Study Finds Both Chronic and New Anxiety Increases Risk of Dementia

According to research published in the Journal of the American Geriatrics Society, both chronic and new anxiety were associated with an increased risk of dementia onset. Additionally, the findings also indicated that where anxiety had resolved, there were not any associations with dementia risk.¹

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For this study, a total of 2132 participants aged 55 to 85 years (mean age: 76 years) were enrolled, of which about 53% were female and the remaining 47% were male. All participants were recruited from the Hunter Community Study and were assessed over 3 different waves. The investigators measured anxiety at baseline (wave 1) and first follow-up (wave 2), with the length of time between the 2 waves being 5 years. Additionally, anxiety was considered chronic if it was present during both waves 1 and 2, resolved if present only at wave 1, and new anxiety if present only at wave 2.^1,2

Anxiety symptoms were assessed using the Kessler Psychological Distress Scale (K-10), which is a 10-item questionnaire with 2 main subscale scores that measure anxiety (items 2, 3, 5, and 6) and depression (items 1, 4, 7, 8, 9, and 10). Each item is scored on a 1-to-5-point scale, with total scores ranging from 10 to 50. Anxiety was considered to be “present” if participants had a K10 total score of 16 or higher and anxiety items were “positive” (≥2).²

Additionally, the primary outcome, which was all-cause dementia, was assessed using the International Classification of Disease—10 (ICD 10) at a maximum follow-up period of 13 years after baseline. The investigators note that the date of diagnosis was the earliest date of recorded dementia codes (F00, F01, F02, F03, or G30), regardless of the source of data.²

The findings indicate that both chronic and new anxiety at follow-up were associated with all-cause dementia risk (HR 2.80, 95% CI 1.35–5.72 and HR 3.20, 95% CI 1.40–7.45, respectively), with an average time to dementia diagnosis of 10 years. Resolved anxiety was not associated with an increased risk of dementia. Additionally, subgroup analyses demonstrated that the results were driven particularly by chronic and new anxiety among participants younger than 70 years of age (chronic anxiety: HR 4.58, 95% CI 01.12–18.81; new anxiety: HR 7.21, 95%CI 1.86–28.02).²

Further, after excluding the participants censored within the first 5 years from baseline, a similar increased risk of all-cause dementia was found in both participants with chronic anxiety (HR 2.94, 95% CI 1.42–6.11, p = 0.004) and new onset anxiety (HR 2.80, 95% CI 1.16–6.78, p = 0.02) at wave 2, unlike those who only had anxiety at baseline and did not have an increased risk (HR 1.10, 95% CI 0.41–2.92, p = 0.85). In addition, those with anxiety and a K10 score of 16 to 30 had a HR of 1.24 (95% CI 0.61 to 2.54, p = 0.55) and those with anxiety and K10 score of 30 or higher had a HR of 2.62 (95% CI 0.58–11.79, p = 0.21); however, the investigators deemed these to be not statistically significantly different.²

According to the investigators, limitations of the study included a change of missing dementia cases or cases later identified, the short duration of which anxiety symptoms were assessed (4 weeks), and the possibility of residual depression with anxiety. Additionally, the authors note that information regarding the resolution of anxiety was missing, and approximately 33% of participants at follow-up had a higher rate of anxiety at baseline were lost, potentially effecting the effect estimate.²

“While this sort of question cannot be subject to a randomized controlled trial, this prospective cohort study used causal inference methods to explore the role of anxiety in promoting the development of dementia,” said corresponding author Kay Khaing, MMed, of University of Newcastle, in a news release. “The findings suggest that anxiety may be a new risk factor to target in the prevention of dementia and also indicate that treating anxiety may reduce this risk.”¹

References

1. Wiley. Can anxiety increase the risk of developing dementia? News release. July 24, 2024. Accessed July 26, 2024. https://www.eurekalert.org/news-releases/1051988

2. Khaing K, Dolja-Gore X, Nair BR, Byles J, Attia J. The effect of anxiety on all-cause dementia: A longitudinal analysis from the Hunter Community Study. J Am Geriatr Soc. 2024; 1-8. doi:10.1111/jgs.19078