A longitudinal analysis from the Hunter Community Study revealed that chronic anxiety and new-onset anxiety may be associated with an increased risk of all-cause dementia.
Published in the Journal of the American Geriatrics Society, researchers analyzed data from 2,132 cognitively healthy participants with a mean age of 76 years. Over a mean follow-up of 10 years, 64 participants (3%) developed dementia and 151 participants (7%) died. The average time to dementia diagnosis was 10 years.
Anxiety symptoms were measured using the Kessler Psychological Distress Scale at baseline and 5-year follow-up. Dementia was ascertained using ICD-10 codes from linked administrative health data. Analyses adjusted for potential confounders including age, gender, and depression.
Compared to participants without anxiety, those with chronic anxiety had a higher risk of developing dementia (adjusted hazard ratio [HR], 2.80, 95% confidence interval [CI], 1.35–5.72). Participants with new-onset anxiety at follow-up also had increased dementia risk (adjusted HR, 3.20, 95% CI, 1.40–7.45). However, participants whose anxiety resolved by follow-up did not have significantly higher dementia risk compared to those without anxiety (adjusted HR, 1.06, 95% CI, 0.40–2.81).
In subgroup analyses by age, the associations of chronic and new-onset anxiety with dementia risk were significant for participants younger than 70 years (HR, 4.58, 95% CI, 01.12–18.81 and HR, 7.21, 95% CI, 1.86–28.02, respectively). Anxiety was not significantly associated with dementia risk in older age groups.
Sensitivity analyses excluding dementia cases and deaths within 5 years of baseline yielded similar results, suggesting the findings were not explained by reverse causation. Additional sensitivity analyses using multiple imputation for missing data and assessing severity of anxiety also aligned with the main findings.
The researchers noted some limitations of the study, including possible missing dementia cases, the anxiety measure assessing only recent symptoms, potential residual confounding by depression despite controlling for it, and loss to follow-up of participants with higher baseline anxiety rates. However, they concluded the results support anxiety as a potential modifiable dementia risk factor, especially in adults younger than age 70, and suggest a possible role for anxiety management in reducing later-life dementia risk.
The authors declared no conflicts of interest.