Changes in neuropsychological functioning following treatmentfor late-life generalised anxiety disorder

• Published in: British journal of psychiatry 2011-09, Vol.199 (3), p.211-218
• Main Authors: Butters, Meryl A, Bhalla, Rishi K, Andreescu, Carmen, Wetherell, Julie Loebach, Rose, Mantella, Begley, Amy E, Lenze, Eric J
• Format: Article
• Language: English
• Subjects: Age; Aging; Anxiety; Anxiety disorders; Chronic illnesses; Cognition; Cognition & reasoning; Cognitive ability; Concept formation; Delayed; Delayed memory; Dementia; Dementia disorders; Ethnicity; Flexibility; Generalized anxiety disorder; Geriatrics; Inhibition; Memory; Mental depression; Mental health; Neuropsychological assessment; Neuropsychology; Older people; Problem solving; Psychiatrists; Psychiatry; Short term memory; Spatial memory; Visual memory
• ISSN: 0007-1250; 1472-1465
• DOI: 10.1192/bjp.bp.110.090217

BackgroundGeneralised anxiety disorder (GAD) in older adults is associated withneuropsychological impairment.AimsWe examined neuropsychological functioning in older adults with GAD incomparison with psychiatrically healthy older adults at baseline, and weexamined changes following a 12-week placebo-controlled trial ofescitalopram.MethodA total of 160 participants without dementia aged ⩾60 with current GADand 37 individuals in a comparison group without psychiatric historyunderwent neuropsychological assessment. Of these, 129 participants withGAD were reassessed post-treatment (trial registration: NCT00105586).ResultsThe participants with GAD performed worse than the comparison group ininformation processing speed, working memory, inhibition, problem-solving(including concept formation and mental flexibility) and immediate anddelayed memory. Neuropsychological functioning was correlated witheveryday functioning. After treatment, those with low cognitive scoresexperienced working memory, delayed memory and visuospatial abilityimprovement and those who reported clinical improvement in anxietyexhibited improvement in the ability to engage inhibition and episodicrecall. These improvements were modest and of similar magnitude in bothtreatment conditions.ConclusionsGeneralised anxiety disorder in older adults is associated withneuropsychological impairments, which are associated with functionalimpairment. Those with GAD who either have a low cognitive performance orreport clinical improvement in anxiety post-treatment, show improvementin multiple cognitive domains. These findings underscore the importanceof treatments that aid cognition as well as anxiety symptoms.