Clinical Manifestations

Area of Science:

• Neuroscience
• Gerontology
• Psychiatry

Background:

• Previous research links depression and anxiety to lower cognitive performance in older adults.
• Most studies are cross-sectional, lacking longitudinal data on affective variability and cognitive change.
• This study investigates the association between intraindividual affective variability and cognitive decline.

Purpose of the Study:

• To assess if intraindividual variability in self-reported depression and anxiety symptoms predicts cognitive decline.
• To explore the relationship between affective symptom fluctuations and cognitive performance over time.
• To inform strategies for mitigating cognitive decline in older adults.

Main Methods:

• Longitudinal study of 817 cognitively unimpaired (CU) middle-aged and older adults (53-102 years).
• Cognition assessed via Montreal Cognitive Assessment (MoCA).
• Depression and anxiety symptoms measured using the Center for Epidemiologic Studies Depression 10-Item and Penn State Worry Questionnaire, respectively. Intrasubject standard deviation (ISD) quantified variability.

Main Results:

• Greater variability in depression and anxiety symptoms was associated with cognitive decline in primary analyses.
• Exploratory analyses indicated that only depressive symptom variability significantly predicted cognitive decline.
• No significant interaction effect was found between depressive and anxiety symptom variability on cognitive decline.

Conclusions:

• Within-subject variability in affective symptoms is associated with a linear decline in cognitive performance over several years in CU older adults.
• Accounting for affective fluctuations can improve estimates in observational and interventional studies.
• Findings suggest potential strategies to mitigate cognitive decline by addressing affective variability.