| Anxiety is a significant problem among the elderly, with prevalence rates ranging between 5% and 10%. Institutionalization and concomitant health problems have been identified as risk factors for developing anxiety. Prior research examining the role of anxiety in cognitively impaired older adults has yielded mixed results. A cognitive model by James (1999) suggests that as cognitive status decreases, anxiety and agitation increase, but this model has not yet been empirically evaluated. The present study aims to evaluate several hypotheses derived from James' (1999) cognitive model of anxiety in older adults with cognitive impairment.;The present study examined the relationships among subjective, cognitive, and physiological components of anxiety, cognitive status, agitation, depression, and health in a sample of 84 nursing home residents with mild cognitive impairment in order to evaluate James' (1999) cognitive conceptualization of anxiety. The strongest determinants of anxiety as measured by the full Beck Anxiety Inventory (BAI) were health variables. Anxious cognitions, self-reported anxiety, and physical health had no significant effect in predicting cognitive status.;Cognitive impairment was negatively related to physiological arousal on the Beck Anxiety Inventory, and unrelated to either cognitive or subjective indicators of anxiety. Anxiety was unrelated to behavioral ratings of agitation. The relationship between somatic anxiety and cognitive impairment was only true for females.;These findings do not support the model proposed by James (1999). They suggest that self-reported anxiety is explained by multiple factors in this frail population, and is difficult to separate from health problems and disability, particularly if measured exclusively by physiological arousal. For women, increasing cognitive impairment may limit the likelihood of reporting anxious arousal. The meaning of cognitive or subjective reports of anxiety in this population is unclear, as they appeared to be unrelated to any other factors except health problems. |
