Regular Research Article
Effects of Anxiety Versus Depression on Cognition in Later Life

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Objective

The authors investigated the relationship between anxiety and cognition in older persons, taking account of comorbid depression.

Methods

Data were used from the Longitudinal Aging Study Amsterdam (LASA), a large epidemiological study of 3,107 elderly citizens in The Netherlands. Anxiety and depression were measured with the Hospital Anxiety and Depression Scale–Anxiety subscale and the Center for Epidemiologic Studies–Depression Scale. In measuring cognitive performance, general cognitive functioning was measured by means of Mini-Mental State Exam, episodic memory was measured with the Auditory Verbal Learning Test (AVLT), fluid intelligence by using the RAVEN, and information-processing speed by the coding task. Analysis of variance examined the association between anxiety symptoms and cognition in persons with and without depression.

Results

Main effects of anxiety symptoms were found for learning and delayed recall of the AVLT. Depression symptoms showed significant main effects on almost all cognitive performance tests. Mild anxiety symptoms were associated with better cognitive performance, whereas severe anxiety symptoms were negatively associated with cognitive functioning. In contrast, depressive symptoms showed a linear association with cognition; more depression was associated with worse cognition.

Conclusion

This study suggests that anxiety has a curvilinear relationship with cognition. Depressive symptoms, however, were always negatively associated with cognitive performance.

Section snippets

Sample

To investigate the association between anxiety and cognition in older persons, we used data from the Longitudinal Aging Study Amsterdam (LASA18). LASA is a longitudinal study of predictors and consequences of changes in well-being and autonomy in older persons. Details on sampling are described elsewhere19., 20., 21. and will briefly be summarized here. The sample was originally drawn for NESTOR-Living Arrangements and Social Network (NESTOR–LSN;22), for which random samples of older residents

RESULTS

Table 1 shows the characteristics of these elderly respondents, divided in four groups: 1) with neither anxiety nor depression symptoms (ANX−/DEP−); 2) with anxiety but no depression symptoms (ANX+/DEP−); 3) with no anxiety but only depression symptoms (ANX−/DEP+); and 4) with both anxiety and depressive symptoms (ANX+/DEP+).

Analysis of variance shows significant main effects of anxiety symptoms on Learning and Delayed Recall of the AVLT. Depression symptoms show significant effects on all

DISCUSSION

The present study sought to investigate whether anxiety and depression have different effects on cognition in a large sample of community-living elderly persons. We found that mild anxiety symptoms seem to be beneficial, whereas severe anxiety negatively influences cognitive performance. Depression symptoms always negatively influence cognitive functioning. The association between anxiety symptoms and cognitive performance seems to be a curvilinear relationship. These findings support the

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