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.”
Gulpers BJA, Verhey FRJ, Eussen SJPM, et al. Anxiety and cognitive functioning in the Maastricht study: a cross-sectional population study. J Affect Disord. 2022;319:570-579. doi:10.1016/j.jad.2022.09.072