SAN FRANCISCO – Unexpectedly, worry predicted better cognitive performance among older adults with mild symptoms of anxiety and depression, according to a cross-sectional, community-based study.
“This just flies in the face of everything that we know about worry in the adult literature,” said Sherry A. Beaudreau, PhD, of the department of psychiatry and behavioral sciences at Stanford (Calif.) University. The findings suggest that older worriers might score lower on some cognitive measures if their worry declines through treatment, she said at the 2016 congress of the International Psychogeriatric Association.
COURTESY DR. BEAUDREAU
Dr. Sherry A. Beaudreau
Old age often is marked by mild symptoms of anxiety and depression that do not meet criteria for a psychiatric diagnosis, but nonetheless predict poorer cognitive performance and mild dementia, Dr. Beaudreau said. Recent work has linked anxiety to decreased attentional control, and late life depression, to slow information processing, delayed verbal memory, and other cognitive deficits. Emerging evidence also suggests that worry leads to worse performance on tests of inhibitory ability and delayed memory, Dr. Beaudreau added.
To further test these relationships, she and her associates studied 119 older adults who were living in the San Francisco Bay area between 2010 and 2012. They averaged 74 years of age (range, 65-91 years), 92% were non-Hispanic white, and 56% were women.
Most of the cohort performed well on the Rey Auditory Verbal Learning test, which assesses word recall after a delay of 20-30 minutes, and also scored above average on condition 3 of the Delis-Kaplan Executive Function System, which is a color word assessment of inhibitory control, Dr. Beaudreau reported. Individuals also tended to score low on the Beck Anxiety Inventory and the Beck Depressive Inventory II, with average scores of 3.7 (range, 0-29) and 5.6 (0-41), respectively. The mean score on the Penn State Worry Questionnaire was 37.7, with a range of 16-76.
Regardless of whether their anxiety score was low or high, those who worried more had significantly better inhibitory control than those who worried less (P = .003), Dr. Beaudreau said. “So folks with high worry actually seemed to be doing better in terms of their inhibitory ability,” she added. “This is intriguing to me, because we assume that anxiety is affecting cognition, but worry seems to be doing something different.”
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High worry also predicted significantly better inhibitory control among individuals with both low and high depression scores (P = .03), she reported. For the word recall test, worry did not seem to affect performance in the absence of depression, but high worry predicted significantly better word recall among individuals with high depression scores (P = .009).
“These results suggest that psychiatric symptoms of anxiety and depression are modulated by worry severity, and it’s interesting that this finding was so consistent throughout the analyses,” Dr. Beaudreau said. Future studies should examine these relationships in groups of older psychiatric patients stratified by symptom severity rather than diagnosis, she added.
The work was supported by the Alzheimer’s Association and the Stanford/VA Alzheimer’s Center. Dr. Beaudreau had no relevant financial disclosures.