Longitudinal Cognitive Profiles by Anxiety and Depressive Symptoms in American Older Adults With Subjective Cognitive Decline

Purpose: The objective of this study was to determine how anxiety and/or depressive symptoms differentially affect specific cognitive domains over time in persons with subjective cognitive decline (SCD). Design: A longitudinal, observational study was conducted using data from the National Alzheimer’s Coordinating Center-Uniform Data Set. Mean follow-up was 4.1 ± 2.4 years. Methods: Using information from a total of 1401 participants (age 74.0 ± 8.2 years), linear mixed-effects regression models were used to assess longitudinal changes in global cognition, episodic memory, attention, language, and executive function by baseline psychological (anxiety [A] and/or depressive [D]) symptoms in individuals with SCD. Reference was the group having no symptoms (A−/D−). Findings: The A+/D− group was not associated with any cognitive changes. The A−/D+ group was associated with a greater decline in episodic memory and executive function. The A+/D+ group had a greater decline in attention. Changes in global cognition and language were not predicted by any psychological symptoms. Conclusions: Depressive symptoms predicted lower episodic memory and executive function. Clinical Relevance: Nurses need to pay attention to depressive symptoms in older adults with SCD because managing depressive symptoms may help protect against cognitive decline more typical of early Alzheimer’s dementia.