Associations between MoCA screening-positive cognitive impairment, anxiety, depression, and quality of life in patients with oral cancer: a cross-sectional study in China.

BACKGROUND: Cognitive impairment identified by screening tools is common among patients with oral cancer and may be associated with psychological distress and reduced quality of life. However, evidence regarding these associations in patients with oral cancer, particularly in Chinese populations, remains limited. AIM: To assess the prevalence of screening-positive cognitive impairment and examine its associations with anxiety, depression, and quality of life among Chinese patients with oral cancer. METHODS: A cross-sectional study was conducted at a tertiary hospital in Changde, Hunan Province, China, from June 15 to July 15, 2023. Data were collected using an online questionnaire, including demographic and clinical characteristics and standardized instruments: the Montreal Cognitive Assessment (MoCA), Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), and the University of Washington Quality of Life Questionnaire (UW-QoL). Spearman correlation analysis and multivariable logistic regression were performed to explore factors associated with screening-positive cognitive impairment. RESULTS: A total of 567 participants were included. The mean MoCA score was 19.25 ± 6.49, and the education-adjusted mean score was 19.55 ± 6.37. Using a MoCA cut-off score of < 24, 67.40% of participants were classified as screening-positive for cognitive impairment. UW-QoL scores were negatively correlated with SAS scores (r =  - 0.2009, p < 0.01) and SDS scores (r =  - 0.2055, p < 0.01), and positively correlated with adjusted MoCA scores (r = 0.2027, p < 0.01). Multivariable logistic regression analysis showed that older age, higher anxiety scores, and higher depression scores were positively associated with screening-positive cognitive impairment, whereas higher UW-QoL scores were negatively associated with cognitive impairment (all p < 0.05). CONCLUSION: Screening-positive cognitive impairment was common among patients with oral cancer in China and was associated with psychological distress and quality of life. These findings suggest the potential value of incorporating cognitive and psychological screening into routine clinical care for patients with oral cancer. Longitudinal studies are needed to further clarify the temporal relationships among cognitive impairment, psychological symptoms, and quality of life.