title: Changes in neuropsychological functioning following treatment for late-life generalised anxiety disorder.
abstract: BACKGROUND
  Generalised anxiety disorder (GAD) in older adults is associated with neuropsychological impairment. Aims We examined neuropsychological functioning in older adults with GAD in comparison with psychiatrically healthy older adults at baseline, and we examined changes following a 12-week placebo-controlled trial of escitalopram.
  
  
  METHODS
  A total of 160 participants without dementia aged ≥60 with current GAD and 37 individuals in a comparison group without psychiatric history underwent neuropsychological assessment. Of these, 129 participants with GAD were reassessed post-treatment (trial registration: NCT00105586).
  
  
  RESULTS
  The participants with GAD performed worse than the comparison group in information processing speed, working memory, inhibition, problem-solving (including concept formation and mental flexibility) and immediate and delayed memory. Neuropsychological functioning was correlated with everyday functioning. After treatment, those with low cognitive scores experienced working memory, delayed memory and visuospatial ability improvement and those who reported clinical improvement in anxiety exhibited improvement in the ability to engage inhibition and episodic recall. These improvements were modest and of similar magnitude in both treatment conditions.
  
  
  CONCLUSIONS
  Generalised anxiety disorder in older adults is associated with neuropsychological impairments, which are associated with functional impairment. Those with GAD who either have a low cognitive performance or report clinical improvement in anxiety post-treatment, show improvement in multiple cognitive domains. These findings underscore the importance of treatments that aid cognition as well as anxiety symptoms.
authors: Western Psychiatric Institute and Clinic, 3811 O'Hara St, Pittsburgh, PA 15213, USA. buttersma@upmc.edu
authors: Meryl A
authors: MA
authors: Butters
authors: Rishi K
authors: RK
authors: Bhalla
authors: Carmen
authors: C
authors: Andreescu
authors: Julie Loebach
authors: JL
authors: Wetherell
authors: Rose
authors: R
authors: Mantella
authors: Amy E
authors: AE
authors: Begley
authors: Eric J
authors: EJ
authors: Lenze
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001008:Anxiety Disorders / Q000188:drug therapy / Q000503:physiopathology*; D001288:Attention / Q000187:drug effects; D015283:Citalopram / Q000627:therapeutic use*; D003072:Cognition Disorders / Q000188:drug therapy / Q000503:physiopathology* / Q000523:psychology; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008606:Mental Processes / Q000187:drug effects*; D008875:Middle Aged; D009483:Neuropsychological Tests; D010919:Placebos; D011569:Psychiatric Status Rating Scales; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D015283:Citalopram; D010919:Placebos; D017367:Selective Serotonin Reuptake Inhibitors