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Older adults with memory problems can progress to Alzheimer’s more rapidly if they also suffer from anxiety symptoms, a preliminary study suggests.
It is common for people with Alzheimer’s disease to have mood symptoms, including anxiety and depression. And some research has suggested that these symptoms may, in older people, act as early indicators of the dementia process.
The new study focused on 339 patients diagnosed with mild cognitive impairment – persistent problems with memory and thinking skills that can progress to full-blown dementia.
But progression isn’t guaranteed, and people vary according to how quickly their mental functioning declines.
There’s no way to predict how things will turn out for a person, said Dr. Maria Vittoria Spampinato, the study’s senior author.
But the researchers are trying to understand if some factors are linked to the rate of progression. The new findings suggest anxiety may be one of them, according to Spampinato, a professor of radiology at the Medical University of South Carolina.
His team found that patients with more anxiety symptoms early on were more likely to be diagnosed with Alzheimer’s disease in the next few years than those with few symptoms.
Does this mean that anxiety accelerates the dementia process? Not necessarily, according to Mary Sano, director of the Alzheimer’s Disease Research Center on Mount Sinai in New York City.
Instead, anxiety is likely another symptom of the underlying brain disease, said Sano, who was not involved in the study.
He doubted that treating anxiety in someone with mild cognitive impairment would “change the underlying biology” of the dementia process.
However, Sano said, recognizing the anxiety in those patients is still important. For one thing, it could serve as a red flag that someone is at risk of a more rapid decline.
That’s key, Sano said, in part because anxiety symptoms are easy to measure. In this study, some other factors were linked to faster progression, including shrinkage in certain areas of the brain. But this can only be assessed with a brain MRI.
Plus, Sano said, helping people cope with anxiety should be a goal in its own right. “It’s an important symptom to consider,” he said.
The results are based on a study of North American patients with mild cognitive impairment that involved memory problems. At first, all were screened for anxiety and depression, MRI brain scans, and blood tests.
Of 339 patients, 72 progressed to Alzheimer’s in the following years. Those with higher anxiety levels initially tended to have faster progression, as did patients with lower tissue volume in two brain areas involved in memory and learning.
Genes were also important: People with a genetic variant linked to a higher Alzheimer’s risk – ApoE4 – also had a faster decline, compared to those with different variants.
Even with these other factors taken into account, however, anxiety was independently linked to faster progression, Spampinato said.
This alone, however, does not mean that anxiety directly worsens cognitive problems.
“People living with mild cognitive impairment may experience anxiety, but what is unclear at this point is whether controlling or reducing anxiety can slow cognitive decline,” said Heather Snyder, vice president of medical and scientific operations. at the Alzheimer’s Association.
He agreed with Sano on the importance of acknowledging anxiety regardless.
“For people living with mild cognitive impairment or dementia,” Snyder said, “managing anxiety and stress is an important aspect of providing care.”
The Alzheimer’s Association recommends some steps for patients and families: simplify daily routines, calm the home environment, and regularly adjust to pleasant activities, such as walking, gardening, and listening to music.
Talking to a healthcare provider is also always an option, Sano said.
“Sometimes older people may be hesitant to talk about anxiety and depression,” he noted. “But I think it’s a mistake.”
The study is expected to be presented Monday at the Radiological Society of North America’s annual meeting, which will be held online. Findings reported at meetings are generally considered preliminary until they are published in a peer-reviewed journal.
More information
The Alzheimer’s Association has more on anxiety and agitation.
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