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

Year 2025, Volume: 15 Issue: 2, 247 - 253, 31.08.2025

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.

References

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  • 16. Harrewijn A, Cardinale EM, Groenewold NA, Bas-Hoogendam JM, Aghajani M, Hilbert K, et al. Cortical and subcortical brain structure in generalized anxiety disorder: findings from 28 research sites in the ENIGMA-Anxiety Working Group. Transl Psychiatry. 2021;11(1):502.
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  • 18. Thai M, Schreiner MW, Mueller BA, Cullen KR, KlimesDougan B. Coordination between frontolimbic resting state connectivity and hypothalamic-pituitary-adrenal axis functioning in adolescents with and without depression. Psychoneuroendocrinology. 2021;125:105123.
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  • 20. Bishop SJ. Trait anxiety and impoverished prefrontal control of attention. Nat Neurosci. 2009;12(1):92–8.
  • 21. Botto R, Callai N, Cermelli A, Causarano L, Rainero I. Anxiety and depression in Alzheimer’s disease: a systematic review of pathogenetic mechanisms and relation to cognitive decline. Neurol Sci. 2022;43(7):4107–4124.
  • 22. Altemus M, Sarvaiya N, Neill Epperson C. Sex differences in anxiety and depression clinical perspectives. Front Neuroendocrinol. 2014;35(3):320–30.
  • 23. McLean CP, Asnaani A, Litz BT, Hofmann SG. Gender differences in anxiety disorders: prevalence, course of illness, comorbidity and burden of illness. J Psychiatr Res. 2011;45(8):1027–35.
  • 24. Kheloui S, Jacmin-Park S, Larocque O, Kerr P, Rossi M, Cartier L, Juster RP. Sex/gender differences in cognitive abilities. Neurosci Biobehav Rev. 2023;152:105333.
  • 25. Bandelow B, Reitt M, Röver C, Michaelis S, Görlich Y, Wedekind D. Efficacy of treatments for anxiety disorders: a meta-analysis. Int Clin Psychopharmacol. 2015;30(4):183–92.
  • 26. Reynolds CF 3rd, Jeste DV, Sachdev PS, Blazer DG. Mental health care for older adults: recent advances and new directions in clinical practice and research. World Psychiatry. 2022;21(3):336–363

Year 2025, Volume: 15 Issue: 2, 247 - 253, 31.08.2025

Abstract

References

  • 1. Sanford, A. M. Mild cognitive impairment. Clin Geriatr Med. 2017;33:325–337.
  • 2. Gauthier S, Reisberg B, Zaudig M, Petersen RC, Ritchie K, Broich K, Belleville S, Brodaty H, Bennett DA, Chertkow H, et al. Mild Cognitive Impairment. Lancet 2006;367:1262–1270.
  • 3. Ganguli M, Dodge HH, Shen C, DeKosky ST. Mild cognitive impairment, amnestic type: an epidemiologic study. Neurology. 2004;63:115–121.
  • 4. Yavuz Veizi BG, Avci C, Yazir HT, et al. Prevalence and risk factors of mild cognitive impairment in a tertiary care setting in Turkey. Z Gerontol Geriat. 2024;57:113–119.
  • 5. Sachdev PS, Lipnicki DM, Kochan NA, Crawford J, Thalamuthu A, Andrews G, et al. The prevalence of mild cognitive impairment in diverse geographical and ethnocultural regions: the COSMIC collaboration. PLoS One. 2015;10:e0142388.
  • 6. Bruscoli M, Lovestone S. Is MCI really just early dementia? A systematic review of conversion studies. Int Psychogeriatr. 2004;16:129–140.
  • 7. Corbo I, et al. The protective role of cognitive reserve in mild cognitive impairment: A systematic review. Journal of Clinical Medicine. 2023;12(5):1759.
  • 8. Ma L. Depression, Anxiety, and Apathy in Mild Cognitive Impairment: Current Perspectives. Front Aging Neurosci. 2020;12:9.
  • 9. Yin, Jiamin, Amber John, and Dorina Cadar. “Bidirectional associations of depressive symptoms and cognitive function over time. ” JAMA Network Open. 2024;7(6):e2416305–e2416305.
  • 10. Zafar, Jawairia, et al. Loneliness may mediate the relationship between depression and the quality of life among elderly with mild cognitive impairment. Psychogeriatrics. 2021;21(5):805–812. of life in people with mild cognitive impairment and mild dementia: the mediating roles of depression and anxiety. American Journal of Alzheimer’s Disease & Other Dementias®. 2020;35:1533317519885264.
  • 12. Güngen C, Ertan T, Eker E, Yaşar R, Engin F. Standardize Mini Mental test’in türk toplumunda hafif demans tanisinda geçerlik ve güvenilirliği [Reliability and validity of the standardized Mini Mental State Examination in the diagnosis of mild dementia in Turkish population]. Turk Psikiyatri Derg. 2002;13(4):273–81. Turkish.
  • 13. Ozdilek B, Kenangil G. Validation of the Turkish Version of the Montreal Cognitive Assessment Scale (MoCA-TR) in patients with Parkinson’s disease. Clin Neuropsychol. 2014;28(2):333–43.
  • 14. Akdemir A, Türkçapar MH, Orsel SD, Demirergi N, Dag I, Ozbay MH. Reliability and validity of the Turkish version of the Hamilton Depression Rating Scale. Compr Psychiatry. 2001 Mar-Apr;42(2):161–5.
  • 15. Aydemir Ö, Kirpinar İ, Sati T, Uykur B, Cengisiz C. Reliability and Validity of the Turkish Version of the Health Anxiety Inventory. Noro Psikiyatr Ars. 2013;50(4):325–331.
  • 16. Harrewijn A, Cardinale EM, Groenewold NA, Bas-Hoogendam JM, Aghajani M, Hilbert K, et al. Cortical and subcortical brain structure in generalized anxiety disorder: findings from 28 research sites in the ENIGMA-Anxiety Working Group. Transl Psychiatry. 2021;11(1):502.
  • 17. Sylvester CM, Corbetta M, Raichle ME, Rodebaugh TL, Schlaggar BL, Sheline YI, Zorumski CF, Lenze EJ. Functional network dysfunction in anxiety and anxiety disorders. Trends Neurosci. 2012;35(9):527–35.
  • 18. Thai M, Schreiner MW, Mueller BA, Cullen KR, KlimesDougan B. Coordination between frontolimbic resting state connectivity and hypothalamic-pituitary-adrenal axis functioning in adolescents with and without depression. Psychoneuroendocrinology. 2021;125:105123.
  • 19. Etkin A, Wager TD. Functional neuroimaging of anxiety: a meta-analysis of emotional processing in PTSD, social anxiety disorder, and specific phobia. Am J Psychiatry. 2007;164(10):1476–88.
  • 20. Bishop SJ. Trait anxiety and impoverished prefrontal control of attention. Nat Neurosci. 2009;12(1):92–8.
  • 21. Botto R, Callai N, Cermelli A, Causarano L, Rainero I. Anxiety and depression in Alzheimer’s disease: a systematic review of pathogenetic mechanisms and relation to cognitive decline. Neurol Sci. 2022;43(7):4107–4124.
  • 22. Altemus M, Sarvaiya N, Neill Epperson C. Sex differences in anxiety and depression clinical perspectives. Front Neuroendocrinol. 2014;35(3):320–30.
  • 23. McLean CP, Asnaani A, Litz BT, Hofmann SG. Gender differences in anxiety disorders: prevalence, course of illness, comorbidity and burden of illness. J Psychiatr Res. 2011;45(8):1027–35.
  • 24. Kheloui S, Jacmin-Park S, Larocque O, Kerr P, Rossi M, Cartier L, Juster RP. Sex/gender differences in cognitive abilities. Neurosci Biobehav Rev. 2023;152:105333.
  • 25. Bandelow B, Reitt M, Röver C, Michaelis S, Görlich Y, Wedekind D. Efficacy of treatments for anxiety disorders: a meta-analysis. Int Clin Psychopharmacol. 2015;30(4):183–92.
  • 26. Reynolds CF 3rd, Jeste DV, Sachdev PS, Blazer DG. Mental health care for older adults: recent advances and new directions in clinical practice and research. World Psychiatry. 2022;21(3):336–363
There are 25 citations in total.

Details

Primary Language English
Subjects Clinical Sciences (Other)
Journal Section Research Article
Authors

Ceyhun Sayman

Uğur Aylak

Şeyda Çankaya This is me

Burak Yuluğ

Publication Date August 31, 2025
Submission Date March 13, 2025
Acceptance Date July 16, 2025
Published in Issue Year 2025 Volume: 15 Issue: 2

Cite

APA Sayman, C., Aylak, U., Çankaya, Ş., Yuluğ, B. (2025). Emotional Burdens and Cognitive Decline: the Role of Anxiety in Mild Cognitive Impairment. Kafkas Journal of Medical Sciences, 15(2), 247-253.
AMA Sayman C, Aylak U, Çankaya Ş, Yuluğ B. Emotional Burdens and Cognitive Decline: the Role of Anxiety in Mild Cognitive Impairment. Kafkas Journal of Medical Sciences. August 2025;15(2):247-253.
Chicago Sayman, Ceyhun, Uğur Aylak, Şeyda Çankaya, and Burak Yuluğ. “Emotional Burdens and Cognitive Decline: The Role of Anxiety in Mild Cognitive Impairment”. Kafkas Journal of Medical Sciences 15, no. 2 (August 2025): 247-53.
EndNote Sayman C, Aylak U, Çankaya Ş, Yuluğ B (August 1, 2025) Emotional Burdens and Cognitive Decline: the Role of Anxiety in Mild Cognitive Impairment. Kafkas Journal of Medical Sciences 15 2 247–253.
IEEE C. Sayman, U. Aylak, Ş. Çankaya, and B. Yuluğ, “Emotional Burdens and Cognitive Decline: the Role of Anxiety in Mild Cognitive Impairment”, Kafkas Journal of Medical Sciences, vol. 15, no. 2, pp. 247–253, 2025.
ISNAD Sayman, Ceyhun et al. “Emotional Burdens and Cognitive Decline: The Role of Anxiety in Mild Cognitive Impairment”. Kafkas Journal of Medical Sciences 15/2 (August2025), 247-253.
JAMA Sayman C, Aylak U, Çankaya Ş, Yuluğ B. Emotional Burdens and Cognitive Decline: the Role of Anxiety in Mild Cognitive Impairment. Kafkas Journal of Medical Sciences. 2025;15:247–253.
MLA Sayman, Ceyhun et al. “Emotional Burdens and Cognitive Decline: The Role of Anxiety in Mild Cognitive Impairment”. Kafkas Journal of Medical Sciences, vol. 15, no. 2, 2025, pp. 247-53.
Vancouver Sayman C, Aylak U, Çankaya Ş, Yuluğ B. Emotional Burdens and Cognitive Decline: the Role of Anxiety in Mild Cognitive Impairment. Kafkas Journal of Medical Sciences. 2025;15(2):247-53.