Alka R Goyal1, Sverre Bergh2, Knut Engedal3, Marit Kirkevold4, Øyvind Kirkevold5. 1. Centre of Old Age Psychiatry Research, Innlandet Hospital Trust, Pb 68, Ottestad 2312, Norway; Norwegian National Advisory Unit on Aging and Health, Vestfold Hospital Trust, Pb 2136, Tønsberg 3103, Norway; Department of Nursing Science, Institute of Health and Society, University of Oslo, Pb 1130, Blindern, OSLO 0318, Norway. Electronic address: alkgoy@sykehuset-innlandet.no. 2. Centre of Old Age Psychiatry Research, Innlandet Hospital Trust, Pb 68, Ottestad 2312, Norway; Norwegian National Advisory Unit on Aging and Health, Vestfold Hospital Trust, Pb 2136, Tønsberg 3103, Norway. Electronic address: Sverre.bergh@sykehuset-innlandet.no. 3. Norwegian National Advisory Unit on Aging and Health, Vestfold Hospital Trust, Pb 2136, Tønsberg 3103, Norway. Electronic address: knut.engedal@aldringoghelse.no. 4. Department of Nursing Science, Institute of Health and Society, University of Oslo, Pb 1130, Blindern, OSLO 0318, Norway. Electronic address: marit.kirkevold@medisin.uio.no. 5. Centre of Old Age Psychiatry Research, Innlandet Hospital Trust, Pb 68, Ottestad 2312, Norway; Norwegian National Advisory Unit on Aging and Health, Vestfold Hospital Trust, Pb 2136, Tønsberg 3103, Norway; Norwegian University of Science and Technology (NTNU) in Gjøvik, Faculty of Health, Care and Nursing, Pb 191, Gjøvik 2802, Norway. Electronic address: oyvind.kirkevold@aldringoghelse.no.
Abstract
BACKGROUND: Knowledge is scarce about the course of anxiety in persons with dementia (PWD) in nursing homes. This study aimed to describe the course of anxiety, anxiety symptoms, and the correlates of change in the Norwegian version of the Rating Anxiety in Dementia scale (RAID-N) score in PWD in nursing homes. METHODS: Using the RAID-N, anxiety was assessed in 298 PWD aged 65 years and above from 17 Norwegian nursing homes. The assessments were made at baseline and after a mean follow-up period of 350 days (SD 12.3). Associations between the change in RAID-N score and demographic and clinical characteristics were analyzed with multilevel regression models. RESULTS: At 12 months, 93 participants (31.2%) had died. There was no significant change in the proportion of participants with anxiety, defined as RAID-N score ≥12, from baseline (33.7%) to follow-up (31.2%) (McNemar, p = 0.597). "Motor tension", "frightened and anxious", and "irritability" were the most frequent anxiety symptoms among those with dementia and anxiety. A higher Neuropsychiatric Inventory-Questionnaire (NPI-Q) sub-syndrome affective baseline score and more use of anxiolytics were associated with reduction in RAID-N score, whereas a higher NPI-Q sub-syndrome aroused baseline score and more use of antipsychotics were associated with an increase in RAID-N score at follow-up. LIMITATIONS: The study did not control for ongoing treatment or changes of comorbidities. CONCLUSIONS: Anxiety and anxiety symptoms are highly prevalent among PWD in nursing homes over a12-month period. The symptoms "motor tension", "frightened and anxious", and "irritability" require attention in screening for anxiety.
BACKGROUND: Knowledge is scarce about the course of anxiety in persons with dementia (PWD) in nursing homes. This study aimed to describe the course of anxiety, anxiety symptoms, and the correlates of change in the Norwegian version of the Rating Anxiety in Dementia scale (RAID-N) score in PWD in nursing homes. METHODS: Using the RAID-N, anxiety was assessed in 298 PWD aged 65 years and above from 17 Norwegian nursing homes. The assessments were made at baseline and after a mean follow-up period of 350 days (SD 12.3). Associations between the change in RAID-N score and demographic and clinical characteristics were analyzed with multilevel regression models. RESULTS: At 12 months, 93 participants (31.2%) had died. There was no significant change in the proportion of participants with anxiety, defined as RAID-N score ≥12, from baseline (33.7%) to follow-up (31.2%) (McNemar, p = 0.597). "Motor tension", "frightened and anxious", and "irritability" were the most frequent anxiety symptoms among those with dementia and anxiety. A higher Neuropsychiatric Inventory-Questionnaire (NPI-Q) sub-syndrome affective baseline score and more use of anxiolytics were associated with reduction in RAID-N score, whereas a higher NPI-Q sub-syndrome aroused baseline score and more use of antipsychotics were associated with an increase in RAID-N score at follow-up. LIMITATIONS: The study did not control for ongoing treatment or changes of comorbidities. CONCLUSIONS:Anxiety and anxiety symptoms are highly prevalent among PWD in nursing homes over a12-month period. The symptoms "motor tension", "frightened and anxious", and "irritability" require attention in screening for anxiety.