Anxiety in older adults with dementia residing in long-term care facilities.

Nonpharmacological Interventions for Anxiety and Dementia in Nursing Homes: A Systematic Review

“…However, the latest Cochrane systematic review of psychotherapeutic interventions found no difference in self-rated or carer-rated anxiety with none of the included studies examining people with dementia living in nursing homes (Orgeta et al, 2014). An examination of the relationship between depression, anxiety, and agitation in one facility in the United States for a doctoral thesis suggests that significant relationships exist between these three conditions, with a history of anxiety being a significant predictor of current anxiety in the nursing home (Hess, 2012). Hess (2012) concluded that it is not always possible to separate anxiety from other issues such as agitation and depression and that this might contribute to a more global construct of distress in the person with dementia living in nursing homes.…”

“…An examination of the relationship between depression, anxiety, and agitation in one facility in the United States for a doctoral thesis suggests that significant relationships exist between these three conditions, with a history of anxiety being a significant predictor of current anxiety in the nursing home (Hess, 2012). Hess (2012) concluded that it is not always possible to separate anxiety from other issues such as agitation and depression and that this might contribute to a more global construct of distress in the person with dementia living in nursing homes. This may account for the dearth of studies considering anxiety as the primary outcome for people living with dementia in nursing homes.…”

“…There were only two studies that identified participants with clinical anxiety in advance of the intervention (Cooke et al, 2010; Guetin et al, 2009). This suggests a need for a more systematic screening of anxiety in nursing home populations, particularly with dementia (Hess et al, 2012) with interventions implemented when assessed symptoms are more prevalent (Cooke et al, 2010).…”

“…Little is known about the experience of people with dementia living with anxiety as a comorbid condition in nursing homes as anxiety in adults living with dementia is often unrecognized by clinicians and so remains untreated. Many older adults with anxiety report having had anxiety throughout their lives, suggesting that older adults with dementia who have a history of anxiety may continue to experience anxiety as their dementia progresses (Hess, 2012). However, there was a dearth of studies that considered anxiety as a primary outcome or identified if participants had clinical anxiety at baseline.…”