Anxiety Symptoms May Not Be a Predictor of Cognitive Decline in Older Adults With Mental Disorders

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Investigators aimed to assess whether anxiety symptoms predict cognitive decline and mortality in older adults with a mental health diagnosis.

Anxiety symptoms are persistent in older adults with a mental disorder, according to research published in the International Journal of Geriatric Psychiatry. Anxiety symptoms are common in old age and researchers investigated whether these symptoms are a risk factor in the development of cognitive impairment and mortality.

A longitudinal study examined data from 201 patients referred to specialist mental health services in a department of geriatric psychiatry. Of this sample, 150 were reexamined after 33 months and 51 died before follow-up. Anxiety symptoms were measured with the Geriatric Anxiety inventory and associations with cognitive decline or mortality were estimated by trajectory analysis and regression models.

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Researchers found that 73.7% of patients had the same level of anxiety symptoms at both follow-up time points and that 29% had a higher level of anxiety from baseline to follow-up. They also determined that the level of anxiety cannot be used as a predictor of cognitive decline or mortality. In addition, at the end of the 33-month follow-up, there was no association found between the severity of anxiety symptoms at baseline and cognitive decline or death.

The study was limited by having several people assess and rate the patients. In addition, researchers considered only symptoms of anxiety and did not diagnose anxiety disorders according to a classification system.

This is the first study to assess the connection between anxiety and cognitive impairment and mortality in older adults with a mental disorder from a longitudinal perspective. Researchers conclude that their findings, “support the notion that level of anxiety symptoms is neither a risk factor, nor protective factor for death.” Anxiety trajectories and severity level were not predictive of future cognitive decline or mortality, which can inform clinicians working with this population.


Bakkane Bendixen A, Engedal K, Selbæk G, Benth JŠ, Hartberg CB. Anxiety symptom levels are persistent in older adults with a mental disorder: a 33 months follow‐up study [published online January 4, 2019]. Int J Geriatr Psychiatry. doi: 10.1002/gps.5058