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Mind & Brain, the Journal of Psychiatry


Table 2. Studies on Anxiety and Risk for Dementia Authors


Study design


Prospective longitudinal


Follow-up duration Sample type


Association between anxiety and risk for dementia Palmer et al.40


3 Years


N and Dx at baseline


Poulation-based 185 NCI 47 A-MCI


Age at base- line (years)


7579


Measures of anxiety


CPRS


Measures of cognition


MMSE WAIS-R Block Design & Digit Span Forward & Backward


Memory tests for words (free & cued recall, recognition) Facial recogniotion task


Gallacher et al.39


Prospective longitudinal


Prospective longitudinal


17 Years


No Association between anxiety and risk for dementia Devier et al.41


46.6924.6 months (MCI)


52.2928.4 months (controls)


Poulation- based*


Clinical population$ 2358 men 4867


148 MCI 63 controls


Mean 66.699.7


STAI CAMCOG


STAI HDRS MMSE SRT


WMS-VR immediate & delayed recall


WAIS-R Similarities & Digit Symbol Block Design & Object Assembly COWAT-CFL BNT ANT BDAE Repitition & Comprehension


Rosen Drawing Test


A-MCIamnestic mild cognitive impairment; ANTAnimal Naming Test; BDAEBoston Diagnostic Examination; BNTBoston Naming Test; CAMCOG Cambridge Cognitive Examination of the Elderly; COWAT-CFL; CPRSControlled Word Association Testletters CFLComprehensive Psychopathological Rating Scale; Dxdiagnosis; HDRSHamilton Depression Rating Scale; MCIMild cognitive impairment; MMSEMini-Mental State Examination; NCI Noncognitively impaired individuals; SRTselective reminding test; STAIstate-trait anxiety inventory; WAIS-RWechsler Adult Intelligence Scale Revised; WMS-VRWechsler Memory Scale  Visual Reproduction.


*Prospective study for cardiovascular and cerebovascular disease. $Memory clinic.


p0.21), but higher Trait scores indicated a lower risk of conversion when STAI State, education, the MMSE and HDRS scores were also included in the model (STAI Trait 530 vs 30 risk ratio, 0.36; 95% CI, 0.16, 0.82; p0.015). In this study, state anxiety was not a significant predictor for AD. However, higher Trait anxiety predicted a lower risk of future conversion to AD. This study had good methods. However, as the above study,40 from an epidemiological point of view, the sample size was small and thus might have had an impact on statistical power.


Affective Symptoms versus MCI and Dementia: Differential Cognitive Profiles?


Older depressed, nondemented patients often present with


deficits in attention, memory, confrontation naming, verbal fluency, visuospatial ability, processing speed, and executive functions. Although these cognitive impairments are also observed in patients with AD, cognitive alterations in early AD are usually more severe than those in patients with depression in nearly every cognitive domain. Memory problems in depression are frequently related to attention and/or executive function deficits, whereas in AD, patients present with severe encoding difficulties more dependent upon the integrity of limbic structures.45,46


In addition, depending on the subtype of MCI, patients presenting with this condition do so with only one (eg,


M&B 2011; 2:(1). July 2011 28


memory or nonmemory) impairment or several cognitive impairments in different cognitive domains.5,6 On the other hand, young and older patients with various mood disorders often present with cognitive performances 2 SDs below the mean on two or more cognitive domains.47 However, very few authors have investigated the differential cognitive profiles of patients with MCI with or without affective symptoms and of patients with affective symptoms. Table 3 presents the design, sample type, n, age, and diagnosis, as well as measures of affective symptoms and of cognition utilized in the only three studies that have investigated this issue in the last 3 years.4850 These studies were all cross-sectional with small sample size, and only one study had a control group49. These results must be interpreted with caution, because some differences between the performances of the clinical groups may not have been demonstrated because of the lack of statistical power.


The first study48 retrospectively compared the performances


of AD, A-MCI, and patients with anxiety/depression (but without A-MCI) on three episodic memory tests (see Table 3). Patients with AD and A-MCI differed from the depressed/ anxious participants on all subcomponents of the memory tests. Scores of total and free recalls significantly distin- guished the three groups of patients: the AD patients had the worst performance, followed by the A-MCI patients, and then by the depressed/anxious participants. Three major limita-


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