Regular Research ArticlePhobic Anxiety and Cognitive Performance Over 4 Years Among Community-Dwelling Older Women in the Nurses' Health Study
Section snippets
Study Sample
The Nurses' Health Study (NHS) included 121,700 U.S. woman registered nurses, age 30–55 at the study's inception in 1976. Since then, participants have completed biennial mailed questionnaires updating information on lifestyle factors and health outcomes; total follow-up >90%. On the 1988 follow-up questionnaire, participants were asked to complete the phobic anxiety scale of the Crown–Crisp Index (CCI).15 Subsequently, between 1995 and 2001, NHS participants age 70 and older, and free of
Results
Table 1 shows characteristics of the study sample in 1988 across phobic anxiety levels. Women in the highest phobic category were generally less healthy than those in the lowest phobic category: for example, higher phobic anxiety was associated with higher BMI, higher prevalence of severe depressive symptoms, hypertension, heart disease, diabetes, elevated cholesterol and current smoking, and lower physical activity. Another notable difference was the pattern of lower educational attainment
Discussion
In this study of 16,351 community-dwelling older women, we observed modest but statistically significant associations between higher mid-life levels of phobic anxiety, measured by a validated symptom scale, and worse later-life performance in overall cognitive function and in verbal memory. Specifically, being in the highest phobic anxiety category was cognitively equivalent to almost 2 years of aging. Associations remained statistically significant after adjustment for depression and numerous
Conclusion
In conclusion, higher mid-life phobic anxiety was related to worse later-life cognition in this study of over 16,000 women; these associations were modest (cognitively equivalent to 1.5–2 years of age) but statistically significant. Yet, profiles of poorer cognitive performance with higher phobic anxiety remained parallel over time. Thus, while anxiety may be related to worse initial cognition, we found no evidence that it is associated with continued decline throughout laterlife. Our results
References (40)
- et al.
Cognitive functioning and neuroticism in an elderly community sample
Pers Individ Diff
(1993) - et al.
Distress proneness and cognitive decline in a population of older persons
Psychoneuroendocrinology
(2005) - et al.
Vulnerability to stress, anxiety, and development of dementia in old age
Am J Geriatr Psychiatry
(2011) - et al.
Effects of anxiety versus depression on cognition in later life
Am J Geriatr Psychiatry
(2005) - et al.
Vascular cognitive disorder: a new diagnostic category updating vascular cognitive impairment and vascular dementia
J Neurol Sci
(2004) - et al.
Mini-Mental State: a practical method for grading the cognitive state of patients for the clinician
J Psychiatr Res
(1975) - et al.
Apolipoprotein E, cardiovascular disease and cognitive function in aging women
Neurobiol Aging
(2005) HPA axis responsiveness to stress: implications for healthy aging
Exp Gerontol
(2011)- et al.
COMT genotype and cognitive ability: a longitudinal aging study
Neurosci Lett
(2007) - et al.
A review on cognitive impairments in depressive and anxiety disorders with a focus on young adults
J Affect Disord
(2008)
Anxiety, cognitive performance, and cognitive decline in normal aging
J Gerontol B Psychol Sci Soc Sci
Proneness to psychological distress is associated with risk of Alzheimer's disease
Neurology
Neuroticism does not affect cognitive functioning in later life
Exp Aging Res
Anxiety symptoms and cognitive performance in later life: results from the longitudinal aging study Amsterdam
Aging Ment Health
Inflammatory proteins in plasma and the risk of dementia: the Rotterdam study
Arch Neurol
Inflammatory markers and cognition in well-functioning African American and white elders
Neurology
Phobic anxiety is associated with higher serum concentrations of adipokines and cytokines in women with diabetes
Diabetes Care
Phobic anxiety and risk of coronary heart disease and sudden cardiac death among women
Circulation
Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication
Arch Gen Psychiatry
A short clinical diagnostic self-rating scale for psychoneurotic patients. The Middlesex Hospital Questionnaire (M.H.Q.)
Br J Psychiatry
Cited by (23)
Aging faster: worry and rumination in late life are associated with greater brain age
2021, Neurobiology of AgingCitation Excerpt :In particular, pathologic worry has been associated with the development of coronary heart disease (Tully et al., 2013), while a higher burden of anxiety symptoms was associated prospectively with increased risk for incident stroke independent of other risk factors (including depression) (Lambiase et al., 2014). In the Nurses' Health Study (Okereke and Grodstein, 2013), a 4-year longitudinal study of community-dwelling older women (N = 16,351), higher midlife anxiety was related to worse later-life overall cognitive function and verbal memory. Chronic anxiety has been associated with higher beta amyloid burden (Donovan et al., 2018).
Anxiety as a Risk Factor for Cognitive Decline: A 12-Year Follow-Up Cohort Study
2019, American Journal of Geriatric PsychiatryCitation Excerpt :There was, however, a significant difference between sexes, with women with increasing levels of anxiety showing a faster deterioration in executive function over time. Previous research showed conflicting results, with some studies reporting a significant deterioration in executive function over time25–29 and others not.30,31 Inconsistent findings in the literature may be explained by researchers’ use of different components of executive function.
Obesity and risk for incident rosacea in US women
2017, Journal of the American Academy of DermatologyAnxiety as a Predictor for Cognitive Decline and Dementia: A Systematic Review and Meta-Analysis
2016, American Journal of Geriatric PsychiatryCitation Excerpt :Interestingly, three of the five studies showed a significant decline due to anxiety on executive functioning. The decline on executive functioning was not observed in two large studies(Okereke et al.17 and Bierman et al.15). Two explanations can be put forward for the negative finding in the study by Okereke et al.17 First, they assessed phobic anxiety, although it might be possible that only generalized anxieties are predictive for cognitive decline.
Anxiety is not associated with the risk of dementia or cognitive decline: The rotterdam study
2014, American Journal of Geriatric PsychiatryCitation Excerpt :Here too, the underlying hypothesis is based on either a shared etiology between anxiety and dementia or on anxiety as early symptom of incipient and yet to be diagnosed dementia.7–9 Previous studies examining the association between anxiety and dementia or cognition remain inconclusive.8–23 Methodologic differences, such as assessment of anxiety or selection of study participants, may explain inconsistencies.
Association Between Anxiety and Cognitive Decline Over 12 Years in a Population-Based Cohort
2024, Advances in Alzheimer's Disease