Association of Anxiety and Depression With Microtubule-Associated Protein 2– and Synaptopodin-Immunolabeled Dendrite and Spine Densities in Hippocampal CA3 of Older Humans

Abstract
Chronic psychological distress has harmful effects on many of the body's physiological systems, including the cardiovascular, endocrine, immune, and central nervous systems.1-4 Anxiety, depression, and other negative emotional states have been associated with increased risk of hypertension, diabetes mellitus, myocardial infarction, stroke, infection, and cancer, along with mortality due to all causes.5 It has long been recognized that psychological distress also has deleterious effects on cognition. In humans and experimental animal models, distress is associated with impairments in learning, memory, attention, executive functions, and other aspects of cognition. Furthermore, our group and others have reported that conditions of chronic psychological distress increase the risk of developing Alzheimer disease (AD)–like dementias in late life.4,6-15 A history of major depression increases risk of clinical AD 2- to 3-fold, whereas longitudinal studies of aging persons without psychiatric illness have found that those who tend to experience more psychological distress in their day-to-day lives are at increased risk of incident mild cognitive impairment and clinical AD and have an accelerated rate of cognitive decline compared with those who experience lower degrees of distress.8,12

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