Date of Award

Spring 3-21-2025

Document Type

Dissertation

Degree Name

Doctor of Philosophy in Clinical Psychology (PhD)

Department

Clinical Psychology

First Advisor/Committee Member

Amy Mezulis, Ph.D.

Second Advisor/Committee Member

Keyne C. Law, Ph.D.

Third Advisor/Committee Member

Erica Brandling-Bennett, Ph.D.

Abstract

Mild cognitive impairment (MCI) is an intermediary state between normal aging and dementia which is growing in prevalence in the older adult population. Trajectories for MCI are variable and can result in a variety of outcomes including a rescinding of the MCI diagnosis, progression to dementia, or a new state of cognition. The current study examined the impact of depression and anxiety on the cognitive domains of executive functioning and processing speed in MCI trajectories. Data was used from the National Alzheimer’s Coordinating Center’s Uniform Data Set and included a sample of 2886 participants with and MCI diagnosis. Hierarchical linear modeling procedures were conducted to examine the impact of depression and anxiety over time on executive functioning and processing speed over a 3 year period. Results indicated that increasing depression over time was significantly associated with declining executive functioning over time (t = 6.20, p < .001) and poorer processing speeds over time (t = -7.06, p< .001). Increasing anxiety over time was significantly associated with declining executive functioning over time (t = 3.06, p = .002) but was not associated with changes in processing speed over time (t = -1.15, p = .250). Additionally, individuals with greater increases in depression (B = 0.10, p = .010) and/or anxiety (B = 1.04, p = < .001) demonstrated a higher chance of progressing from MCI to dementia within the 3 years of the study. Results suggest that mental health factors including depression and anxiety may serve as unique predictors of cognitive decline and trajectories in MCI. Clinical implications, limitations, and future directions are discussed.

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