title: Association of Depression, Anxiety, and Type D Personality with Cognitive Function in Patients with Coronary Artery Disease.
abstract: OBJECTIVE
  Cognitive impairment predicts poor outcomes in patients with coronary artery disease (CAD), but much remains to be learned about these patients' cognitive function. We investigated how depression, anxiety, and Type D personality relate to cognitive function in patients with CAD, adjusting for sociodemographic factors and clinical markers of CAD severity.
  
  
  METHODS
  We evaluated 510 consecutive patients with CAD (364 men, 146 women; mean age 58±9 years) but no history of coronary artery bypass graft surgery or cognitive impairment who were attending a cardiac rehabilitation program. We assessed the patients' cognitive function (Mini-Mental State Examination, Digit Span Test, Digit Symbol Test, and Trail Making Test Part A), depressive symptoms (Beck Depression Inventory-II), anxiety (State-Trait Anxiety Inventory), Type D personality (14-item Type D Scale), and clinical markers of CAD severity.
  
  
  RESULTS
  After adjusting for sex, age, education, New York Heart Association functional class, and left ventricular ejection fraction, we found that higher depression symptom scores correlated with longer Digit Symbol Test completion time (β=0.158, P<0.004). Higher state anxiety scores correlated with worse Digit Span Test backward recall (β=-0.117, P<0.008) and Trail Making Test Part A scores (β=0.182, P<0.004). Type D personality correlated with lower Mini-Mental State Examination scores (β=-0.148, P=0.001).
  
  
  CONCLUSIONS
  For patients with CAD undergoing a cardiac rehabilitation program, depression, anxiety, and Type D personality were associated with worse cognitive performance independent of clinical CAD severity and sociodemographic characteristics.
authors.affiliation: *Behavioral Medicine Institute, Lithuanian University of Health Sciences, Palanga, Lithuania †Laboratory of Clinical Research, Neuroscience Institute, Lithuanian University of Health Sciences, Kaunas, Lithuania.
authors.forename: Julius
authors.initials: J
authors.lastname: Burkauskas
authors.forename: Julija
authors.initials: J
authors.lastname: Brozaitiene
authors.forename: Adomas
authors.initials: A
authors.lastname: Bunevicius
authors.forename: Julius
authors.initials: J
authors.lastname: Neverauskas
authors.forename: Violeta
authors.initials: V
authors.lastname: Zaliunaite
authors.forename: Robertas
authors.initials: R
authors.lastname: Bunevicius
mesh_terms: D000368:Aged; D001007:Anxiety / Q000209:etiology / Q000523:psychology*; D003071:Cognition; D003324:Coronary Artery Disease / Q000150:complications / Q000523:psychology*; D003863:Depression / Q000209:etiology / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis; D064415:Type D Personality