The synergistic effects of anxiety and cerebral hypoperfusion on cognitive dysfunction in older adults with cardiovascular disease

Michael L. Alosco; John Gunstad; Courtney Beard; Xiaomeng Xu; Uraina S. Clark; Donald R. Labbe; Beth A. Jerskey; Maura Ladino; Denise M. Cote; Edward G. Walsh; Athena Poppas; Ronald A. Cohen; Lawrence H. Sweet

doi:10.1177/0891988714541871

The synergistic effects of anxiety and cerebral hypoperfusion on cognitive dysfunction in older adults with cardiovascular disease

Michael L. Alosco, John Gunstad, Courtney Beard, Xiaomeng Xu, Uraina S. Clark, Donald R. Labbe, Beth A. Jerskey, Maura Ladino, Denise M. Cote, Edward G. Walsh, Athena Poppas, Ronald A. Cohen, Lawrence H. Sweet

Research output: Contribution to journal › Article › peer-review

11 Scopus citations

Abstract

Objectives: Anxiety is a risk factor for cardiovascular disease (CVD) and is associated with neurocognitive outcomes. The effect of anxiety on brain perfusion in a CVDpopulation 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.

Original language	English
Pages (from-to)	57-66
Number of pages	10
Journal	Journal of Geriatric Psychiatry and Neurology
Volume	28
Issue number	1
DOIs	https://doi.org/10.1177/0891988714541871
State	Published - 13 Mar 2015

Keywords

anxiety
arterial spin labeling
cardiovascular disease
cerebral blood flow
cerebrovascular disease
cognitive function
magnetic resonance imaging
neuroimaging

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10.1177/0891988714541871

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Alosco, M. L., Gunstad, J., Beard, C., Xu, X., Clark, U. S., Labbe, D. R., Jerskey, B. A., Ladino, M., Cote, D. M., Walsh, E. G., Poppas, A., Cohen, R. A., & Sweet, L. H. (2015). The synergistic effects of anxiety and cerebral hypoperfusion on cognitive dysfunction in older adults with cardiovascular disease. Journal of Geriatric Psychiatry and Neurology, 28(1), 57-66. https://doi.org/10.1177/0891988714541871

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abstract = "Objectives: Anxiety is a risk factor for cardiovascular disease (CVD) and is associated with neurocognitive outcomes. The effect of anxiety on brain perfusion in a CVDpopulation 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.",

keywords = "anxiety, arterial spin labeling, cardiovascular disease, cerebral blood flow, cerebrovascular disease, cognitive function, magnetic resonance imaging, neuroimaging",

author = "Alosco, {Michael L.} and John Gunstad and Courtney Beard and Xiaomeng Xu and Clark, {Uraina S.} and Labbe, {Donald R.} and Jerskey, {Beth A.} and Maura Ladino and Cote, {Denise M.} and Walsh, {Edward G.} and Athena Poppas and Cohen, {Ronald A.} and Sweet, {Lawrence H.}",

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Alosco, ML, Gunstad, J, Beard, C, Xu, X, Clark, US, Labbe, DR, Jerskey, BA, Ladino, M, Cote, DM, Walsh, EG, Poppas, A, Cohen, RA & Sweet, LH 2015, 'The synergistic effects of anxiety and cerebral hypoperfusion on cognitive dysfunction in older adults with cardiovascular disease', Journal of Geriatric Psychiatry and Neurology, vol. 28, no. 1, pp. 57-66. https://doi.org/10.1177/0891988714541871

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AU - Gunstad, John

AU - Beard, Courtney

AU - Xu, Xiaomeng

AU - Clark, Uraina S.

AU - Labbe, Donald R.

AU - Jerskey, Beth A.

AU - Ladino, Maura

AU - Cote, Denise M.

AU - Walsh, Edward G.

AU - Poppas, Athena

AU - Cohen, Ronald A.

AU - Sweet, Lawrence H.

N1 - Publisher Copyright: © The Author(s) 2014.

PY - 2015/3/13

Y1 - 2015/3/13

N2 - Objectives: Anxiety is a risk factor for cardiovascular disease (CVD) and is associated with neurocognitive outcomes. The effect of anxiety on brain perfusion in a CVDpopulation 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.

AB - Objectives: Anxiety is a risk factor for cardiovascular disease (CVD) and is associated with neurocognitive outcomes. The effect of anxiety on brain perfusion in a CVDpopulation 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.

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The synergistic effects of anxiety and cerebral hypoperfusion on cognitive dysfunction in older adults with cardiovascular disease

Abstract

Keywords

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