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

• Published in: Journal of nursing scholarship 2021-11, Vol.53 (6), p.698-708
• Main Authors: Ahn, Sangwoo, Mathiason, Michelle A., Yu, Fang
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Alzheimer's dementia; Alzheimer's disease; Anxiety; Attention; Clinical nursing; Cognition; Cognition & reasoning; Cognitive change; Cognitive Dysfunction; Cognitive impairment; Dementia; Depression - psychology; depressive symptoms; Episodic memory; Executive function; Humans; Longitudinal Studies; Memory, Episodic; Mental depression; Nurses; Older people; Psychological problems; subjective cognitive decline; United States
• ISSN: 1527-6546; 1547-5069; 1547-5069
• DOI: 10.1111/jnu.12692

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.