Association between anxious-depression and cognitive function in community-dwelling older adults: a latent class analysis

BACKGROUND: Anxiety and depression commonly coexist in later life, yet little is known about the heterogeneous manifestations of anxious-depression symptoms and their cognitive correlates among community-dwelling older adults in China. The purpose of this study is to identify heterogeneous anxious-depression symptom profiles and examine their associations with cognitive function among community-dwelling older adults in China. METHODS: A total of 5,116 community-dwelling older adults aged ≥60 years were surveyed. Anxiety and depressive symptoms were assessed using the 7-item Generalized Anxiety Disorder Scale and the 15-item Geriatric Depression Scale, with latent class analysis (LCA) used to identify anxious-depression symptom patterns. Cognitive function was assessed using the brief Community Screening Inventory for Dementia. Multivariable linear regression analyses were performed to examine the associations between anxious-depression phenotypes and cognitive function. RESULTS: LCA identified four anxious-depression symptom profiles: high anxious-depression (7.41%), moderate anxious-depression (8.64%), high depression (13.94%), and low anxious-depression (70.01%). After adjusting for covariates, both anxious-depression and depression-dominant phenotypes were significantly linked to lower cognitive function scores (all p < 0.001). Individuals with comorbid anxiety and depression showed greater cognitive decline compared to those with predominantly depressive symptoms, with the high anxious-depression group exhibiting the most pronounced reduction in cognitive scores (p < 0.001). CONCLUSION: Distinct anxious-depression symptom subtypes were identified among community-dwelling older adults. The more pronounced the anxiety and depression symptoms, the poorer the cognitive function. These findings underscore the importance of addressing anxiety and depression in community-based cognitive screening and prevention programs.