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Changes in neuropsychological functioning following treatment for late-life generalised anxiety disorder

  • Meryl A. Butters (a1), Rishi K. Bhalla (a2), Carmen Andreescu (a1), Julie Loebach Wetherell (a3), Rose Mantella (a4), Amy E. Begley (a1) and Eric J. Lenze (a5)...

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.

Method

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.

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Copyright

Corresponding author

Meryl A. Butters, PhD, Western Psychiatric Institute and Clinic, 3811 O'Hara St, Pittsburgh, PA 15213, USA. Email: buttersma@upmc.edu

Footnotes

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This research was supported by United States Public Health Service grants MH070547, MH072947 and MH52247, as well as a 2009 NARSAD Young Investigator Award to C.A.

Declaration of interest

R.M. is employed by Abbott Laboratories.

Footnotes

References

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Changes in neuropsychological functioning following treatment for late-life generalised anxiety disorder

  • Meryl A. Butters (a1), Rishi K. Bhalla (a2), Carmen Andreescu (a1), Julie Loebach Wetherell (a3), Rose Mantella (a4), Amy E. Begley (a1) and Eric J. Lenze (a5)...
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