Longitudinal Cognitive Profiles by Anxiety and Depressive Symptoms in American Older Adults With Subjective Cognitive Decline

J Nurs Scholarsh. 2021 Nov;53(6):698-708. doi: 10.1111/jnu.12692. Epub 2021 Aug 3.

Abstract

Purpose: The objective of this study was to determine how anxiety and/or depressive symptoms differentially affect specific cognitive domains over time in persons with subjective cognitive decline (SCD).

Design: A longitudinal, observational study was conducted using data from the National Alzheimer's Coordinating Center-Uniform Data Set. Mean follow-up was 4.1 ± 2.4 years.

Methods: Using information from a total of 1401 participants (age 74.0 ± 8.2 years), linear mixed-effects regression models were used to assess longitudinal changes in global cognition, episodic memory, attention, language, and executive function by baseline psychological (anxiety [A] and/or depressive [D]) symptoms in individuals with SCD. Reference was the group having no symptoms (A-/D-).

Findings: The A+/D- group was not associated with any cognitive changes. The A-/D+ group was associated with a greater decline in episodic memory and executive function. The A+/D+ group had a greater decline in attention. Changes in global cognition and language were not predicted by any psychological symptoms.

Conclusions: Depressive symptoms predicted lower episodic memory and executive function.

Clinical relevance: Nurses need to pay attention to depressive symptoms in older adults with SCD because managing depressive symptoms may help protect against cognitive decline more typical of early Alzheimer's dementia.

Keywords: Alzheimer's dementia; depressive symptoms; episodic memory; executive function; subjective cognitive decline.

Publication types

  • Observational Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anxiety
  • Cognition
  • Cognitive Dysfunction*
  • Depression / psychology
  • Humans
  • Longitudinal Studies
  • Memory, Episodic*
  • United States

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