The effects of sub‐threshold depression and anxiety symptoms on fluid cognitive performance in older adults: an exploratory analysis

Abstract

AbstractBackgroundClinical anxiety and depression have well‐understood cognitive effects, but less is known about sub‐threshold symptoms. This study explored differences in cognition between older adults with sub‐threshold symptoms of depression or anxiety in comparison to those with no symptoms and investigated whether the COVID‐19 pandemic or APOE4 carrier status contributed to these symptoms.Method72 older adults (age 64.33±6.3) completed the Patient Health Questionnaire (PHQ‐9), Generalized Anxiety Disorder scale (GAD‐7), and NIH Toolbox Cognition Battery (NIHTB‐CB). Participants were split into a Pre‐COVID Group (participation before March 2020) and a Post‐COVID Group. Subjects were also split based on their mood assessment scores. Those who scored 0 on the PHQ‐9 (“None” Group) were separated from those who scored 1–4 (“Some” Group). The same process was performed for the GAD‐7 assessment. Age‐corrected NIHTB‐CB scores were compared between groups for both mood assessments by ANCOVA using SAS Studio software, adjusting for education level.ResultThere were no significant differences in PHQ‐9 or GAD‐7 scores between Pre‐ and Post‐COVID groups, nor did mood symptoms differ by APOE4 status (p’s>.05). The PHQ‐9 “Some” Group produced higher scores on the Fluid Cognition Composite than the “None” Group (111.11±2.24 and 102.57±2.81, respectively; p = .023). This was driven by significantly better performances on Pattern Comparison (PC; p = .014) and a trend of better performance on Dimensional Change Card Sort task (DCCS; p = .054). Reaction times were also faster for the “Some” Group on DCCS (p = .002) and PC (p = .002) tasks. No significant differences were found for GAD‐7 subgroupings.ConclusionAnxious and depressive symptoms did not differ between COVID‐19 or APOE4 groups. While sub‐threshold anxiety did not affect cognition, those with some depressive symptoms performed better on fluid cognitive measures, specifically tests of processing speed, than those with no symptoms. Further analysis exploring the relationship between components of these two mood assessments and fluid cognitive performance is warranted.