Anxiety’s Impact on Dementia

Researchers evaluated the longitudinal association between the risk of all-cause dementia (a progressive cognitive decline that affects memory and reasoning) and anxiety, including chronic, resolved, and new onset anxiety, in a recent study that was published in the Journal of the American Geriatrics Society.

Context
In 2020, there were more than 55 million dementia sufferers worldwide; by 2030, that figure is expected to increase to 78 million, and by 2050, to 139 million. Dementia is expected to cost the world $1.3 trillion in 2019 and $2.8 trillion by 2050, according to estimates.

In 2020, dementia ranked second in high-income countries and the sixth leading cause of death globally. The focus of dementia preventive initiatives is on modifiable risk factors, such as anxiety, due to the growing social and economic burden of dementia.

To create focused preventative treatments, more research is required to elucidate the relationship between the timing and chronicity of anxiety and the risk of dementia.

About the study
Longitudinal Hunter Community Study (HCS) data were used in this investigation. Between December 2004 and December 2007, participants from Newcastle, Australia’s New South Wales (NSW), ages 55 to 85, were recruited at random.

There were 2132 individuals after non-English speakers, residents of assisted living facilities, those with baseline dementia, and people with missing data were excluded.

At baseline, questionnaires were used to gather demographic and health information, including information on alcohol consumption, smoking, hypertension (chronic high blood pressure), diabetes (high blood sugar), cardiovascular disease (high blood sugar), and cerebrovascular disease (disorders affecting blood flow to the brain).

The Center for Epidemiologic Studies Depression Scale (CES-D score) was used to measure depression; a score of 16 or higher was considered depressive. At baseline and the first follow-up, anxiety was measured using the Kessler Psychological Distress Scale (K10), which classified it as resolved, chronic, or new.

Using the earliest documented diagnosis date, incident all-cause dementia was detected using International Classification of Disease 10 (ICD 10) codes from connected data sources, such as disease registrations and the national death index.

Using t-tests and Chi-square tests, statistical analysis was used to compare the features of individuals who got dementia vs those who did not. A directed acyclic graph (DAG) was used to account for confounders.

Using death as a competing event, the Fine and Gray regression model calculated the subdistribution hazard of anxiety on dementia risk. Sensitivity analysis looked at the degree of anxiety and missing data. Software from SAS was used to conduct statistical analysis (version 9.4).

In conclusion
In summary, this is the first study to investigate the longitudinal connection between all-cause dementia risk and resolved, chronic, and new onset anxiety.

Within the sample of 2,132 participants in cognitive health, anxiety that was either resolved or new was not significantly associated with a higher risk of dementia, particularly in individuals under the age of 70.

Sensitivity analysis supported the results, indicating that reverse causality has no bearing on the connection. The results emphasize anxiety as a modifiable risk factor and stress the need of anxiety management to possibly lower the incidence of dementia in later life.

For more information: The effect of anxiety on all-cause dementia: A longitudinal analysis from the Hunter Community Study, Journal of the American Geriatrics Society, https://doi.org/10.1111/jgs.19078