Comorbid anxiety disorder in late life depression: association with memory decline over four years.
OBJECTIVE
In elderly persons with Major Depressive Disorder (MDD), coexisting Generalized Anxiety Disorder (GAD) or Panic Disorder (PD) is associated with more severe symptoms and poorer short-term treatment outcomes. The purpose of this study was to determine whether comorbid GAD or PD was associated with poorer long-term outcomes of late-life MDD, in terms of symptoms, functional disability, and cognitive status.


METHODS
Seventy-nine older subjects with major depressive disorder who had responded to initial treatment in clinical trials were followed at yearly intervals for up to four years with assessment of their symptoms, cognitive status, and functional disability. For this analysis, subjects were divided into two groups, anxious and non-anxious, based on presence (n = 37) or absence (n = 42) of a lifetime diagnosis of GAD and/or PD.


RESULTS
The anxious group showed a greater decline in memory, but not in other cognitive measures or measures of functional status. Depression recurrence was similar in the anxious and non-anxious groups. Among those in the anxious group, a later age of onset (> 55) of the anxiety disorder was associated with worse overall cognition at baseline, but a similar rate of decline in cognition over time, compared with early-onset anxiety disorder.


CONCLUSIONS
We found evidence that comorbid GAD or PD is associated with a greater decline in memory in late-life MDD. The data also suggest that anxiety disorders with an onset later in life may be associated with cognitive impairment, although further study is needed to confirm this finding.
DeLuca
Alison K
AK
The Intervention Research Center for Late-Life Mood Disorders, Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Lenze
Eric J
EJ
Mulsant
Benoit H
BH
Butters
Meryl A
MA
Karp
Jordan F
JF
Dew
Mary Amanda
MA
Pollock
Bruce G
BG
Shear
M Katherine
MK
Houck
Patricia R
PR
Reynolds
Charles F
CF
D000368:Aged; D000369:Aged, 80 and over; D001008:Anxiety Disorders / Q000523:psychology*; D003072:Cognition Disorders / Q000209:etiology; D003866:Depressive Disorder / Q000523:psychology*; D005500:Follow-Up Studies; D006801:Humans; D008569:Memory Disorders / Q000209:etiology*; D008875:Middle Aged; D009483:Neuropsychological Tests; D011379:Prognosis; D011569:Psychiatric Status Rating Scales