Anxiety May Affect Cognitive Function, Memory in Older Adults

Generalized anxiety symptoms are associated with poorer cognitive function among older adults, according to study findings published in Journal of Affective Disorders.

Researchers conducted a cross-sectional study using data sourced from the Maastricht Study, which recruited community-dwelling adults (N=6666) from the Netherlands with a strategy that oversampled patients with type 2 diabetes. Evidence of anxiety disorders were evaluated using the Mini International Neuropsychiatric Interview (MINI) and Generalized Anxiety Disorder 7-item scale (GAD-7) instruments. Executive functioning, memory, and processing speed outcomes on the basis of the presence of anxiety symptoms or disorders were compared.

Among the participants, 50.1% were women, mean age was 59.7 (SD, 8.6) years, mean body mass index was 26.9 (SD, 4.5) kg/m², 52.8% had hypertension, and 23.2% had type 2 diabetes.

A total of 283 participants had evidence of generalized anxiety symptoms (GAD-7≥10). The anxiety cohort was younger (P <.01), comprised more women (P <.01), tended to be less educated (P <.01), had higher prevalence of depressive disorder (P <.01), had a poorer diet (P =.04), and received took antidepressants, anxiolytic medications, sleep medications antipsychotics, glucose lowering medications, antihypertensive and cholesterol lowering medications (all P <.01) than the individuals without anxiety.

In the fully adjusted model that accounted for age, gender, education, type 2 diabetes, somatic diseases, and depressive disorder, the presence of generalized anxiety symptoms was associated with decreased processing speed (β, -0.11; 95% CI, -0.20 to -0.03; P =.010) and cognitive impairment (adjusted odds ratio [aOR], 1.42; 95% CI, 1.02-1.97; P =.036) compared with the rest of the population. The presence of anxiety was associated with poorer executive functioning (β, -0.15; 95% CI, -.02 to -0.06; P =.001) and memory (β, -0.11; 95% CI, -0.20 to -0.01; P =.034) before adjusting for depressive disorder.

The presence of agoraphobia (n=418) was associated with poorer executive functioning (β, -0.12; 95% CI, -0.20 to -0.05; P =.001), memory (β, -0.10; 95% CI, -0.18 to -0.02; P =.019), processing speed (β, -0.10; 95% CI, -0.17 to -0.04; P =.003), and cognitive impairment (aOR, 1.51; 95% CI, 1.18-1.93; P =.001) compared with individuals without agoraphobia.

The presence of panic disorder (n=49) was associated with poorer memory (β, -0.25; 95% CI, -0.48 to -0.02; P =.037) in the fully adjusted model compared with individuals without panic disorder. Lifetime pain disorder (n=144) was not significantly associated with any cognitive outcomes.

Significant interactions were observed in which adults with high GAD-7 scores and type 2 diabetes had poorer cognitive scores and processing speeds than individuals without type 2 diabetes.

This study was limited by the exclusion of visual memory, visuoconstruction, and language outcomes.

Study authors concluded, “The current study found a generalized cognitive impairment in agoraphobia, which was associated with worse functioning on all cognitive domains, independent of comorbid depressive disorder. Also, high scores on the GAD-7 were associated with worse scores on processing speed and higher odds of cognitive impairment. For panic disorder a significant association was found with memory.”

This article originally appeared on Psychiatry Advisor