The Synergistic Effects of Anxiety and Cerebral Hypoperfusion on Cognitive Dysfunction in Older Adults With Cardiovascular Disease

Author:

Alosco Michael L.1,Gunstad John1,Beard Courtney2,Xu Xiaomeng3,Clark Uraina S.4,Labbe Donald R.5,Jerskey Beth A.5,Ladino Maura6,Cote Denise M.7,Walsh Edward G.8,Poppas Athena9,Cohen Ronald A.10,Sweet Lawrence H.511

Affiliation:

1. Department of Psychology, Kent State University, Kent, OH, USA

2. Department of Psychiatry McLean Hospital/Harvard Medical School, Belmont, MA, USA

3. Department of Psychology, Idaho State University, Pocatello, ID, USA

4. Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA

5. Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, Providence, RI, USA

6. Columbia Teachers College, New York, NY, USA

7. Care New England, Providence, RI, USA

8. Brown University, Departments of Neuroscience and Diagnostic Imaging., Providence, RI, USA

9. Section of Cardiology, Brown University, Providence, RI USA

10. Cognitive Aging and Memory Program, Clinical Translational Research Program, Institute on Aging, University of Florida, Gainesville, FL, USA

11. Department of Psychology, University of Georgia, Athens, GA, USA

Abstract

Objectives: Anxiety is a risk factor for cardiovascular disease (CVD) and is associated with neurocognitive outcomes. The effect of anxiety on brain perfusion in a CVD population has yet to be examined, and no study has investigated the interactive effects of anxiety and cerebral perfusion on cognition. Methods: A total of 55 older adults with CVD completed the Beck Anxiety Inventory (BAI) and underwent arterial spin labeling to quantify cortical perfusion and thickness. Participants were administered the Mini-Mental State Examination (MMSE) and the Repeatable Battery for the Assessment of Neuropsychological Status. Results: Reduced perfusion predicted poorer cognition and decreased cortical thickness. Higher anxiety score predicted worse memory performance and decreased frontal perfusion. Frontal lobe hypoperfusion combined with increased BAI scores exacerbated poorer MMSE performance. Conclusions: Higher anxiety may exacerbate the effects of cerebral hypoperfusion on cognitive impairment. Longitudinal studies are needed to confirm our findings and determine whether anxiety treatment improves neurocognitive outcomes in CVD.

Publisher

SAGE Publications

Subject

Psychiatry and Mental health,Geriatrics and Gerontology,Clinical Neurology

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