Sex differences on anxiety and depression in older adults and their relationship with cognitive impairment

Abstract

Introduction: Subjective memory complaints (SMCs) in elderly adults could express cognitive decline in the future. A consensus has been reached about how these SMC relate to mood variables, but further research is required to determine which socio-demographic, cognitive, functional and occupational factors will act as predictors in elderly adults.

Objetive: To analyze, through a descriptive observational study, the relationship between anxiety/depression and sex, age and occupation, with cognitive/functional performance in 367 older adults with SMC, but without objective cognitive impairment in a primary healthcare center.

Methods: The cognitive variables were measured by applying the Spanish version of Mini-Mental State Examination (MEC-35) and Set-test for verbal fluency. To measure functional level, the Barthel index and Lawton and Brody scales were employed. Physical occupational status and mental occupational status were measured based on three levels, low, medium and high, according to the American Occupational Therapy Association.

Results: Low educational and occupational physical and mental levels were related to anxiety and depression. In addition, differences by sex were found on anxiety and depression related to different factors. In men, anxiety was related to higher cognitive level, and in women to higher functional performance in IADLs. On the contrary, depression in men was related to lower cognitive level and higher performance in ADLs.

Conclusions: It is important to maintain a sex-gender perspective on the study of anxiety and depression in elderly, taking into account social roles and the traints of the work environment, in order to avoid cognitive and functional impairment.

Keywords: Aging; Cognitive impairment; Cognitive mini-exam; Deterioro cognitivo; Envejecimiento; Mental health; Mental occupation; Mini examen cognitivo; Occupational therapy; Ocupación física; Ocupación mental; Physical occupation; Salud mental; Terapia ocupacional.