Elevated Anxious and Depressed Mood Relates to Future Executive Dysfunction in Older Adults: A Longitudinal Network Analysis of Psychopathology and Cognitive Functioning

Abstract

Vulnerability models posit that executive functioning (EF) problems centrally impact future common (vs. rare) psychopathology symptoms. Conversely, scar theory postulates that depression/anxiety (vs. other psychopathology) symptoms centrally influence reduced EF. However, most studies so far have been cross-sectional. We used cross-lagged panel network analysis to determine temporal and component-to-component relations on this topic. Community older adults participated across four time-points. Cognitive tests and the caregiver-rated Neuropsychiatric Inventory assessed nine psychopathology and eight cognitive functioning nodes. Nodes with the highest bridge expected influence cross-sectionally were agitation and episodic memory. Episodic memory had the strongest inverse relation with age. Agitation had the strongest negative association with global cognition. EF nodes tended to be centrally impacted by prior depressed and anxious moods rather than influential on any future nodes. Heightened anxious and depressed mood (vs. other nodes) centrally predicted future decreased EF-related (vs. non-EF-related) nodes in older adults, supporting scar (vs. vulnerability) theory.

Keywords: anxiety; cross-lagged panel network; executive function; network analysis; psychopathology.

Figure 1

Contemporaneous Network Across Waves 1 to 4 Note. ABR = aberrant motor behaviors; ANX = anxiety; APY = apathy; AT = attention; BNT = Boston naming test (language); DYS = depressed mood; DSH = disinhibition; DLS = delusions; EM = episodic memory; GC = global cognition; HLC = hallucinations; IRT = irritability; PS = processing speed; WM = working memory; VF = phonemic verbal fluency; SF = semantic verbal fluency. The cognitive functioning community is represented by the white nodes. The psychopathology community is indicated by the grey nodes. The black node signifies the age covariate. Black or grey bold lines represent positive non-zero estimated edges. Grey dotted lines indicate negative non-zero estimated edges. Thicker and bolder lines denote stronger relations.

Figure 2

Temporal Network Across Waves 1 to 4 Note. ABR = aberrant motor behaviors; ANX = anxiety; APY = apathy; AT = attention; BNT = Boston naming test (language); DYS = depressed mood; DSH = disinhibition; DLS = delusions; EM = episodic memory; GC = global cognition; HLC = hallucinations; IRT = irritability; PS = processing speed; WM = working memory; VF = phonemic verbal fluency; SF = semantic verbal fluency. The cognitive functioning community is represented by the black nodes. The psychopathology community is indicated by the white nodes. The grey node signifies the age covariate. Arrow thickness and boldness indicates strength of association and line type communicates sign of the effect (black/grey bold line marks positive non-zero estimated edges/node relations, whereas grey dotted line marks negative non-zero estimated edges/node relations).

Figure 3

In-Strength (or Predictability) Centrality Indices for Temporal Networks Across Waves 1 to 4 Note. ABR = aberrant motor behaviors; ANX = anxiety; APY = apathy; AT = attention; BNT = Boston naming test (language); DYS = depressed mood; DSH = disinhibition; DLS = delusions; EM = episodic memory; GC = global cognition; HLC = hallucinations; IRT = irritability; PS = processing speed; WM = working memory; VF = verbal phonemic fluency; SF = semantic fluency. Black bars signify cognitive functioning nodes. White bars denote psychopathology nodes.

Figure 4

Out-Strength (or Influence) Centrality Indices for Temporal Networks Across Waves 1 to 4 Note. ABR = aberrant motor behaviors; ANX = anxiety; APY = apathy; AT = attention; BNT = Boston naming test (language); DYS = depressed mood; DSH = disinhibition; DLS = delusions; EM = episodic memory; GC = global cognition; HLC = hallucinations; IRT = irritability; PS = processing speed; WM = working memory; VF = verbal phonemic fluency; SF = semantic fluency. Black bars signify cognitive functioning nodes. White bars denote psychopathology nodes.