Anxiety symptoms in mild cognitive impairment

Anxiety disorders are less well studied in elderly people than other disorders such as depression. In particular the diagnosis of anxiety is more difficult in patients with Mild Cognitive Impairment (MCI) since the current definition of MCI does not mention neuropsychiatric symptoms.

To validate the Italian version of Geriatric Anxiety Inventory (GAI), an instrument that measures dimensional anxiety in elderly people, and assess whether MCI subjects with anxiety symptoms show different neuropsychological profiles in comparison with MCI without anxiety symptoms.

Fifty-seven outpatients with MCI were consecutively recruited. All patients were assessed using a complete neuropsychological battery to detect the cognitive impairment, and the GAI for the presence of anxiety symptoms.

Anxiety + patients (GAI >or= 10) show more behavioral and psychological disturbances than patients with Anxiety- (GAI < 10); in particular they had more agitation, anxiety, depression and more sleep disorders. Moreover, Anxiety + patients are more compromised on instrumental daily functions and on executive functions evaluated with Trail Making B test (TMB). Linear Regression analysis was completed to estimate the coefficients of the linear equation, involving neuropsychological, psychobehavioural and functional characteristics: the executive functions (TMB) are the only variable independently related to the presence of anxiety disturbances.

Executive functions are independently related to anxiety disorders in MCI patients. We hypothesized that the strict interaction between anxiety symptoms and executive functions could depend on specific pathological features at the level of caudate nucleus characterizing early phases of dementia.