Influence of depression, anxiety and stress on cognitive performance in community-dwelling older adults living in rural Ecuador: Results of the Atahualpa Project

To assess the relationship between cognitive status and self-reported symptoms of depression, anxiety and stress of older adults living in an underserved rural South American population. Methods: Community-dwelling Atahualpa residents aged ≥60years were identified during a door-to-door census, and evaluated with the Depression Anxiety Stress Scale-21 (DASS-21) and the Montreal Cognitive Assessment (MoCA). We explored whether positivity in each of the DASS-21 axes was related to total and domain-specific MoCA performance after adjustment for age, sex and education. Results: A total of 280 persons (59% women; mean age, mean age 70±8years) were included. Based on established cut-offs for the DASS-21, 12% persons had depression, 15% had anxiety and 5% had stress. Mean total MoCA scores were significantly lower for depressed than for not depressed individuals (15.9±5.5 vs 18.9±4.4, P<0.0001). Depressed participants had significantly lower total and domain-specific MoCA scores for abstraction, short-term memory and orientation. Anxiety was related to significantly lower total MoCA scores (17±4.7 vs 18.8±4.5, P=0.02), but not to differences in domain-specific MoCA scores. Stress was not associated with significant differences in MoCA scores. Conclusion: The present study suggests that depression and anxiety are associated with poorer cognitive performance in elderly residents living in rural areas of developing countries. Geriatr Gerontol Int 2015; 15: 508-514.