Anxiety, depression, psychotropic drug use and cognitive impairment.
BACKGROUND
Numerous studies have shown that anxiety and depression are related to cognitive impairment, but the concomitant association between anxious symptoms, depressive symptoms and cognitive function has not been investigated, and, most studies have not considered psychotropic drug use as a possible confounding factor.


METHODS
We assessed the independent association between depression, anxiety, psychotropic drug use and cognitive performance in 457 men and 659 women, aged 59-71 years living in the community. Data on demographic background, occupation, medical history, drug use and personal habits were obtained using a standardized questionnaire. The Spielberger Inventory Trait and the Center for Epidemiologic Study-Depression (CES-D) scales were used to evaluate anxious and depressive symptomatology respectively. Cognitive assessment included six traditional tests covering the main areas of cognitive functioning.


RESULTS
In men, anxious and depressive symptomatologies had independent significant associations with most cognitive abilities, independent of psychotropic drug use. In women, the association between anxiety or depression and cognitive functioning was less strong and disappeared after adjustment for psychotropic drug use. Psychotropic drug use was associated with lower cognitive scores in both sexes. In men with high CES-D scores, we found positive correlations between anxiety level and cognitive scores.


CONCLUSIONS
The study showed that anxiety, depression and psychotropic drug use were significantly and independently associated with cognitive functioning in elderly men. The high prevalence of psychotropic drug use in women with or without psychological disorders may explain its major effect in women. Results suggested that anxiety may partly compensate for some negative effects of depression on cognitive functioning.
Paterniti
S
S
Institut National de la Santé et de la Recherche Medicale, Unit 360, Paris, France.
Dufouil
C
C
Bisserbe
J C
JC
Alpérovitch
A
A
D017677:Age Distribution; D000368:Aged; D001008:Anxiety Disorders / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology; D002391:Catchment Area, Health; D003072:Cognition Disorders / Q000139:chemically induced* / Q000175:diagnosis; D003866:Depressive Disorder / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011619:Psychotropic Drugs / Q000009:adverse effects*; D012720:Severity of Illness Index; D017678:Sex Distribution; D019966:Substance-Related Disorders / Q000175:diagnosis* / Q000453:epidemiology
D011619:Psychotropic Drugs