Intervention for four weeks 19.73±1.53 13.91±2.38 16.218 <0.001

Intervention for eight

weeks

21.05±2.71 15.57±2.21 11.540 <0.001

Values are expressed as mean ± SD, points.

Cognitive impairment and emotional state in Alzheimer’s disease 43

Vol. 65(1): 37 - 47, 2024

correlation with PANAS positive emotions

(p<0.05) and a negative correlation with

PANAS negative emotions (p<0.05). Please

refer to Table 4 for details.

DISCUSSION

Cognitive impairment is one of the typi-

cal clinical manifestations of Alzheimer’s

disease patients, and the severity of this

symptom is closely related to the patient’s

age. Among 119 Alzheimer’s disease pa-

tients included in this study, approximately

61.34% had mild cognitive impairment,

which was higher than previous studies 6.

This might be due to the fact that the over-

all age of patients with Alzheimer’s disease

included in this study was lower than in pre-

vious studies, and most of them were in the

early stages of disease development. The

older patients were, the more severe their

cognitive impairment was. This view was also

drawn through statistical analysis of the age

of patients with mild and moderate to severe

cognitive impairment. At present, although

the pathogenesis of Alzheimer’s disease is

not yet known, previous studies have pointed

out that neuroinflammation is a crucial fac-

tor in the spread of misfolded proteins in the

body’s brain, leading to cognitive dysfunc-

tion in Alzheimer’s patients. Cognitive im-

pairment not only led to progressive mem-

ory impairment, language impairment, and

impaired visuospatial function in patients

Visual space and executive function: Fgroup/Ftime/Finteraction=1201.342/59.948/0.230, Pgroup/Ptime/Pinterac-

tion=<0.001/<0.001/0.795;

Naming: Fgroup/Ftime/Finteraction=15.880/11.213/0.577, Pgroup/Ptime/Pinteraction=<0.001/<0.001/0.563;

Memory/delayed recall:Fgroup/Ftime/Finteraction=764.494/1321.194/6.301, Pgroup/Ptime/Pinterac-

tion=<0.001/<0.001/0.002;

Attention:Fgroup/Ftime/Finteraction=105.003/58.112/16.016, Pgroup/Ptime/Pinteraction=<0.001/<0.001/<0.001;

Calculation:Fgroup/Ftime/Finteraction=15.172/21.538/1.893, Pgroup/Ptime/Pinteraction=<0.001/<0.001/0.155;

Language: Fgroup/Ftime/Finteraction=16.137/10.940/1.326, Pgroup/Ptime/Pinteraction=<0.001/<0.001/0.269; Abstract

thinking: Fgroup/Ftime/Finteraction=13.946/14.957/0.407, Pgroup/Ptime/Pinteraction=<0.001/<0.001/0.667;

Directional force: Fgroup/Ftime/Finteraction=190.214/5.893/0.238, Pgroup/Ptime/Pinteraction=<0.001/0.004/0.788; Total

score: Fgroup/Ftime/Finteraction=274.967/96.583/0.604, Pgroup/Ptime/Pinteraction=<0.001/<0.001/0.548.

Table 3

Comparison of PANAS Emotional Dimension scores between two groups of patients.

Dimension Time Mild impairment

group

(n=73)

Moderate to severe

disorder group

(n=46)

t p

Positive

emotions

Before intervention 29.90±3.32 23.80±2.40 10.808 <0.001

Intervention for 4 weeks 31.56±3.40 25.26±2.20 11.179 <0.001

Intervention for 8 weeks 32.86±3.46 26.80±2.70 10.084 <0.001

Negative

emotions

Before intervention 30.00±3.32 35.74±3.14 -9.377 <0.001

Intervention for 4 weeks 28.52±3.67 34.02±2.47 -8.965 <0.001

Intervention for 8 weeks 26.95±3.63 32.96±3.31 -9.103 <0.001

Values are expressed as x ± SD, Points.

Positive mood: Fgroup/Ftime/Finteraction=116.369/706.314/1.955，Pgroup/Ptime/Pinteraction=<0.001/<0.001/0.146；Nega-

tive emotions:Fgroup/Ftime/Finteraction=85.093/799.196/6.094，Pgroup/Ptime/Pinteraction=<0.001/<0.001/0.003.

Table 2

Continuation

44 Qiu et al.

Investigación Clínica 65(1): 2024

Table 4

Correlation between the degree of cognitive impairment and emotional state of patients.

(r value)

MoCA Before intervention Intervention

for four weeks

Intervention

for eight weeks

Positive

emotions

Negative

emotions

Positive

emotions

Negative

emotions

Positive

emotions

Negative

emotions

Visual space and

executive function 0.676** -0.661** 0.835** -0.791** 0.812** -0.768**

Name 0.320** -0.392** 0.524** -0.534** 0.575** -0.551**

Memory/delayed

recall 0.877** -0.853** 0.867** -0.818** 0.836** -0.796**

Attention 0.750** -0.751** 0.696** -0.694** 0.665** -0.666**

Calculation 0.134 -0.199* 0.657** -0.677** 0.623** -0.673**

Language 0.273** -0.325** 0.375** -0.383** 0.585** -0.587**

Abstraction 0.493** -0.553** 0.512** -0.506** 0.581** -0.568**

Directive force 0.740** -0.724** 0.776** -0.732** 0.809** -0.825**

Total score 0.790** -0.802** 0.896** -0.864** 0.935** -0.921**

*P<0.05，**P<0.01.

Fig. 1. Heat Map of the correlation between the degree of Cognitive Impairment and Emotional State in pa-

tients.

Cognitive impairment and emotional state in Alzheimer’s disease 45

Vol. 65(1): 37 - 47, 2024

but also led to facial recognition and com-

putational impairment, seriously affecting

the quality of life of patients and causing a

severe burden on their families 7. Therefore,

actively guiding patients to undergo cogni-

tive rehabilitation interventions positively

improved their cognitive function and qual-

ity of life. Based on conventional drug ther-

apy, this study guided all enrolled patients

to undergo aerobic exercise, pathway electri-

cal stimulation and targeted cognitive train-

ing. The results showed that after an eight-

week rehabilitation intervention, the MoCA

scores in each cognitive domain of the two

groups of patients were effectively improved

compared to before the intervention, consis-

tent with the research results of Costanzo et

al. 8, Cheng et al. 9, Li et al. 10, and others.

This result fully demonstrated that suitable

cognitive rehabilitation interventions could

often effectively improve the cognitive func-

tion level of Alzheimer’s disease patients.

Regarding the relationship between the

degree of cognitive impairment and emo-

tional state in Alzheimer’s disease patients,

the Pearson correlation analysis results of

this study showed that the MoCA scores and

total scores of various cognitive domains in

Alzheimer’s disease patients were positively

correlated with PANAS-positive emotions,

and negatively correlated with PANAS-nega-

tive emotions. This suggested that the more

severe the cognitive impairment in Alzheim-

er’s disease patients, the less positive emo-

tional expression they had, and the more neg-

ative emotional expression they had, which

was consistent with Boutoleau-Bretonnière

C et al. 11. The research results of Moon et al.

12 and Craft et al.13 were consistent. In addi-

tion, this study also found through cognitive

rehabilitation interventions for patients that

during the eight-week intervention, not only

did the MoCA scores and total scores of each

cognitive domain show a continuous upward

trend, but their PANAS positive emotional

score also showed a corresponding upward

trend. In contrast, their PANAS negative

emotional score showed a downward trend,

indirectly reflecting that the emotional state

of Alzheimer’s disease patients would gradu-

ally improve with the improvement of cogni-

tive function. This study suggested that this

result might be related to cognitive decline

and decreased ability to live in Alzheimer’s

disease patients, leading to physiological and

psychological balance disorders. Other stud-

ies suggested that after cognitive dysfunc-

tion in Alzheimer’s disease patients, central

neurotransmitters such as serotonin (5-HT)

and norepinephrine (NE) were insufficient,

leading to emotional disorders. Yoon et al.14

believed that cognitive impairment might be

related to damage to the frontal and tem-

poral lobes, which could lead to decreased

memory and execution abilities, intellec-

tual decline, delayed thinking and behavior,

and thus exacerbated negative emotions in

patients. There was interaction and integra-

tion between cognition and emotion, a deep

integration process of the brain. Cognition

and emotion interacted with each other,

such as some people being calm in times of

trouble. Happiness and anger did not mani-

fest in appearance, which belonged to the

influence of cognition on emotions. When

a person was emotional, such as happiness,

they often agreed to things that were usually

difficult to promise, which was the impact of

emotion on cognition. However, Guo 15 study

found that the probability of anxiety and

depression symptoms only increased in the

early stages of cognitive decline in Alzheim-

er’s disease patients and decreased with fur-

ther decline in cognitive function. This indi-

cated that there was a specific correlation

between the emotional state of Alzheimer’s

disease patients and the degree of cognitive

dysfunction, but this relationship would gra-

dually dissolve as the cognitive dysfunction

continued to worsen.

In summary, the degree of cognitive

impairment in Alzheimer’s disease patients

is negatively and positively correlated with

their positive and negative emotions, respec-

tively. Implementing intervention measures

to enhance patients’ cognitive abilities can

46 Qiu et al.

Investigación Clínica 65(1): 2024

help improve their emotional state, promote

disease recovery, and improve quality of life.

In addition, this study only explored the im-

pact of cognitive function on emotional state

in Alzheimer’s disease patients. Therefore,

future research needs to improve patients’

emotional states through a series of means

to explore the impact of emotional states on

cognitive function in Alzheimer’s disease pa-

tients. Whether the correlation between the

two will decrease with the continuous wor-

sening of cognitive dysfunction in patients

remains to be verified.

Conflict of interest

The authors declare that they have no

conflict of interest.

Funding

No funding is applicable.

ORCID numbers of authors

• Zhichao Qiu (ZQ):

0009-0002-2505-8850

• Jingjing Cai (JC):

0009-0004-2057-8069

• Fanlin Xia (DX):

0009-0001-5288-9169

Authors contribution

ZQ put forward the research experi-

ment and proposed intervention strategies.

JC analyzed the data, and FX helped with

the constructive discussion. ZQ, JC and FX

made significant contributions to manus-

cript preparation.

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