Unlocking Neurocognitive Substrates of Late-Life Affective Symptoms Using the Research Domain Criteria: Worry Is an Essential Dimension

Abstract

While investigations have sought to identify the distinct and shared contributions of anxiety and depression to neurocognitive processes in late life, less is known regarding the further contribution of worry, a unique and critical dimension of affective dysregulation. Capturing the full range of symptoms, as inspired by the NIH Research Domain Criteria (RDoC), may provide finer-grained information on inter-relationships among worry, anxiety and depression on neurocognitive processing in later life. The objective of this study was to determine if the dimensional trait of worry intensifies known negative associations of dimensional measures of anxiety and depressive symptoms with neurocognitive processes, specifically cognitive control and memory processes. Using a cross-sectional and observational design, this study was conducted within a translational research center located with a Veterans medical center in Northern California. One hundred and nineteen community-residing older adults ages 65–91 years participated, and were characterized with psychiatric and neurocognitive dimensional measures. Affective symptom severity was assessed with the Penn State Worry Questionnaire, the Beck Anxiety Inventory (BAI), and the Beck Depression Inventory-II. Primary neurocognitive outcomes were inhibitory control assessed using a Stroop paradigm and delayed verbal memory assessed with the Rey Auditory Verbal Learning Test. Secondary outcomes included other less frequently examined cognitive control mechanisms (working memory, information processing, and verbal fluency) and memory processes (visual delayed memory). Contrary to prediction, the dimensional trait of worry attenuated negative associations between anxiety and depressive symptoms and inhibitory control on the one hand, and between depressive symptoms and delayed verbal memory processes on the other. In the secondary models, symptom dimensions were not associated with other cognitive control or visual delayed memory processes. Our fine-grained approach, in line with the NIMH RDoC model, suggests the neurocognitive processes associated with dimensional measures of late-life affective symptoms are dissociable. Specifically, dimensional measures of worry operate independently from other anxiety and depression symptoms to reveal differential patterns of neurocognitive processes associated with affective dysregulation.

Effect of Worry Level on Recall Memory for Odors in ApoE-ε4 Carriers and Non-Carriers

“…There is some evidence in the literature to support an enhancing effect of worry on performance. Beaudreau et al (2017) found that elevated worry improved performance on tests of cognitive control and delayed verbal memory in older adults with anxiety or depression; however, this effect was only found among participants with high levels of depressive symptoms, which would not be consistent with the current findings given low depressive symptoms in the current sample. The processing efficiency theory of anxiety (Eysenck & Calvo, 1992) may provide additional insight into these findings.…”

Heterogenous Subtypes of Late-Life Depression and Their Cognitive Patterns: A Latent Class Analysis

“…The Yerkes-Dodson law ( 61 ) proposed an inverted u-shaped relationship between the state of stress and cognitive performance, in which a proper amount of stress or arousal contributed to better cognitive function. In addition, Beaudreau et al ( 62 ), who found that worry attenuated the negative effect of depressive and anxiety symptoms on inhibitory control, suggested that the personality trait of perfectionism characterized by higher motivation for better performance and worry level could be a possible explanation. Moreover, it has been hypothesized that abnormalities in the functional connectivity between and within the executive control network (ECN) and the default mode network (DMN) ( 63 , 64 ) together with the failure of DMN deactivation during cognitive tasks ( 65 ) lead to negative cognitive bias and cognitive impairment in LLD subjects ( 66 ).…”

Mnemonic Discrimination Under Stress and Its Clinical Relevance for Anxiety

“…If the stressor does facilitate better performance among older participants, it could be due to different manifestations of anxiety between age groups. For example, experimental work has demonstrated dissociable effects of these types of anxious symptoms on some cognitive tasks in older adults (65+ years; Beaudreau et al, 2017); such differences could extend to slightly younger adults (40-50 years) and mnemonic discrimination, a specific form of episodic memory.…”