# Functional Neuroanatomy Correlates of Worry in Older Adults

> **NIH NIH R01** · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · 2020 · $380,611

## Abstract

Severe worry, a transdiagnostic symptom particularly pernicious for the health of older adults, is associated
with increased risk of conversion from mild cognitive impairment to Alzheimer's disease, and with increased
risk of stroke and other cardiovascular events. Severe worry, defined as intense, uncontrollable worry
associated with interruption in functioning and reduced quality of life, is surprisingly prevalent in the community,
with 20% of older adults reporting severe worry. While there are no studies regarding the lifespan incidence of
severe worry, we can draw inferences based on the incidence of Generalized Anxiety Disorder (GAD), for
which up to half of the cases are late-onset. These data suggest a particularly heavy burden of severe worry
loaded in the second half of life, pointing toward an increasing role for the neuropathologic changes of aging.
Identifying neural mechanisms for late-life worry is a crucial step for understanding why worry crops up in the
latter part of life, and for eventually improving treatment. Our team has made significant headway in this
regard. Through her K23 award, which was focused on the neuroanatomy of late-life GAD, the PI has shown
that neural markers of worry differ across ages. Preliminary results indicate that older worriers have impaired
functional connectivity both at rest and during worry reappraisal. In addition to documenting age-related brain
pathology, our preliminary findings may explain why current treatment choices, such as cognitive-behavioral
therapy, which relies on worry reappraisal to interrupt the worry loop, have proven less effective in reducing
worry severity in older adults and may actually be counterproductive. However, the examination of the neural
architecture underlying worry has garnered relatively little attention, especially with regard to the mechanism
underlying essential processes such as worry induction and reappraisal. This project will test a mechanistic
model anchored in systems neuroscience and aimed at characterizing the functional neuroanatomy of severe
worry in older adults. We focus on the roles of three canonical brain networks: 1) the network subserving the
“resting” state, a time when many worriers would worry naturally [the Default Mode], 2) the network involved in
the detection of environmentally salient, often threatening information, ideally allowing us to anchor the neural
features of worry in the RDoC's threat reactivity categories [the Salience Network], and 3) the network active
during cognitive efforts to reappraise worry [the Executive Control]. We will characterize the specificity of this
model for aging, by testing the moderating effect of brain aging, as measured by white matter disease. The
phenomenological layout of worry from everyday reactions to stress to anxious perseveration, together with the
distribution of worry across various disorders, makes this investigation fit ideally within the RDoC framework.
We plan to recruit a stratified s...

## Key facts

- **NIH application ID:** 9970531
- **Project number:** 5R01MH108509-05
- **Recipient organization:** UNIVERSITY OF PITTSBURGH AT PITTSBURGH
- **Principal Investigator:** Carmen Andreescu
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $380,611
- **Award type:** 5
- **Project period:** 2016-09-20 → 2022-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9970531

## Citation

> US National Institutes of Health, RePORTER application 9970531, Functional Neuroanatomy Correlates of Worry in Older Adults (5R01MH108509-05). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/9970531. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*