title: The synergistic effects of anxiety and cerebral hypoperfusion on cognitive dysfunction in older adults with cardiovascular disease.
abstract: OBJECTIVE
  Anxiety is a risk factor for cardiovascular disease (CVD) and is associated with neurocognitive outcomes. The effect of anxiety on brain perfusion in a CVD population has yet to be examined, and no study has investigated the interactive effects of anxiety and cerebral perfusion on cognition.
  
  
  METHODS
  A total of 55 older adults with CVD completed the Beck Anxiety Inventory (BAI) and underwent arterial spin labeling to quantify cortical perfusion and thickness. Participants were administered the Mini-Mental State Examination (MMSE) and the Repeatable Battery for the Assessment of Neuropsychological Status.
  
  
  RESULTS
  Reduced perfusion predicted poorer cognition and decreased cortical thickness. Higher anxiety score predicted worse memory performance and decreased frontal perfusion. Frontal lobe hypoperfusion combined with increased BAI scores exacerbated poorer MMSE performance.
  
  
  CONCLUSIONS
  Higher anxiety may exacerbate the effects of cerebral hypoperfusion on cognitive impairment. Longitudinal studies are needed to confirm our findings and determine whether anxiety treatment improves neurocognitive outcomes in CVD.
authors.affiliation: Department of Psychology, Kent State University, Kent, OH, USA malosco@kent.edu.
authors.forename: Michael L
authors.initials: ML
authors.lastname: Alosco
authors.affiliation: Department of Psychology, Kent State University, Kent, OH, USA.
authors.forename: John
authors.initials: J
authors.lastname: Gunstad
authors.affiliation: Department of Psychiatry McLean Hospital/Harvard Medical School, Belmont, MA, USA.
authors.forename: Courtney
authors.initials: C
authors.lastname: Beard
authors.affiliation: Department of Psychology, Idaho State University, Pocatello, ID, USA.
authors.forename: Xiaomeng
authors.initials: X
authors.lastname: Xu
authors.affiliation: Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Uraina S
authors.initials: US
authors.lastname: Clark
authors.affiliation: Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, Providence, RI, USA.
authors.forename: Donald R
authors.initials: DR
authors.lastname: Labbe
authors.affiliation: Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, Providence, RI, USA.
authors.forename: Beth A
authors.initials: BA
authors.lastname: Jerskey
authors.affiliation: Columbia Teachers College, New York, NY, USA.
authors.forename: Maura
authors.initials: M
authors.lastname: Ladino
authors.affiliation: Care New England, Providence, RI, USA.
authors.forename: Denise M
authors.initials: DM
authors.lastname: Cote
authors.affiliation: Brown University, Departments of Neuroscience and Diagnostic Imaging., Providence, RI, USA.
authors.forename: Edward G
authors.initials: EG
authors.lastname: Walsh
authors.affiliation: Section of Cardiology, Brown University, Providence, RI USA.
authors.forename: Athena
authors.initials: A
authors.lastname: Poppas
authors.affiliation: Cognitive Aging and Memory Program, Clinical Translational Research Program, Institute on Aging, University of Florida, Gainesville, FL, USA.
authors.forename: Ronald A
authors.initials: RA
authors.lastname: Cohen
authors.affiliation: Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, Providence, RI, USA Department of Psychology, University of Georgia, Athens, GA, USA.
authors.forename: Lawrence H
authors.initials: LH
authors.lastname: Sweet
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000453:epidemiology / Q000503:physiopathology* / Q000523:psychology; D001008:Anxiety Disorders / Q000150:complications; D001921:Brain / Q000098:blood supply* / Q000503:physiopathology; D002318:Cardiovascular Diseases / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology* / Q000523:psychology; D002560:Cerebrovascular Circulation / Q000502:physiology*; D003071:Cognition / Q000502:physiology; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology* / Q000523:psychology; D005260:Female; D005625:Frontal Lobe / Q000503:physiopathology; D006801:Humans; D008297:Male; D008568:Memory; D008875:Middle Aged; D059906:Neuroimaging / Q000379:methods; D009483:Neuropsychological Tests; D013113:Spin Labels
chemical_list: D013113:Spin Labels
keywords: anxiety; arterial spin labeling; cardiovascular disease; cerebral blood flow; cerebrovascular disease; cognitive function; magnetic resonance imaging; neuroimaging