Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA.
Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany.
J Alzheimers Dis. 2024;100(4):1355-1364. doi: 10.3233/JAD-240213.
Studies that assess cognition prospectively and study in detail anxiety history in the participants' medical records within the context of brain aging and Alzheimer's disease are limited.
To examine the associations of anxiety and unspecified emotional distress (UED) acquired throughout a person's life with prospectively collected cognitive outcomes.
Mayo Clinic Study of Aging participants who were cognitively unimpaired at baseline were included. Anxiety and UED data were abstracted from the medical record using the Rochester Epidemiology Project (REP) resources and were run separately as predictors in our models. The data were analyzed using Cox proportional hazards models for the outcomes of incident mild cognitive impairment (MCI) and dementia and using linear mixed effects models for the outcomes of global and domain specific cognitive z-scores and included key covariates.
The study sample (n = 1,808) had a mean (standard deviation) age of 74.5 (7.3) years and 51.4% were male. Anxiety was associated with increased risk of MCI and dementia and was associated with lower baseline cognitive z-scores and accelerated decline over time in the global, memory, and attention domains. UED was associated with faster decline in all domains except visuospatial but did not show evidence of association with incident cognitive outcomes. These results varied by medication use and timing of anxiety.
Anxiety and UED both showed inverse associations with cognition. Utilization of anxiety and UED data from across the life course, as available, from the REP system adds robustness to our results.
在脑老化和阿尔茨海默病的背景下，前瞻性评估认知并详细研究参与者病历中焦虑病史的研究有限。
研究一生中获得的焦虑和未特指的情绪困扰（UED）与前瞻性认知结果的相关性。
纳入认知未受损的 Mayo 诊所衰老研究参与者。使用罗切斯特流行病学项目（REP）资源从病历中提取焦虑和 UED 数据，并分别作为我们模型中的预测因子进行运行。使用 Cox 比例风险模型分析事件性轻度认知障碍（MCI）和痴呆的结果，使用线性混合效应模型分析全球和特定领域认知 z 分数的结果，并包括关键协变量。
研究样本（n=1808）的平均（标准差）年龄为 74.5（7.3）岁，51.4%为男性。焦虑与 MCI 和痴呆的风险增加相关，与较低的基线认知 z 分数和全球、记忆和注意力领域的认知衰退加速相关。UED 与所有领域（除了视觉空间）的认知衰退速度加快有关，但没有证据表明与新发认知结果有关。这些结果因药物使用和焦虑的时间而异。
焦虑和 UED 均与认知呈负相关。利用 REP 系统中贯穿一生的焦虑和 UED 数据增加了我们结果的稳健性。
