The Role of State Versus Trait Anxiety on Cognition in Older Adults With Major Depressive Disorder

IF 3.8 2区 医学 Q1 GERIATRICS & GERONTOLOGY American Journal of Geriatric Psychiatry Pub Date : 2024-03-28 DOI:10.1016/j.jagp.2024.03.014
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Abstract

Objective

Anxiety superimposed on late life depression (LLD) results in greater changes to prefrontal and medial temporal brain regions compared to depression alone. Yet, the combined impact of anxiety and depression on cognition in LLD has not been thoroughly investigated. The current study investigated whether annual changes in state and trait anxiety were associated with cognitive changes in older adults with major depression. We hypothesized that the presence of anxiety among older depressed adults would be associated with worse cognitive performance in the domains of memory and executive functioning over time.

Design

Three-year longitudinal observational study of older adults with LLD who were offered antidepressant treatment.

Setting

Academic Health Center.

Methods

Participants included 124 adults aged 60+ who met criteria for major depression at baseline. The association between anxiety and cognition was examined with separate multilevel linear models that addressed both between-subject and within-person effects of state and trait anxiety on cognitive functioning tests.

Results

Individuals who experienced annual increases in anxiety above his/her personal average also experienced cognitive decline. Increases in state anxiety were associated with declines in memory and global cognition. By contrast, increases in trait anxiety were associated with declines in mental flexibility and memory. These findings remained significant even when controlling for changes in depression over time.

Conclusion

In LLD, individual increases in state and trait anxiety were associated with cognitive declines in different domains.

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状态焦虑与特质焦虑对患有重度抑郁症的老年人认知能力的影响
目的 晚期抑郁症(LLD)患者的焦虑症会导致前额叶和颞叶内侧脑区发生比单纯抑郁症更大的变化。然而,焦虑和抑郁对晚年抑郁症患者认知能力的综合影响尚未得到深入研究。本研究调查了状态焦虑和特质焦虑的年度变化是否与患有重度抑郁症的老年人的认知变化有关。我们假设,随着时间的推移,老年抑郁症患者中存在的焦虑会与记忆和执行功能领域认知能力的下降相关联。焦虑与认知之间的关系是通过单独的多层次线性模型进行研究的,这些模型同时考虑了状态焦虑和特质焦虑对认知功能测试的受试者之间和受试者内部的影响。状态焦虑的增加与记忆力和整体认知能力的下降有关。相比之下,特质焦虑的增加与心理灵活性和记忆力的下降有关。结论 在低密度脂蛋白血症患者中,个人状态焦虑和特质焦虑的增加与不同领域认知能力的下降有关。
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来源期刊
CiteScore
13.00
自引率
4.20%
发文量
381
审稿时长
26 days
期刊介绍: The American Journal of Geriatric Psychiatry is the leading source of information in the rapidly evolving field of geriatric psychiatry. This esteemed journal features peer-reviewed articles covering topics such as the diagnosis and classification of psychiatric disorders in older adults, epidemiological and biological correlates of mental health in the elderly, and psychopharmacology and other somatic treatments. Published twelve times a year, the journal serves as an authoritative resource for professionals in the field.
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