Anxiety disorders, depressive episodes and cognitive impairment no dementia in community-dwelling older men and women

Background: Anxiety symptoms are highly prevalent in elders with mild cognitive disorders, but little is known about the associations of specific anxiety disorders to mild cognitive disorders. Objective: To identify the clinical and subclinical anxiety disorders associated with cognitive impairment no dementia (CIND) and to determine whether these associations differ depending on sex and concomitant depressive episodes. Method: Participants constituted a random sample (n = 2414) of community-dwelling adults aged 65-96 years. The following clinical and subclinical DSM-IV anxiety disorders were identified with a semi-structured interview: specific phobia, social phobia, agoraphobia, panic disorder, obsessive-compulsive, and generalized anxiety disorder (GAD). Major depressive episodes or minor depression (MDE/MD) were also determined based on the DSM-IV criteria. CIND cases were defined based on Mini-Mental State Examination (MMSE) cut-offs (15th percentile) stratified for age, education, and sex. Potentially confounding variables (age, education, MDE/MD, chronic diseases, and psychotropic drug use) were statistically controlled. Results: In men, after adjusting for confounding variables, CIND was associated with subclinical GAD (odds ratio (OR): 4.93, 95% confidence interval: 1.84-13.23). Further analyses showed that in men, CIND was related to clinical/subclinical GAD whether MDE/MD was present (7.05, 1.88-26.43) or absent (9.33, 3.24-26.83). In women, CIND was not linked to any clinical or subclinical anxiety disorder. Conclusions: These results suggest that in community-dwelling elders, GAD is the main anxiety disorder associated with poor global cognitive functioning. Moreover, this association is modified by sex, but not by the presence of depressive episodes. Copyright (C) 2010 John Wiley & Sons, Ltd.