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The frequency and correlates of anxiety in patients with first-time diagnosed mild dementia

Published online by Cambridge University Press:  12 June 2012

Minna J. Hynninen ,
Monica H. Breitve ,
Arvid Rongve ,
Dag Aarsland  and
Inger Hilde Nordhus
Minna J. Hynninen*
Affiliation:
Department of Clinical Psychology, University of Bergen, Bergen, Norway
Monica H. Breitve
Affiliation:
Section of Mental Health Research, Clinic of Psychiatry, Helse-Fonna HF Haugesund Hospital, Haugesund, Norway
Arvid Rongve
Affiliation:
Section of Mental Health Research, Clinic of Psychiatry, Helse-Fonna HF Haugesund Hospital, Haugesund, Norway
Dag Aarsland
Affiliation:
Centre for Old Age Related Medicine, Stavanger University Hospital, Stavanger, Norway KI Alzheimer Disease Research Center, Department of NVS, Karolinska Institutet, Stockholm, Sweden
Inger Hilde Nordhus
Affiliation:
Department of Clinical Psychology, University of Bergen, Bergen, Norway Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway Kavli Research Center for Aging and Dementia, Haraldsplass Deaconess Hospital, Bergen, Norway
*
Correspondence should be addressed to: Minna J. Hynninen, Department of Clinical Psychology, University of Bergen, Christies Gate 12, N-5015 Bergen, Norway. Phone: +47-55 58 88 96; Fax: +47-55 58 98 77. Email: [email protected].
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Abstract

Background: Anxiety in persons with dementia has received little attention despite its severe consequences. In this observational cross-sectional study, we investigated the frequency of anxiety and associations between anxiety and socio-demographic and clinical variables in an outpatient sample with first-time diagnosed mild dementia.

Methods: The study sample (n = 169) comprised participants recruited from clinics in geriatric medicine and old age psychiatry for a longitudinal dementia study. Symptoms of anxiety were rated by a caregiver on the Neuropsychiatric Inventory (NPI) and by the patient on the anxiety tension item on the Montgomery and Åsberg Depression Rating Scale. Measures of caregiver stress, dementia-related impairment (Clinical Dementia Rating (CDR) scale), and cognitive functioning were also included.

Results: According to caregiver reports, 19.5% had clinically significant anxiety and an additional 22.5% had subclinical anxiety. Half of the patients reported experiencing anxiety from time to time. Patients with Lewy-body dementia reported anxiety more often compared to patients with Alzheimer's disease. Anxiety was associated with depression, higher caregiver stress, and more dementia-related impairment, but not with cognitive test performance. Caregiver stress and higher CDR score increased the odds for anxiety significantly, even when controlling for depression.

Conclusion: Anxiety is common in patients with mild dementia, and seems to be associated not so much with cognitive test performance than with caregiver distress and the patient's ability to function in daily life. Anxiety should be taken into account when assessing dementia, as well as screened for when examining patients with known dementia.

Keywords

dementiaanxietypsychogeriatrics
Type
Research Article
Information
International Psychogeriatrics , Volume 24 , Issue 11 , November 2012 , pp. 1771 - 1778
Copyright
Copyright © International Psychogeriatric Association 2012

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References

Aalten, P., Jolles, J., de Vugt, M. E. and Verhey, F. R. J. (2007). The influence of neuropsychological functioning on neuropsychiatric problems in dementia. Journal of Neuropsychiatry and Clinical Neurosciences, 19, 50–56.CrossRefGoogle ScholarPubMed
Aarsland, D. et al. (2008). Frequency and case identification of dementia with Lewy bodies using the revised consensus criteria. Dementia and Geriatric Cognitive Disorders, 26, 445–452.CrossRefGoogle ScholarPubMed
Aarsland, D. et al. (2009). The spectrum of neuropsychiatric symptoms in patients with early untreated Parkinson's disease. Journal of Neurology, Neurosurgery & Psychiatry, 80, 928–930.CrossRefGoogle ScholarPubMed
Archer, N. et al. (2007). Premorbid personality and behavioral and psychological symptoms in probable Alzheimer disease. American Journal of Geriatric Psychiatry, 15, 202–213.CrossRefGoogle ScholarPubMed
Armitage, S. G. (1946). An analysis of certain psychological tests used for the evaluation of brain injury. Psychological Monographs, 60, 1–47.CrossRefGoogle Scholar
Ballard, C., Neill, D., O'Brien, J., McKeith, I. G., Ince, P. and Perry, R. (2000). Anxiety, depression and psychosis in vascular dementia: prevalence and associations. Journal of Affective Disorders, 59, 97–106.CrossRefGoogle ScholarPubMed
Beaudreau, S. A. and O'Hara, R. (2008). Late-life anxiety and cognitive impairment: a review. American Journal of Geriatric Psychiatry, 16, 790–803.CrossRefGoogle ScholarPubMed
Borroni, B., Agosti, C. and Padovani, A. (2008). Behavioral and psychological symptoms in dementia with Lewy-bodies (DLB): frequency and relationship with disease severity and motor impairment. Archives of Gerontology and Geriatrics, 46, 101–106.CrossRefGoogle ScholarPubMed
Cummings, J. L., Mega, M., Gray, K., Rosenberg-Thompson, S., Carusi, D. A. and Gornbein, J. (1994). The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology, 44, 2308–2314.CrossRefGoogle ScholarPubMed
Delis, D. C., Kramer, J. H., Kaplan, E. and Ober, B. A. (2000). California Verbal Learning Test, 2nd edn, adult version, manual. San Antonio, TX: The Psychological Corporation.Google Scholar
Ecklund-Johnson, E. and Torres, I. (2005). Unawareness of deficits in Alzheimer's disease and other dementias: operational definitions and empirical findings. Neuropsychology Review, 15, 147–166.CrossRefGoogle ScholarPubMed
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). Mini-mental state. Journal of Psychiatric Research, 12, 189–198.CrossRefGoogle ScholarPubMed
Gibbons, L. E., Teri, L. and Logsdon, R. (2002). Anxiety symptoms as predictors of nursing home placement in patients with Alzheimer's disease. Journal of Clinical Geropsychology, 8, 335–342.CrossRefGoogle Scholar
Gibbons, L. E., Teri, L., Logsdon, R. G. and McCurry, S. M. (2006). Assessment of anxiety in dementia: an investigation into the association of different methods of measurement. Journal of Neuropsychiatry and Clinical Neurosciences, 19, 202–208.Google ScholarPubMed
Greene, J. G., Smith, R., Gardiner, M. and Timbury, G. C. (1982). Measuring behavioural disturbance of elderly demented patients in the community and its effects on relatives: a factor analytic study. Age and Ageing, 11, 121–126.CrossRefGoogle ScholarPubMed
Hart, D. J., Craig, D., Compton, S. A., Critchlow, S., Kerrigan, B. M. and McIlory, S. P. (2003). A retrospective study of the behavioural and psychological symptoms of mild and late phase Alzheimers's disease. International Journal of Geriatric Psychiatry, 18, 1037–1042.CrossRefGoogle Scholar
Haupt, M., Karger, A. and Janner, M. (2000). Improvement of agitation and anxiety in demented patients after psychoeducative group intervention with their caregivers. International Journal of Geriatric Psychiatry, 15, 1125–1129.3.0.CO;2-F>CrossRefGoogle ScholarPubMed
Kaufer, D. I. et al. (1998). Assessing the impact of neuropsychiatric symptoms in Alzheimer's disease: the Neuropsychiatric Inventory Caregiver Distress Scale. Journal of the American Geriatrics Society, 46, 210–215.CrossRefGoogle ScholarPubMed
Lezak, M. D., Howieson, D. B. and Loring, D. W. (2004). Neuropsychological Assessment. New York: Oxford University Press.Google Scholar
Mintzer, J. E., Brawman-Mintzer, O., Mirski, D. F. and Barkin, K. (2000). Anxiety in the behavioural and psychological symptoms of dementia. International Psychogeriatrics, 12, 139–142.CrossRefGoogle Scholar
Montgomery, S. A. and Åsberg, M. (1979). A new depression scale designed to be sensitive to change. British Journal of Psychiatry, 134, 382–389.CrossRefGoogle ScholarPubMed
Moran, M., Walsh, C., Lynch, A., Coen, R. F., Coakley, D. and Lawlor, B. A. (2004). Syndromes of behavioural and psychological symptoms in mild Alzheimer's disease. International Journal of Geriatric Psychiatry, 19, 359–364.CrossRefGoogle ScholarPubMed
Morris, J. C. (1997). Clinical Dementia Rating: a reliable and valid diagnostic and staging measure for dementia of the Alzheimer type. International Psychogeriatrics, 9, 173–176; discussion 177–178.CrossRefGoogle ScholarPubMed
Orrell, M. V. and Bebbington, P. (1996). Psychosocial stress and anxiety in senile dementia. Journal of Affective Disorders, 39, 165–173.CrossRefGoogle ScholarPubMed
Pachana, N. A. and Byrne, G. J. (2012). The Geriatric Anxiety Inventory: international use and future directions. Australian Psychologist, 47, 33–38.CrossRefGoogle Scholar
Porter, V. R. et al. (2003). Frequency and characteristics of anxiety among patients with Alzheimer's disease and related dementias. Journal of Neuropsychiatry and Clinical Neurosciences, 15, 180–186.CrossRefGoogle ScholarPubMed
Ricci, M. et al. (2009). Clinical findings, functional abilities and caregiver distress in the early stage of dementia with Lewy bodies (DLB) and Alzheimer's disease (AD). Archives of Gerontology and Geriatrics, 49, e101–e104.CrossRefGoogle ScholarPubMed
Schultz, S. K., Hoth, A. and Buckwalter, K. (2004). Anxiety and impaired social function in the elderly. Annals of Clinical Psychiatry, 16, 47–51.CrossRefGoogle ScholarPubMed
Seignourel, P. J., Kunik, M. E., Snow, L., Wilson, N. and Stanley, M. (2008). Anxiety in dementia: a critical review. Clinical Psychology Review, 28, 1071–1082.CrossRefGoogle ScholarPubMed
Shankar, K. K., Walker, M., Frost, D. and Orrell, M. W. (1999). The development of a valid and reliable scale for rating anxiety in dementia (RAID). Aging & Mental Health, 3, 39–49.CrossRefGoogle Scholar
Tatsch, M. F. et al. (2006). Neuropsychiatric symptoms in Alzheimer disease and cognitively impaired, nondemented elderly from a community-based sample in Brazil: prevalence and relationship with dementia severity. American Journal of Geriatric Psychiatry, 14, 438–445.CrossRefGoogle ScholarPubMed
Teri, L. et al. (1999). Anxiety in Alzheimer's disease: prevalence and comorbidity. Journals of Gerontology, 54A, 348–352.Google Scholar
Twelftree, H. and Qazi, A. (2006). Relationship between anxiety and agitation in dementia. Aging & Mental Health, 10, 362–367.CrossRefGoogle ScholarPubMed
United Nations (2002). World Population Ageing: 1950–2050. New York: Department of Economic and Social Affairs, UN Population Division.Google Scholar