Eva Becker1, Claudia Lorena Orellana Rios2, Claas Lahmann3, Gerta Rücker4, Joachim Bauer5, Martin Boeker6. 1. Physician, Department of Psychosomatic Medicine and Psychotherapy,Faculty of Medicine and Medical Center,University of Freiburg,Germany. 2. Psychologist, Department of Palliative Care,Faculty of Medicine and Medical Center,University of Freiburg,Germany. 3. Professor of Psychosomatic Medicine and Psychotherapy,Department of Psychosomatic Medicine and Psychotherapy,Faculty of Medicine and Medical Center,University of Freiburg,Germany. 4. Statistician, Institute of Medical Biometry and Statistics,Faculty of Medicine and Medical Center,University of Freiburg,Germany. 5. Professor of Psychoneuroimmunology,International Psychoanalytic University Berlin,Germany. 6. Institute of Medical Biometry and Statistics,Faculty of Medicine and Medical Center,University of Freiburg,Germany.
Abstract
BACKGROUND: The aetiology of dementia is not yet fully understood. Stress can have a damaging effect on brain health. The prognostic effect of anxiety is still unclear regarding Alzheimer's disease as well as vascular dementia.AimsTo explore the association between anxiety and future dementia. METHOD: Medline, PsycINFO, CINAHL, Web of Science and ALOIS were searched for publications up to 12 January 2018. Longitudinal studies with a follow-up of at least 2 years were included, if the trait or state anxiety had been assessed at baseline. Studies with cognitive impairment at baseline were not included. We used a random effects model to calculate the pooled time to Alzheimer's disease and incidence of vascular dementia. RESULTS: Anxiety predicts risk of Alzheimer's disease (n = 26 193 out of seven studies, hazard ratio1.53, 95% CI 1.16-2.01, P < 0.01) and vascular dementia (n = 4916 out of two studies, odds ratio1.88, 95% CI 1.05-3.36, P < 0.01). The pooled hazard ratio regarding risk of Alzheimer's disease was still significant when excluding studies with critical risk of bias (n = 14 110 out of six studies, hazard ratio 1.35, 95% CI 1.08-1.70, P < 0.01). CONCLUSIONS: Anxiety is a risk factor for both types of dementia. The temporal and functional relation between anxiety and dementia needs investigation in future studies. The protective value of treating anxiety should be explored further.Declaration of interestNone.
BACKGROUND: The aetiology of dementia is not yet fully understood. Stress can have a damaging effect on brain health. The prognostic effect of anxiety is still unclear regarding Alzheimer's disease as well as vascular dementia.AimsTo explore the association between anxiety and future dementia. METHOD: Medline, PsycINFO, CINAHL, Web of Science and ALOIS were searched for publications up to 12 January 2018. Longitudinal studies with a follow-up of at least 2 years were included, if the trait or state anxiety had been assessed at baseline. Studies with cognitive impairment at baseline were not included. We used a random effects model to calculate the pooled time to Alzheimer's disease and incidence of vascular dementia. RESULTS:Anxiety predicts risk of Alzheimer's disease (n = 26 193 out of seven studies, hazard ratio1.53, 95% CI 1.16-2.01, P < 0.01) and vascular dementia (n = 4916 out of two studies, odds ratio1.88, 95% CI 1.05-3.36, P < 0.01). The pooled hazard ratio regarding risk of Alzheimer's disease was still significant when excluding studies with critical risk of bias (n = 14 110 out of six studies, hazard ratio 1.35, 95% CI 1.08-1.70, P < 0.01). CONCLUSIONS:Anxiety is a risk factor for both types of dementia. The temporal and functional relation between anxiety and dementia needs investigation in future studies. The protective value of treating anxiety should be explored further.Declaration of interestNone.
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