Does Anxiety Affect Risk of Dementia? Findings From the Caerphilly Prospective Study

Abstract

Anxiety is a risk factor for CIND and dementia. The extent to which the association is independent of depression and whether or not it is causal requires further study.

Anxiety disorders in older adults: a comprehensive review

“…Among individuals with both MCI and anxiety, the relative risk of developing AD almost doubled with each anxiety symptom, from 1.8 to 2.7 per symptom. Gallacher et al [147] examined men aged 48-67 with and without symptoms of anxiety but no detectable cognitive impairment, and reevaluated them again 17 years later. Among those with trait anxiety symptom scores at the 30th percentile and above, there was an elevated risk for developing ''cognitive impairment not dementia'' (CIND) as well as dementia, with risk increasing as anxiety score increased.…”

Anxiety in old age and dementia - implications for clinical and research practice

“…In view of the research evidence highlighted above, one might argue that as anxiety is a potentially treatable condition [69,[136][137][138][139], intervention may prove am important factor in the management of individuals living with cognitive impairment and dementia [2,62,75], with dissemination of information regarding late-life anxiety disorder vital as evidence-based treatments, pharmacological and psychotherapy, are available [43, [131][132][133][134][135][136][137][138][139][140][141]. There are however important caveats to consider.…”

“…Anxiety in general is associated with decreased cognitive functioning in older adulthood and increased risk of cognitive decline [35,36,51,62,[72][73][74][75][76]. Although there is some evidence of decreased performance in some components of cognition, including processing vision, attention, inhibition, sleep, health and depression…”

“…The relationship between anxiety and dementia is however both complex and controversial with overlap between the symptoms of anxiety and dementia and other behavioral and psychological problems such as agitation and depression [10,12,43,62,65,71,73,77,82,[86][87][88]. Although anxiety may increase the rate of conversion of MCI to Alzheimer's disease, be related to neuropathological status, associated with an increased risk of developing AD, and to influence cognitive impairment in MCI [19,47,62,68,73,74,87,89], directionality is complex [47,71,74,90]. For example, in some individuals, perceived change in cognition or a diagnosis of MCI or SCI, can promote anxiety, whereas others are more susceptible to both anxiety and cognitive impairment [12,65,68,70,79,82].…”

“…Research Andrea Tales of aetiology, type and theoretical approach, in practical, real life terms, a substantial body of research indicates that anxiety in older adults can be associated with considerable disease burden, poor outcome, detrimental impact upon daily living and quality of life, poor functional status and physical activity, poorer self-perceptions with regards to health, decreased life satisfaction, increased loneliness and service use, depression, urinary incontinence, sleep disturbance, unhealthy behaviors such as smoking, physical inactivity, poor diet and alcohol misuse [12,48,49], diabetes, stroke, cardiovascular disease, tachycardia, increased arousal and muscle tension, altered interoceptive prediction signals, enhanced sensitivity to new stimuli, impeded decision making skills, language and cognitive function, cognitive decline and dementia [2,9,24,26,38,41,42,45,47,[50][51][52][53][54][55][56][57][58][59][60][61][62]. Less well known are the effects of anxiety upon some of the more fundamental levels of information processing, as described in the following sections.…”