Researchers aimed to address the association of all-cause dementia risk and 3 separate chronicities of anxiety.
Patients experiencing chronic or new onset anxiety—also known as new anxiety—were associated with an increased risk of all-cause dementia, with an average time of 10 years to diagnosis. However, patients that resolved their anxiety were associated with a reduced risk of dementia, urging researchers to better understand how to manage anxiety in order to reduce dementia risks for patients in the future.
“Globally, there were over 55 million people living with dementia in 2020, and this number is estimated to increase to 78 million by 2030 and 139 million by 2050. The global cost of dementia was estimated to be $1.3 trillion in 2019 and is projected to rise to $2.8 trillion by 2050. With the increasing social and economic burden of dementia in the community, the focus has been directed toward prevention, targeting possible modifiable risk factors including anxiety,” wrote authors of a study published in the Journal of the American Geriatrics Society.1
Regarding previous studies on the topic, many have yielded inconclusive results for various reasons. No previous study has measured the relationship between anxiety and dementia with follow-up protocols to assess the change in patients throughout time. Furthermore, previous studies have not assessed the persistence of anxiety, while Khaing et al’s study focused on chronic vs. resolved vs. new anxiety.
Furthermore, on studies prior to Khaing et al’s, researchers have previously found an association between anxiety and dementia. However, they were unable to establish a distinction between whether anxiety impacted dementia or if it was just an early symptom persisting in dementia cases.
Globally, there were over 55 million people living with dementia in 2020, and this number is estimated to increase to 78 million by 2030 and 139 million by 2050. | image credit: 1STunningART / stock.adobe.com
“Anxiety is significantly associated with an increased risk of all-cause dementia. The treatment or prevention of anxiety might help to reduce dementia incidence rates, but more research is needed to clarify whether anxiety is a cause of dementia rather than a prodrome,” wrote the authors.2
Khaing et al’s study analyzed 2132 participants (mean age, 76; 53% women), measuring levels of anxiety and dementia using the Kessler Psychological Distress Scale (K10) and the 10 codes of the International Classification of Disease, respectively. Finally, they used the Fine–Gray subdistribution hazard model to measure dementia risk.1
Of 2132 study participants, 449 (21%) had anxiety at baseline—or wave 1 as the authors defined it—64 (3%) developed dementia, and 151 (7%) died during the mean follow-up period of 10 years.
In each of the researchers’ 3 testing waves, chronic anxiety’s association with dementia persisted in waves 1 and 2. New anxiety cases showed greater risks of dementia in wave 2 especially, while there was no significant risk for resolved anxiety cases.
Figure 2, Anxiety and increased risk of dementia, from Khaing et al's study.1 | image credit: Khaing et al
“Considering age, the age group younger than 70 years old who had chronic anxiety had higher risk of dementia. Similar effects were seen for those younger than 70 years who had anxiety only at follow-up. Anxiety did not have a significant association with dementia risk in the other age groups,” they wrote.1
With the hypothesis that age and chronicity of anxiety could have specific effects on the development of dementia, researchers successfully found that dementia risks persisted in patients under 70 experiencing new onset or chronic anxiety. Their findings confirm various studies conducted prior, showing that anxiety at a younger age can be a catalyst for the development of all-cause dementia.
Researchers also discussed the pathways in which anxiety can lead to all-cause dementia. They explored the fact that individuals suffering from any chronicity of anxiety can develop poor lifestyle habits such as an unhealthy diet, smoking, and a lack of physical activity. While patients with anxiety are susceptible to those lifestyle habits, those same patients would be at risk of cardiovascular disease, which is also linked to all-cause dementia.
There are many explanations regarding anxiety’s link to dementia, and researchers throughout the years have proportionately confirmed previous studies on the topic. With more and more literature on this relationship available to researchers, their next goal is to understand in fuller extent whether or not resolving anxiety can lead to a reduction in dementia risk.
“In conclusion, both chronic anxiety and new anxiety at follow-up were associated with increased risk of all-cause dementia, especially in those 70 years and younger even after considering mortality as a competing risk and controlling for depression as a confounder. The risk of dementia among resolved anxiety cases was similar to those who had no anxiety. Therefore, these findings support anxiety as a potential modifiable risk factor for dementia and point to the possible role of managing anxiety in middle-aged and ‘young’ older adults to reduce the risk of dementia in later life,” concluded the authors.1
READ MORE: Slideshow: Exploring Dementia Risk, Hot Flashes, Oral Health in Postmenopausal Women
Pharmacy practice is always changing. Stay ahead of the curve: Sign up for our free Drug Topics newsletter and get the latest drug information, industry trends, and patient care tips, straight to your inbox.
