Phobic Anxiety and Cognitive Performance Over 4 Years Among Community-Dwelling Older Women in the Nurses' Health Study

Abstract

Objective To examine the relation of phobic anxiety to late-life cognitive trajectory. Design Prospective cohort. Setting Nurses’ Health Study – U.S. registered nurses. Participants 16,351 women among whom phobic anxiety symptoms were assessed in 1988 (mean age=63 years). Measurements Beginning a decade after phobic anxiety ascertainment (mean age=74 years), three assessments of general cognition, word and paragraph immediate and delayed recall, category fluency, and attention/working memory were administered over an average of 4.4 years; global cognitive and verbal memory composite scores were generated from the component tests. General linear models of response profiles were used to evaluate relations of phobic anxiety to initial cognitive performance and subsequent change. Results Higher phobic anxiety was associated with poorer initial performance: e.g., comparing women with the highest anxiety to those with no/minimal symptoms, the multivariate-adjusted mean difference (95% confidence interval) in scores was −0.10 (−0.13,−0.06) standard units for the global score summarizing all tests, and −0.08 (−0.11,−0.04) standard units for verbal memory (summarizing 4 word- and paragraph-recall tasks). Mean differences between extreme categories of phobic anxiety were equal to those for participants aged 1.5–2 years apart: i.e., cognitively equivalent to being about two years older. There were no relations of phobic anxiety to subsequent cognitive change. Conclusions Higher mid-life phobic anxiety was related to worse later-life overall cognition and verbal memory. Yet, profiles of poorer cognition with higher anxiety remained parallel over time, suggesting phobic anxiety may impose impact on cognition earlier in life, rather than ongoing impact in later-life.

Phobic anxiety and plasma levels of global oxidative stress in women

“…In additional analyses, logistic regression models were used to calculate odds ratios for the highest CCI score (≥6) vs. lower scores (0-5) across quartiles of the three different FlOPs. Although prior work 32,34 indicates that a score of ≥6 on the CCI may indicate a critical threshold of anxiety symptoms, there may be other important contrasts involving sub-threshold levels of anxiety, which have been addressed in prior NHS investigations 4,45 . Thus, we also utilized polytomous logistic regression models to investigate the relations of continuous log transformed FlOPs to finer contrasts of phobic anxiety rather than just the dichotomized approach; in these models, persons scoring 0/1 on the CCI served as the reference group for comparisons with those in all higher categories of phobic anxiety.…”

Phobic anxiety symptom scores and incidence of type 2 diabetes in US men and women

“…The CCI score was calculated and categorized into 5 groups as follows: <2 (the reference group); 2-<3; 3-<4; 4-<6; and 6 or above (the highest phobic anxiety symptoms group) (26). We used Cox proportional-hazards models to estimate the hazard ratios (HRs) and 95% confidence intervals (CI) of developing T2D across the 5 categories of the CCI; the comparison group was participants with CCI <2.…”

Anxiety symptoms predicted decline in episodic memory in cognitively healthy older adults: A 3‐year prospective study

“…Researchers begin to postulate that anxiety may be an early sign of neurodegenerative disorders. However, findings from recent prospective studies on anxiety and cognitive decline are still inconclusive due to the heterogeneity in anxiety and cognitive measurements used in the literatures . Of those prospective studies, only 4 reported positive results in relation to cognitive decline.…”

“…Pietrzak et al (2012) found evidences for decline in visual learning and memory in anxious older adults, while others reported decline in executive functioning in participants with generalized anxiety disorders . The null findings in others may be explained by different sampling frame and the use of a less specific test for cognitive functioning . It is still unclear as to whether poor cognitive performance in older adults is a result of suffering from anxiety disorders, or merely reflecting other concomitant condition that impairs cognition in the ageing brain.…”