Anxiety in people with dementia: A common, but unidentified and underestimated, condition

Abstract

Although anxiety and anxiety symptoms are common in older people with dementia, anxiety often goes unidentified by health care personnel due to overlapping symptoms with dementia and depression. A lack of validated, dementia-specific anxiety assessment scales in Norwegian could be contributing to the limited knowledge about and attention on anxiety and anxiety symptoms in people with dementia in Norway. In her thesis, Alka Rani Goyal and collaborators translated the Rating Anxiety in Dementia scale (RAID) into Norwegian (RAID-N), and investigated the validity of the RAID-N scale. Further, anxiety and anxiety symptoms were assessed with the RAID-N scores among people with dementia living in Norwegian nursing homes to describe the prevalence and the course of anxiety in dementia. About one of three nursing home residents with dementia had clinically significant anxiety (RAID-N sum score 12 and above) and anxiety symptoms both at baseline and at 12 months follow-up. Motor tension, frightened and anxiousness, irritability, and restlessness were the most prevalent symptoms of anxiety, and should encourage further assessments in people with dementia. Anxiety was associated with poor general physical health and a number of behavioral symptoms in people with dementia. Anxiety was also associated with poor quality of life over a 12-month period among these people. Severe anxiety was highly comorbid with depression. People with dementia and comorbid anxiety and depression had poorer general physical health, more behavioral symptoms and poorer quality of life than people with dementia and only anxiety, only depression, or none of these conditions. Comorbidity of anxiety and depression reduced the probability of remission of anxiety or depression in people with dementia, which is an important finding of this thesis. RAID-N could be a useful scale in the assessment of anxiety that needs adequate attention and management among people with dementia in Norwegian nursing homes.