The Relationship Between Depression and Anxiety in Older Adults and Memory Functionality: An Assessment Using Neuropsychological Tests

Yıl 2025, Cilt: 22 Sayı: 5, 1121 - 1132, 30.09.2025

Ayşe Hazal Dündar , Ali Yasin Kafes

https://doi.org/10.26466/opusjsr.1693428

Öz

This research evaluates memory function, depression and anxiety symptoms in elderly individuals and examines the relationship between these variables. The Digit Span Test and the 10/36 Spatial Recall Test were used to evaluate memory function, and the Depression, Anxiety and Stress Scale-21 was used to evaluate mental health. Participants were reached through Healthy Ageing and Support Centres, Public Education Courses and an easily accessible sampling method. Participants were included in the research based on inclusion and exclusion criteria. The tests and questionnaires were administered by a clinical psychologist and a clinical neuropsychologist. The study sample consisted of 160 volunteer participants aged between 66 and 74. The average age of the participants was M= 68.00 (SD=2.31). The correlation analysis revealed that increasing levels of depression and anxiety were associated with decreasing memory performance. In gender comparisons, while there was no significant difference between female participants and male participants in terms of memory functionality, it was determined that female participants had higher levels of depression and anxiety than male participants. The findings of the research draw attention to the relationship between mental health and cognitive functionality. In conclusion, managing depression and anxiety in older adults is critical for preserving cognitive function. In this regard, multidisciplinary approaches are needed to develop strategies that support both the cognitive and mental health of older adults.

Anahtar Kelimeler

older adults , memory functioning , clinical neuropsychology/neuropsychological assess-ment , mental health

Yaşlı Bireylerde Depresyon ve Anksiyetenin Bellek İşlevselliği ile İlişkisi: Nöropsikolojik Testler ile Bir Değerlendirme

Öz

Bu çalışma, yaşlı bireylerde bellek işlevselliği, depresyon ve anksiyete belirtilerini değerlendirmekte olup bu değişkenler arasındaki ilişkiyi incelemektedir. Çalışmada, bellek işlevselliğini değerlendirmek için Sayı Dizisi Testi ve 10/36 Uzamsal Geri Çağırma Testi, ruh sağlığını değerlendirmek için Depresyon, Anksiyete ve Stres Ölçeği-21 kullanılmıştır. Katılımcılara, Sağlıklı Yaş Alma ve Dayanışma Merkezleri, Halk Eğitim Kursları ve kolay ulaşılabilir örneklem yöntemi ile ulaşılmıştır. Dahil olma ve dışlama kriterleri dikkate alınarak bireyler çalışmaya dahil edilmiştir. Test ve anketler, klinik psikolog ve klinik nöropsikolog tarafından uygulanmıştır. Araştırmanın örneklemi, 66 ile 74 yaş arası 160 gönüllü katılımcıdır. Katılımcıların yaş ortalaması M= 68.00 (SS=2.31)’dir. Yapılan korelasyon analizi sonucu, artan depresyon ve anksiyete düzeylerinin azalan bellek performansı ile ilişkili olduğu bulunmuştur. Cinsiyetler arası karşılaştırmalarda, bellek işlevselliği açısından kadınlar ve erkekler arasında anlamlı bir fark bulunmazken, kadınların erkeklere kıyasla daha yüksek depresyon ve anksiyete düzeylerine sahip olduğu belirlenmiştir. Çalışmanın bulguları, ruh sağlığı ile bilişsel işlevsellik arasındaki ilişkiye dikkat çekmektedir. Sonuç olarak, yaşlılık döneminde depresyon ve anksiyetenin yönetilmesi, bilişsel işlevlerin korunması açısından kritik bir öneme sahiptir. Bu doğrultuda, multidisipliner yaklaşımlar ile yaşlı bireylerin hem bilişsel hem de ruhsal sağlıklarını destekleyici stratejiler geliştirilmesi gerekmektedir.

Anahtar Kelimeler

yaşlı bireyler , bellek işlevselliği , klinik nöropsikoloji/nöropsikolojik değerlendirme , ruh sağlığı.

Kaynakça

• Asperholm, M., Hijazi, R. A., Holmes, J., & Rönnlund, M. (2019). The magnitude of sex differences in verbal episodic memory increases with social progress: Data from 54 countries across 40 years. Psychological Science, 30(9), 1343-1357.
• Balash, Y., Mordechovich, M., Shabtai, H., Giladi, N., Gurevich, T., & Korczyn, A. D. (2013). Subjective memory complaints in elders: Depression, anxiety, or cognitive decline? Acta Neurologica Scandinavica, 127(5), 344-350.
• Bangasser, D. A., & Valentino, R. J. (2014). Sex differences in stress-related psychiatric disorders: Neurobiological perspectives. Frontiers in Neuroendocrinology, 35(3), 303-319.
• Barker, M. J., Greenwood, K. M., Jackson, M., & Crowe, S. F. (2004). Persistence of cognitive effects after withdrawal from long-term benzodiazepine use: a meta-analysis. Archives of Clinical Neuropsychology, 19(3), 437–454. https://doi.org/10.1016/S0887-6177(03)00096-9
• Beaudreau, S. A., & O'Hara, R. (2009). The association of anxiety and depressive symptoms with cognitive performance in communitydwelling older adults. Psychology and Aging, 24(2), 507.
• Benedict, R.H.B. (1997). Brief visuospatial memory test – revised: Professional manual. Odessa, FL: Psychological Assessment Resources.
• Boringa JB, Lazeron RH, Reuling IE, Ader HJ, Pfennings L, Lindeboom J, de Sonneville LM, Kalkers NF, Polman CH. (2001). The briefrepeatable battery of neuropsychological tests: normative values allow application in multiple sclerosis clinical practice. Mult Scler; 7, 263-267.
• Butters, M. A., Young, J. B., Lopez, O., Aizenstein, H. J., Mulsant, B. H., Reynolds, C. F., & Becker, J. T. (2004). Pathways linking late-life depression to persistent cognitive impairment and dementia. Dialogues in Clinical Neuroscience, 6(2), 143-157.
• Cacioppo, J. T., & Hawkley, L. C. (2009). Perceived social isolation and cognition. Trends in Cognitive Sciences, 13(10), 447-454.
• Campbell, N. L., Boustani, M. A., Lane, K. A., et al. (2009). Use of anticholinergics and the risk of cognitive impairment in an African American population. Neurology, 72(2), 115–120. https://doi.org/10.1212/01.wnl.0000339037.05215.2f
• Çökmüş, F., & Atabek, G. (2007). Okuryazarlık düzeyinin nöropsikolojik test performansına etkisi. Türk Psikoloji Dergisi, 22(60), 61–74.
• Colcombe, S., & Kramer, A. F. (2003). Fitness effects on the cognitive function of older adults: A meta-analytic study. Psychological Science, 14(2), 125-130.
• Craik, F. I., & Bialystok, E. (2006). Cognition through the lifespan: Mechanisms of change. Trends in Cognitive Sciences, 10(3), 131 138.
• Erickson, K. I., Voss, M. W., Prakash, R. S., Basak, C., Szabo, A., Chaddock, L., ... & Kramer, A. F. (2011). Exercise training increases size of hippocampus and improves memory. Proceedings of the National Academy of Sciences, 108(7), 3017-3022.
• Eysenck, M. W., Derakshan, N., Santos, R., & Calvo, M. G. (2007). Anxiety and cognitive performance: Attentional control theory. Emotion, 7(2), 336.
• Ferreira, D., Nordberg, A., Westman, E., & Wahlund, L. O. (2017). Biological subtypes of Alzheimer disease: A systematic review and meta-analysis. Neurology, 88(24), 2189-2196.
• Geda, Y. E., Roberts, R. O., Knopman, D. S., et al. (2006). Depression, apolipoprotein E genotype, and the incidence of mild cognitive impairment. Archives of Neurology, 63(3), 435-440.
• Green, M. F., Kern, R. S., Braff, D. L., & Mintz, J. (2000). Neurocognitive deficits and functional outcome in schizophrenia: are we measuring the “right stuff”? Schizophrenia Bulletin, 26(1), 119–136.
• Gulpers, B., Ramakers, I., Hamel, R., Köhler, S., Voshaar, R. C., & Verhey, F. (2016). Anxiety as a predictor for cognitive decline and dementia: A systematic review and meta‐analysis. American Journal of Geriatric Psychiatry, 24(10), 823-842.
• Haslam, C., Cruwys, T., & Haslam, S. A. (2014). "The we’s have it": Evidence for the distinctive benefits of group engagement in enhancing cognitive health in aging. Social Science & Medicine, 120, 57-66.
• Hertzog, C., Kramer, A. F., Wilson, R. S., & Lindenberger, U. (2008). Enrichment effects on adult cognitive development: Can the functional capacity of older adults be preserved and enhanced? Psychological Science in the Public Interest, 9(1), 1-65.
• Karakaş S, Eski R, Başar E. (1996). Türk Kültürü için standardizasyonu yapılmış nöropsikolojik testler topluluğu: BİLNOT Bataryası. 32. Ulusal Nöroloji Kongresi. Kongre Kitabı, İstanbul, Ufuk Matbaası, s.43-70.
• Killgore, W. D. S. (2010). Effects of sleep deprivation on cognition. Progress in Brain Research, 185, 105–129. https://doi.org/10.1016/B978-0-444-53702-7.00007-5
• Kramer, A. F., Erickson, K. I., & Colcombe, S. J. (2004). Exercise, cognition, and the aging brain. Journal of Applied Physiology, 96(4), 1345 1352.
• Lenze, E. J., Hickman, S., Hershey, T., Wendleton, L., Ly, K., Dixon, D., ... & Wetherell, J. L. (2014). Mindfulness‐based stress reduction for older adults with worry symptoms and co‐occurring cognitive dysfunction. International Journal of Geriatric Psychiatry, 29(10), 991-1000.
• Lezak, M.D., et al. (2012). Neuropsychological Assessment (5th Ed.).
• Lindenberger, U. (2014). Human cognitive aging: Corriger la fortune? Science, 346(6209), 572-578.
• Lovibond, P. F., & Lovibond, S. H. (1995). The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behaviour research and therapy, 33(3), 335-343.
• Manly, J. J., Touradji, P., Tang, M. X., & Stern, Y. (1999). Literacy and cognitive change among ethnically diverse elders. International Journal of Psychology, 34(2), 119–135.
• Mascherek, A., Werkle, N., Göritz, A. S., & Kühn, S. (2020). Lifestyle variables do not predict subjective memory performance over and above depression and anxiety. Frontiers in Psychology, 11, 484.
• McCarrey, A. C., An, Y., Kitner-Triolo, M. H., Ferrucci, L., Resnick, S. M., & Zonderman, A. B. (2016). Sex differences in cognitive trajectories in clinically normal older adults. Psychology and Aging, 31(2), 166.
• McDaniel, M. A., Einstein, G. O., & Jacoby, L. L. (2008). New considerations in aging and memory: The glass is half full. Current Directions in Psychological Science, 17(5), 284-287.
• McLean, C. P., Asnaani, A., Litz, B. T., & Hofmann, S. G. (2011). Gender differences in anxiety disorders: Prevalence, course of illness, comorbidity and burden of illness. Journal of Psychiatric Research, 45(8), 1027-1035.
• McLaren, M. E., Szymkowicz, S. M., Kirton, J. W., Dotson, V. M. (2015). Impact of education on memory deficits in subclinical depression. Archives of Clinical Neuropsychology, 30(5), 387–393.
• Mesholam-Gately, R. I., Giuliano, A. J., Goff, K. P., Faraone, S. V., & Seidman, L. J. (2009). Neurocognition in first-episode schizophrenia: A meta-analytic review. Neuropsychology, 23(3), 315–336.
• Nebes, R. D., Butters, M. A., Mulsant, B. H., et al. (2000). Decreased working memory and processing speed mediate cognitive impairment in geriatric depression. Psychological Medicine, 30(3), 679–691.
• Ngandu, T., Lehtisalo, J., Solomon, A., Ahtiluoto, S., et al. (2015). A 2-year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people. The Lancet, 385(9984), 2255-2263.
• Nyberg, L., Lövdén, M., Riklund, K., Lindenberger, U., & Bäckman, L. (2012). Memory aging and brain maintenance. Trends in Cognitive Sciences, 16(5), 292-305.
• Oscar-Berman, M., & Marinkovic, K. (2007). Alcohol: Effects on neurobehavioral functions and the brain. Neuropsychology Review, 17(3), 239–257. https://doi.org/10.1007/s11065-007-9038-6
• Ownby, R. L., Crocco, E., Acevedo, A., John, V., & Loewenstein, D. (2006). Depression and risk for Alzheimer disease. Archives of General Psychiatry, 63(5), 530-538.
• Park, D. C., & Reuter-Lorenz, P. (2009). The adaptive brain: Aging and neurocognitive scaffolding. Annual Review of Psychology, 60, 173-196.
• Ritchie, S. J., Tucker-Drob, E. M., Cox, S. R., Corley, J., Dykiert, D., Redmond, P., & Deary, I. J. (2018). Risk and protective factors for structural brain ageing in the eighth decade of life. Brain Structure and Function, 223(6), 2513-2525.
• Salthouse, T. A. (2010). Major issues in cognitive aging. Oxford University Press.
• Sapolsky, R. M. (2000). Glucocorticoids and hippocampal atrophy in neuropsychiatric disorders. Archives of General Psychiatry, 57(10), 925-935.
• Sarıçam, H. (2018). The psychometric properties of Turkish version of Depression Anxiety Stress Scale-21 (DASS-21) in health control and clinical samples. Journal of Cognitive Behavioral Psychotherapies and Research; 7(1), 19.
• Sheline, Y. I., Barch, D. M., Garcia, K., Gersing, K., Pieper, C., Welsh Bohmer, K., ... & Doraiswamy, P. M. (2003). Cognitive function in late life depression: Relationships to depression severity, cerebrovascular risk factors, and processing speed. Biological Psychiatry, 54(3), 262-269.
• Stern, Y. (2009). Cognitive reserve. Neuropsychologia, 47(10), 2015-2028.
• Tabachnick, B.G., & Fidell, L.S. (2013). Using Multivariate Statistics. Pearson.
• Valenzuela, M. J., & Sachdev, P. (2009). Can cognitive exercise prevent the onset of dementia? Systematic review of randomized clinical trials with longitudinal follow‐up. American Journal of Geriatric Psychiatry, 17(3), 179-187.
• Verdejo-García, A., Pérez-García, M., & Bechara, A. (2004). Impulsivity, decision-making and executive function in polysubstance abusers in comparison to alcoholics and controls. Drug and Alcohol Dependence, 73(2), 193–202. https://doi.org/10.1016/j.drugalcdep.2003.10.003.
• Wechsler, D. (2008). WAIS-IV: Wechsler Adult Intelligence Scale–Fourth Edition. San Antonio, TX: NCS Pearson.
• Voss, M. W., Nagamatsu, L. S., Liu‐Ambrose, T., & Kramer, A. F. (2013). Exercise, brain, and cognition across the life span. Journal of Applied Physiology, 111(5), 1505-1513.
• Weber, M. T., Mapstone, M., Staskiewicz, J., & Maki, P. M. (2014). Reconciling subjective memory complaints with objective memory performance in the menopausal transition. Menopause, 21(5), 1-8.
• Yaffe, K., Blackwell, T., Gore, R., Sands, L., Reus, V., & Browner, W. S. (2010). Depressive symptoms and cognitive decline in, nondemented elderly women. Archives of General Psychiatry, 56(5), 425-430.