Association Between Anxiety and Cognitive Decline Over 12 Years in a Population-Based Cohort

Abstract

Background: Findings on the associations between anxiety and cognitive decline are mixed and often confounded. Objective: We studied whether anxiety symptoms were associated with the risk of cognitive decline after adequate adjustment of confounding factors. Methods: Our study consists of 2,551 community-dwelling older adults recruited between the ages of 60–64 years and followed up for 12 years in the PATH Through Life cohort study. Anxiety symptoms were measured using the Goldberg Anxiety Scale (GAS; range 0–9). General cognitive function, episodic memory, working memory, verbal intelligence, processing speed, and psychomotor speed were measured. Multilevel analyses were carried out to investigate the association between anxiety symptoms and cognitive decline over 12 years, taking into account confounding variables. Results: We did not find a significant association between baseline anxiety symptoms and cognitive decline over 12 years. Although some associations between anxiety symptoms with psychomotor speed (β= –0.04, 99% CI: –0.08, 0.00) and processing speed (β= –0.27, 99% CI: –0.48, –0.07) were found, these were attenuated after adjusting for depression. We also did not find an association between cumulative anxiety and decline in cognitive performance. Conclusion: In this sample of cognitively healthy men and women aged 60 years and above, anxiety symptoms were not associated with the risk of cognitive decline. Long follow-up study time, appropriate selection of confounding factors, and estimating the effect of cumulative anxiety are important to establish the association between anxiety and cognitive symptoms.