Cognitive aspects of anxiety and depression in the elderly

Cognitive function associated with different diagnoses of anxiety disorders over the lifespan: Results from a Spanish representative sample

BACKGROUND

Previous research suggests an association between anxiety disorders and worse cognitive function. However, this association may vary depending on the type of disorder and age. We analysed the association of panic attack, 12-month and lifetime panic disorder (PD), and generalized anxiety disorder (GAD), with cognitive function in a representative sample of Spanish adults, and compared three age groups (18-49, 50-64, and 65+).

METHODS

Some 4,582 participants were interviewed with an adapted CIDI interview. Unadjusted and adjusted linear regression models were calculated by age group, using T scores of verbal fluency and episodic memory as the outcomes.

RESULTS

In young adults, 12-month GAD was associated with significantly lower scores of memory performance and verbal fluency, and 12-month PD with worse verbal fluency. In middle-aged participants, lifetime panic attack was related to better performance in verbal fluency, whereas having a diagnosis of lifetime PD was associated with lower scores. However, only participants aged 18-49 with 12-month GAD showed lower memory and verbal fluency, at almost one standard deviation below participants without 12-month GAD.

LIMITATIONS

Low prevalence rates of anxiety disorder could have led to biased results.

CONCLUSIONS

In young adults, a concurrent GAD might be particularly associated with memory and verbal fluency deficits, whereas only verbal fluency is affected in middle-aged adults with a history of PD, although this association is small. In older adults, anxiety disorders are not clearly associated with worse cognition, probably because in this age group other confounder variables might be attenuating this link. Overall, our findings suggest that cognitive interventions for anxiety disorders may be relevant, especially for young and middle-aged adults.

Measures of anxiety, amygdala volumes, and hippocampal scopolamine phMRI response in elderly female rhesus macaques

In nonhuman primates, anxiety levels are typically assessed by observing social hierarchies or behavior in an intruder task. As measures of anxiety might influence performance on a particular cognitive task, it is important to analyze these measures in the same room as used for the cognitive task. As we use a playroom for the spatial maze test, we classified elderly female rhesus macaques (Macaca mulatta) monkeys, as bold or reserved monkeys based on the time spent in specific areas of this room. Based on their exploratory behavior in the playroom, bold monkeys were defined as animals that spent 20% more time in the unprotected areas of the room than in the protected areas, whereas reserved monkeys spent a comparable amount of time in both areas. MRI analyses showed that reserved monkeys had a smaller amygdala compared to bold monkeys but there were no group differences in hippocampal volumes. In addition, the amount of time spent in the corners of the room was negatively correlated with the right amygdala as well as the total amygdala size. Finally, reserved monkeys showed a lower phMRI response to the muscarinic receptor antagonist scopolamine compared to the bold monkeys. Thus, in elderly female nonhuman primates measures of anxiety are associated with structural amygdala differences and hippocampal muscarinic receptor function. This article is part of a Special Issue entitled 'Anxiety and Depression'.