Emotional Burdens and Cognitive Decline: the Role of Anxiety in Mild Cognitive Impairment

Abstract

Aim: This study investigates the complex interactions between mild cognitive impairment (MCI), depression, and anxiety, focusing on how these factors affect cognitive function and progression risks. The goal is to inform early diagnostic strategies and targeted therapeutic interventions in individuals with MCI Matherial and Methods: This prospective study included 45 patients diagnosed with MCI (mean age: 66.1±7.7 years; 23 males [51%], 22 females [49%]) at a neurology outpatient clinic. Sociodemographic data, including education level and medical history, were collected. Cognitive and psychiatric assessments were conducted using the Montreal Cognitive Assessment (MoCA), Standardized Mini-Mental State Examination (SMMT), Hamilton Depression Rating Scale (HDRS), and Hamilton Anxiety Scale (HAS). Stratification was done according to anxiety severity, and comparisons were made across these groups on the cognitive performances. Results: Anxiety levels were significantly higher in females than males (p=0.001). While global MoCA and SMMT scores did not differ significantly by gender, males showed significantly better performance in verbal fluency (p=0.025) and a trend in abstract thinking (p=0.057). A significant decline in MoCA total scores was observed with increasing anxiety severity (p=0.024), with verbal fluency (p=0.011), abstract thinking (p=0.005), and attention (p=0.050) notably affected in the severe anxiety group. Conclusions: This study highlights anxiety as a key modifiable risk factor for cognitive impairment in MCI, with domain-specific deficits in executive function. Unlike depression, anxiety showed a stronger correlation with cognitive decline. These findings suggest that early identification and targeted treatment of anxiety in MCI could help delay progression to dementia and improve clinical outcomes.

Keywords

• mild cognitive impairment
• anxiety
• depression
• Montreal cognitive assessment; cognitive decline

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