Cognitive Impairment in Late-Life Generalized Anxiety Disorder

This study sought to characterize cognitive functioning in elderly patients with generalized anxiety disorder (GAD), as compared with normal comparison subjects and patients with major depression.

Methods: The cognitive functioning in GAD (N=19) was assessed with the Mattis Dementia Rating Scale and across specific domains of naming, executive ability, and memory, in comparison with late-life major depressive disorder (MDD; N=68) and versus no psychiatric illness (N=40).

Results: In comparison to healthy normal comparison subjects, anxious subjects were impaired on measures of short-term and delayed memory. Depressed subjects also performed worse than normal comparison subjects on delayed memory, as well as in naming. Anxious subjects did not differ significantly from depressed subjects in any measure of cognitive function.

Conclusion: In this preliminary study, anxious subjects displayed cognitive impairments in short-term memory; while depressed patients compared to normal comparison subjects showed executive dysfunction and more general cognitive impairments not evident in anxious subjects. Studies of neuropsychological function in elderly anxious subjects may be informative in developing treatment interventions that mitigate cognitive dysfunction and illuminate the course of illness and underlying neural pathways.

Key Words: Cognitive functioning • generalized anxiety disorder • major depressive disorder • late-life mood disorder • memory

Rose C. Mantella, Ph.D., Meryl A. Butters, Ph.D., Mary Amanda Dew, Ph.D., Benoit H. Mulsant, M.D., Amy E. Begley, M.A., Barbara Tracey, M.S.N., M. Katherine Shear, M.D., Charles F. Reynolds III, M.D., and Eric J. Lenze, M.D.

From the Advanced Center in Interventions and Services Research for Late-Life Mood Disorders and the John A. Hartford Center of Excellence in Geriatric Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.