Clinically significant anxiety as a risk factor for Alzheimer's disease: Results from a 10‐year follow‐up community study

• Published in: International journal of methods in psychiatric research Vol. 32; no. 3; pp. e1934 - n/a
• Main Authors: Gracia‐García, Patricia, Bueno‐Notivol, Juan, Lipnicki, Darren M., de la Cámara, Concepción, Lobo, Antonio, Santabárbara, Javier
• Format: Journal Article
• Language: English
• Published: United States John Wiley & Sons, Inc 01.09.2023; John Wiley and Sons Inc; Wiley
• Subjects: Activities of daily living; Alzheimer's disease; Anxiety; Anxiety disorders; Body mass index; Clinical significance; competing risk; Computers; Dementia; Dementia disorders; Geriatrics; Hearing loss; Institutionalization; Interviews; Marital status; Mental depression; Mental disorders; Neurodegenerative diseases; Original; Psychiatrists; Questionnaires; risk factor; Risk factors; Survival analysis; ZARADEMP; ZARADEMP; Alzheimer's disease; competing risk; risk factor
• DOI: 10.1002/mpr.1934
• ISSN: 1049-8931; 1557-0657

There is growing evidence for an association between anxiety and an increased risk of dementia, but it is not clear whether anxiety is a risk factor or a prodromic symptom. In this study, we investigated if clinically significant anxiety increases the risk of developing Alzheimer's disease (AD) up to 10 years later. We used data from the longitudinal Zaragoza Dementia and Depression (ZARADEMP) Project. Excluding subjects with dementia at baseline left us with 3044 individuals aged >65 years. The Geriatric Mental State-Automated Geriatric Examination for Computer Assisted Taxonomy (GMS-AGECAT) package was used to identify cases and subcases of anxiety. AD was diagnosed by a panel of research psychiatrists according to the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) criteria. Multivariate survival analysis with a competing risk regression model was performed. We observed a significant association between clinically significant anxiety at baseline and AD risk within a 10-year follow-up (SHR 2.82 [95% CI 1.21-6.58]), after controlling for confounders including depression. In contrast, isolated symptoms of anxiety were not significantly associated with an increased incidence of AD. Our results support the hypothesis that clinically significant anxiety is an independent risk factor for AD and not just a prodromic symptom. Future studies should clarify if treating anxiety reduces the incidence of AD.