Chronic and new onset anxiety may increase dementia risk in older adults

• Past studies have found a connection between anxiety and an increased risk for specific health concerns, including dementia.
• Researchers from the University of Newcastle have now found that both chronic and new-onset anxiety in older age are correlated with an increased risk of dementia.
• Scientists discovered that when anxiety was resolved, the increased dementia risk association disappeared.

Researchers estimate that about 4% of the world’s population lives with an anxiety disorder .

Previous research shows that people who have anxiety may be at an increased risk for cardiovascular disease , gastrointestinal issues , and an impaired immune system .

Past studies have also found a connection between anxiety and an increased risk for dementia .

Now, researchers from the University of Newcastle in Australia add to this body of research with a new study reporting that both chronic and new-onset anxiety in older age are correlated with an increased risk of dementia.

However, when anxiety was resolved, the increased dementia risk association disappeared.

The study was recently published in the Journal of the American Geriatrics Society .

Chronic, new-onset anxiety linked to increased dementia risk

For this study, researchers analyzed data from about 2,000 people, with an average age of 76, participating in the Hunter Community Study in Australia.

Each person had their anxiety measured using the Kessler Psychological Distress Scale (K10) .

“Anxiety is linked to dementia pathology — neuronal inflammation, neurodegeneration, neuronal apoptosis , and cardiovascular disease,” Kay Khaing, MMed , conjoint lecturer in the School of Medicine and Public Health at the University of Newcastle, Australia, and the corresponding author of this study told Medical News Today. “Therefore, we hypothesized that anxiety might be associated with dementia risk, which led to our study.”

Study participants were followed for an average of 10 years. Scientists found that participants with chronic anxiety were associated with a 2.8 times higher risk of having dementia, while those with new-onset anxiety had a 3.2 times increased risk.

“Chronic anxiety is anxiety which persists for a long time,” Khaing explained. “In our study, chronic anxiety is anxiety (that) persisted for at least five years.”

“New onset anxiety is new or first detectable anxiety,” she continued. “In our study, new-onset anxiety is participants who did not have anxiety in the first examination but had anxiety in the second examination five years apart.”

Resolving anxiety removes dementia risk

Also during the study, Khaing and her team found that when a participant’s anxiety was alleviated, they did not have a higher dementia risk compared to participants with chronic or new onset anxiety.

In their study, researchers believe this finding suggests that “timely management of anxiety may be a viable strategy in reducing the risk of dementia.”

“It is (a) significant finding. Anxiety can be treated and can be recovered. Successful management of anxiety can reduce the dementia risk in later life. Our findings enable clinicians/doctors to raise awareness of anxiety among older patients and pay attention to the management of anxiety as management/treatment of anxiety can reduce the risk of dementia.”
— Kay Khaing, MMed

“The number of people living with dementia is increasing ,” she continued. “The social and economic burden of dementia is also increasing. Dementia is (the) seventh leading cause of death worldwide and (the) second leading cause of death in high-income countries. Therefore, in order to prevent dementia, it is important for researchers to continue to find new ways in which a person’s dementia risk might be increased.”

Critical need for mental health management in older adults

After reviewing this study, Shannel Kassis Elhelou, PsyD , geropsychology and neuropsychology fellow at Pacific Neuroscience Institute’s Brain Wellness and Lifestyle Programs in Santa Monica, CA told MNT that this research validates the profound link between mental and physical health.

“The association between chronic anxiety and increased dementia risk highlights the critical need for comprehensive mental health management in older patients,” Elhelou continued. “It underscores the importance of early detection and intervention for anxiety to potentially mitigate the long-term risk of developing dementia.”

“These findings provide a compelling argument for addressing anxiety proactively in older adults. Some providers may now better understand the impact of anxiety on dementia risk and be encouraged to screen for anxiety and refer patients to mental health professionals who specialize in older adults, anxiety, and neurodegenerative diseases. This collaborative approach ensures patients receive comprehensive and specialized care.”
— Shannel Kassis Elhelou, PsyD

Elhelou said that future research should focus on understanding the mechanisms by which anxiety contributes to dementia risk.

“Additionally, investigating effective interventions for anxiety that could also reduce dementia risk would be invaluable,” she added. “From a preventative perspective, it would be beneficial to explore the role of anxiety treatment in younger populations and its long-term effects on cognitive health.”

Contributing anxiety factors need to be analyzed

MNT also spoke with Karen D. Sullivan, PhD, ABPP , a board-certified neuropsychologist, owner of I CARE FOR YOUR BRAIN, and Reid Healthcare Transformation Fellow at FirstHealth of the Carolinas in Pinehurst, NC, about this study.

“My first reaction was that perhaps they had their chicken and egg in reverse order,” Sullivan commented. “That is, maybe the anxiety they were measuring at Time 1 was, in fact, the earliest manifestation of an early dementia. The authors address this by stating that the dose-response curve they found between baseline, untreated anxiety, and dementia risk suggests that anxiety is a causal factor.”

“It speaks to the need for more intensive assessment and interventions of mental health symptoms in older adults, particularly anxiety. This study provides hope that we have identified yet another modifiable risk factor for the development of the dementias.”
— Karen D. Sullivan, PhD, ABPP

When asked what she would like to see in the next steps of this research, Sullivan said that researchers need to tease apart other possible contributing factors that often go along with untreated anxiety like disrupted sleep due to ruminative worry, poor diet, and sedentary lifestyle.

“We need a factor analysis in a larger sample to ensure we can isolate the syndrome of anxiety as the cause of increased dementia risk,” she explained.

“It would also be important to co-factor out the different domains of anxiety. Different people experience anxiety differently. For some, anxiety is experienced as thought perseveration, and for others, it is stomachaches and headaches, and for others still, anxiety is felt as overwhelmed and brain fog. A deeper understanding of what specific aspects of anxiety (are) at play here would be very helpful,” Sullivan said.