Anxiety in late-life depression is associated with poorer performance across multiple cognitive domains

Maria Kryza-Lacombe; Michelle T Kassel; Philip S Insel; Emma Rhodes; David Bickford; Emily Burns; Meryl A Butters; Duygu Tosun; Paul Aisen; Rema Raman; Andrew J Saykin; Arthur W Toga; Clifford R Jack Jr; Michael W Weiner; Craig Nelson; R Scott Mackin

doi:10.1017/S1355617724000262

Anxiety in late-life depression is associated with poorer performance across multiple cognitive domains

J Int Neuropsychol Soc. 2024 Sep 18:1-5. doi: 10.1017/S1355617724000262. Online ahead of print.

Authors

Maria Kryza-Lacombe^{1

2}, Michelle T Kassel^{1

2}, Philip S Insel², Emma Rhodes^{1

2}, David Bickford², Emily Burns², Meryl A Butters³, Duygu Tosun^{4

5}, Paul Aisen^{6

7}, Rema Raman^{6

7}, Andrew J Saykin⁸, Arthur W Toga⁹, Clifford R Jack Jr¹⁰, Michael W Weiner^{2

4

5}, Craig Nelson², R Scott Mackin^{2

3}

Affiliations

¹ Mental Illness Research Education and Clinical Centers, Veterans Affairs Medical Center, San Francisco, CA, USA.
² Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA.
³ Department of Psychiatry Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
⁴ Veterans Affairs Medical Center, San Francisco, CA, USA.
⁵ Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA.
⁶ University of Southern California, Los Angeles, CA, USA.
⁷ Alzheimer's Therapeutic Research Institute, Keck School of Medicine, University of Southern California, San Diego, CA, USA.
⁸ Indiana Alzheimer's Disease Research Center and Center for Neuroimaging, Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA.
⁹ Laboratory of Neuro Imaging, Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
¹⁰ Department of Radiology, Mayo Clinic, Rochester, MN, USA.

PMID: 39291416
DOI: 10.1017/S1355617724000262

Abstract

Objective: Anxiety is a common comorbid feature of late-life depression (LLD) and is associated with poorer global cognitive functioning independent of depression severity. However, little is known about whether comorbid anxiety is associated with a domain-specific pattern of cognitive dysfunction. We therefore examined group differences (LLD with and without comorbid anxiety) in cognitive functioning performance across multiple domains.

Method: Older adults with major depressive disorder (N = 228, ages 65-91) were evaluated for anxiety and depression severity, and cognitive functioning (learning, memory, language, processing speed, executive functioning, working memory, and visuospatial functioning). Ordinary least squares regression adjusting for age, sex, education, and concurrent depression severity examined anxiety group differences in performance on tests of cognitive functioning.

Results: Significant group differences emerged for confrontation naming and visuospatial functioning, as well as for verbal fluency, working memory, and inhibition with lower performance for LLD with comorbid anxiety compared to LLD only, controlling for depression severity.

Conclusions: Performance patterns identified among older adults with LLD and comorbid anxiety resemble neuropsychological profiles typically seen in neurodegenerative diseases of aging. These findings have potential implications for etiological considerations in the interpretation of neuropsychological profiles.

Keywords: Late-life depression; anxiety; cognition; neurodegeneration; neuropsychological functioning; older adults.