Anxiety, Anxiety Symptoms, and Their Correlates in Persons with Dementia in Norwegian Nursing Homes: A Cause for Concern

Abstract

Background/Aims: Little is known about anxiety and its associations among persons with dementia in nursing homes. This study aims to examine anxiety, anxiety symptoms, and their correlates in persons with dementia in Norwegian nursing homes. Methods: In all, 298 participants with dementia ≥65 years old from 17 nursing homes were assessed with a validated Norwegian version of the Rating Anxiety in Dementia scale (RAID-N). Associations between anxiety (RAID-N score) and demographic and clinical characteristics were analyzed with linear regression models. Results: Anxiety, according to a cutoff of ≥12 on the RAID-N, was found in 34.2% (n = 102) of the participants. Irritability (59.7%) and restlessness (53.0%) were the most frequent anxiety symptoms. The participants' general physical health, a wide range of neuropsychiatric symptoms, and anxiolytic use were significant correlates of higher RAID-N scores. Conclusion: Knowledge about anxiety, anxiety symptoms, and their correlates may enhance early detection of anxiety and planning of necessary treatment and proactive measures among this population residing in nursing homes.

Norwegian version of the rating anxiety in dementia scale (RAID-N): a validity and reliability study

“…Assessing clinically significant depression with a cut-off score of > 10 on the Geriatric depression scale (GDS) (Yesavage et al, 1982), a longitudinal study of a Dutch nursing home reported the prevalence of clinically significant depression to be 41% at baseline and 30% at 6-month follow-up, with an incidence of 5% and a persistence rate of 63% at 6-month followup. The authors found that the persistence of depression symptoms was more frequent in patients with higher GDS scores (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30) at baseline compared to those with lower GDS scores (Smalbrugge et al, 2006). This observation is in line with study III of this thesis, which shows a high persistence (55%) of clinically significant depression (CSDD score ≥ 10).…”

“…It is well known that anxiety and depression are highly prevalent among nursing home residents with dementia, and that these affect their self-rated QoL [4,[18][19][20], but the association between anxiety and depression and proxy-rated QoL of PWD has been ambiguous [4]. A systematic review indicates that dementia-specific depression scales, such as the Cornell Scale of Depression in Dementia (CSDD) [21], have been used in research studies on QoL of PWD [4,7].…”

“…The questionnaire has 12 items assessing NPS severity, and the score ranges between zero and 36, with a higher score representing more severe NPS [33]. The 12 items of NPI-Q were grouped into four distinct sub-syndromes based on a factor analysis derived from the baseline study sample: psychosis (delusions and hallucinations), affective (dysphoria, anxiety, apathy, and appetite), agitation (agitation, irritability, disinhibition, and aberrant motor) and aroused (euphoria and nighttime disturbances) [18].…”

Prevalence, Recognition, and Treatment of Dementia in Assisted Living Facilities

“…Other frequently accompanied neuropsychiatric conditions including anxiety, depression, and irritability are also underdiagnosed and undertreated in ALF. The most recent study from Norway found that 34.2% of participants with dementia also suffered from anxiety and 59.8% suffered from irritability or restlessness [9]. These findings suggest a vulnerable population with a high burden of functional and cognitive impairment.…”

People with dementia attending farm‐based day care in Norway – Individual and farm characteristics associated with participants’ quality of life

“…Anxiety was assessed by the Rating Anxiety in Dementia‐Norwegian version (RAID‐N) (Goyal, Bergh, Engedal, Kirkevold, & Kirkevold, ; Shankar, Walker, Frost, & Orrell, ). The scale consists of 18 statements that measure anxiety with a score range between 0 and 54.…”