High anxiety may be linked to dementia in older adults, according to a study conducted in the Netherlands, recently published in the Journal of Affective Disorders.
According to the study, anxiety is considered a relatively common condition, affecting about 15% of the general population at some point during their lifetime. More than 7,300 people ages 40-75 years old were studied.
Anxiety is a feeling of fear, dread, or uneasiness as a response to stress. It’s normal but is considered a disorder if it persists or gets worse, especially when real danger is no longer present. Some of the types of anxiety symptoms observed for this study were related to generalized anxiety disorder, agoraphobia (fear of large crowds and/or public spaces), and panic disorder. General anxiety disorder is when people worry excessively over common life stressors such as work, family, bills, etc.
A few of the key findings from the study include:
- Agoraphobia was associated with worse functioning in all cognitive areas.
- Some anxiety symptoms were associated with worse scores on processing speed.
- Panic disorder was associated with worse scores on memory.
“Multiple anxiety disorders and generalized anxiety symptoms were associated with worse cognitive functioning on several cognitive domains,” the study concluded.
The study also takes into account individual subjects’ differences in age and gender, as well as other underlying physical and psychological conditions and co-morbidities such as depression and diabetes.
The findings of this study could potentially impact the way that anxiety disorders are recognized and treated in older adults, according to Gail Saltz, MD, Clinical Associate Professor of Psychiatry at The New York Presbyterian Hospital, and host of the “How Can I Help?” podcast from iHeartRadio.
“The reason this study’s results matter is that anxiety disorders are treatable and that once treated these effects diminish,” Saltz told The Atlanta Journal-Constitution. “A big issue in treating an older population is that anxiety disorders are often missed because some of the symptoms like disrupted sleep, somatic symptoms like body aches and pains, headache, nausea are also things that happen at a much higher rate in older adults.”
“Recently, family doctors and internists have been directed to screen for anxiety disorders for those under 65, and the cut off was because over 65 many of the screening tools are picking up normal symptoms of aging and they feared screening in too many people,” Saltz added.
This study did not answer the reasons for the link, such as what causes high levels of anxiety to correlate with decreased planning, focusing, remembering, and other executive functioning and increased cognitive impairment.
“It is only a noted correlation. But (we do know that) high anxiety causes release of increased cortisol, the stress hormone, and that chronic high levels of cortisol bathing the brain is harmful to it,” Saltz said, which causes brain cell death over time. “And we also know that the experience of high anxiety does interrupt the ability to concentrate, and therefore to learn, and to cognitively process complex information.”
The people who cognitively fared the worst in the study were those with higher scores for GAD and those with agoraphobia, “which is usually the most severe form of panic disorder that has also caused the person to fear being outside their home…” said Saltz. These were the patients with the most severe anxiety, which “could likely be picked up on a screening,” or by a family member who observes the symptoms of anxiety.
One key takeaway of the study, according to Saltz, is that older people with anxiety “should get treatment, not only to feel better regarding anxiety but to decrease impairment in executive functioning and ongoing cognitive decline,” she said. Potential treatments may include psychotherapy alone, or psychotherapy plus medication.
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