Department of Psychology, Rosalind Franklin University of Medicine and Science, USA.
J Anxiety Disord. 2013 Aug;27(6):608-18. doi: 10.1016/j.janxdis.2013.03.008. Epub 2013 Apr 3.
To better understand the development and exacerbation of late-life anxiety, we tested a risk model positing that trait negative affect (NA) characteristics would interact with cognitive functioning, thereby increasing some older adults' risk for increased anxiety symptoms. The moderator-mediator model consisted of measures of NA, cognitive functioning, and their interaction, as predictors of later Hamilton Anxiety Rating Scale scores (HARS) via a mediational process, subjective memory concerns (SMCs). Older adults (aged 65-years and over; M(age)=76.7 years, SD=6.90 years) completed evaluations four times over approximately 18 months. A latent growth curve model including Anxiety Sensitivity Index total score (ASI), Mattis Dementia Rating Scale-2 (DRS) total raw score, the ASI×DRS interaction, a SMC measure as mediator, HARS intercept (scores at times 3 and 4), and HARS slope provided good fit. The ASI×DRS-2 interaction at Time 1 predicted HARS slope score (β=-.34, p<.05). When ASI score was high, stronger cognitive functioning was associated with fewer anxiety symptoms. The indirect effect of ASI score predicting HARS score 18-months later through the SMC mediator was statistically significant (β=.08, p<.05). Results suggest that the cognitive functioning changes associated with aging might contribute to the development of anxiety symptoms in older adults with specific NA traits. Implications for predicting and preventing late life anxiety disorders are discussed.
为了更好地理解老年期焦虑的发展和恶化,我们测试了一个风险模型,假设特质性负性情绪(NA)特征将与认知功能相互作用,从而增加一些老年人焦虑症状加重的风险。该调节-中介模型由 NA、认知功能及其交互作用的测量值组成,作为通过中介过程(主观记忆担忧(SMCs))预测以后 Hamilton 焦虑量表(HARS)评分的预测因子。老年人(年龄在 65 岁及以上;平均年龄=76.7 岁,标准差=6.90 岁)在大约 18 个月内完成了 4 次评估。包括焦虑敏感指数总分(ASI)、Mattis 痴呆评定量表-2(DRS)总分、ASI×DRS 交互作用、SMCs 测量值作为中介、HARS 截距(第 3 次和第 4 次得分)和 HARS 斜率的潜在增长曲线模型提供了良好的拟合度。第 1 次时的 ASI×DRS-2 交互作用预测 HARS 斜率得分(β=-.34,p<.05)。当 ASI 得分较高时,较强的认知功能与较少的焦虑症状相关。ASI 得分通过 SMC 中介预测 HARS 得分 18 个月后的间接效应具有统计学意义(β=.08,p<.05)。结果表明,与衰老相关的认知功能变化可能导致具有特定 NA 特征的老年人出现焦虑症状。讨论了预测和预防老年期焦虑障碍的意义。