The impact of anxiety on conversion from mild cognitive impairment to Alzheimer's disease

Abstract

SUMMARYObjective-To compare state and trait anxiety in mild cognitive impairment (MCI) patients and matched control subjects, and to assess the impact of these variables in predicting conversion to Alzheimer's disease.Methods-One hundred and forty-eight patients with MCI, broadly defined, were assessed and followed systematically. Baseline predictors for follow-up conversion to AD (entire sample: 39/148 converted to Alzheimer's disease (AD)) included the Spielberger State-Trait Anxiety Inventory (STAI).Results-At baseline evaluation, MCI patients had higher levels of state and trait anxiety than controls, with no differences between future AD converters (n = 39) and non-converters. In agestratified Cox proportional hazards model analyses, STAI State was not a significant predictor of conversion to AD (STAI State ≤30 vs. > 30 risk ratio, 1.68; 95% CI, 0.75, 3.77; p = 0.21), but higher Trait scores indicated a lower risk of conversion when STAI State, education, the Folstein MiniMental State Examination and HAM-D (depression score) were also included in the model (STAI Trait ≤30 vs. > 30 risk ratio, 0.36; 95% CI, 0.16, 0.82; p = 0.015).Conclusions-In contrast to two other recent studies that showed anxiety predicted cognitive decline or conversion to AD, in this clinic-based sample, state anxiety was not a significant predictor. However, higher Trait anxiety predicted a lower risk of future conversion to AD. Further research with systematic long-term follow-up in larger samples is needed to clarify the role of state and trait anxiety in predicting MCI conversion to AD.

Anxiety symptoms and disorder predict activity limitations in the elderly

“…Overall scores range from 20 to 80. Different cut-offs are available in the literature for the elderly but none of them have been validated (Devier et al, 2009;Himmelfarb & Murrell, 1984;Tinetti et al, 1995). Himmelfarb (1983) established a cut-off score of 44+ as best discriminating between a hospitalised clinical sample and a non-hospitalised community sample of older persons (Himmelfarb & Murrell, 1984).…”

“…Devier at al. (2009) used a previously reported threshold of 30+ in studying conversion in patients from MCI to Alzheimer's disease (Devier et al, 2009) and Tinetti et al (1995) used Spielberger's (1983 normative mean score value of 32 in 50-69 year old adults to dichotomise the score (Tinetti et al, 1995). In the absence of a validated cut-off score, we decided to group STAI trait scores into tertiles and to compare the highest tertile to the lowest two.…”

Correlation between maternal anxiety, reactivity of fetal cerebral circulation to auditory stimulation, and birth outcome in normotensive and gestational hypertensive women

“…Subjects from both experimental groups completed the Spielberger (Bunevicius et al, 2013;Devier et al, 2009; for a detailed review, see Glozman, 2004;Özpelit et al, 2015). In our study, we have indeed utilized STAI scores as a continuous variable to determine possible correlations with RePi.…”

The Relationship Between Mild Cognitive Impairment and Mood in Older People

“…Other research required that participants had an MMSE score of 1SD below age-and education-specific means (Forsell, Palmer, & Fratiglioni, 2003). Other studies (Devier et al, 2009;G. J. McDougall et al, 2006;Rozzini et al, 2009) did not specify the cut-off scores for the neuropsychological tests used.…”

“…J. McDougall et al, 2006;Rozzini et al, 2009) did not specify the cut-off scores for the neuropsychological tests used. Of the twenty-two studies, ten required a subjective memory complaint in order to classify participants as having MCI (Devier et al, 2009;Elfgren, Gustafson, Vestberg, & Passant, 2010;Hidaka et al, 2012). …”