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Clinical Manifestations.

Michael H Malek-Ahmadi1,2, Angela Kuramoto3, Farah Shaikh3

  • 1Banner Alzheimer's Institute, Phoenix, AZ, USA.

Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|December 25, 2025
PubMed
Summary
This summary is machine-generated.

Fluctuations in depression and anxiety symptoms are linked to cognitive decline in older adults. Understanding affective variability may help predict and mitigate cognitive changes over time.

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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.