Summary: A new longitudinal study finds that persistent (chronic) and newly developed (new-onset) anxiety are each linked to a substantially higher risk of developing dementia, while anxiety that resolved over time carries no increased risk. Researchers followed 2,132 Australian adults for an average of 10 years and observed that chronic anxiety raised dementia risk by about 2.8 times and new-onset anxiety by about 3.2 times. The association was strongest for people whose anxiety began before age 70. These results suggest that identifying and treating anxiety may present an opportunity to reduce dementia risk.
Key Facts
- Chronic anxiety was associated with a 2.8-fold higher risk of dementia; new-onset anxiety was associated with a 3.2-fold higher risk.
- The study followed 2,132 participants from the Hunter Community Study in Australia, with a mean age of 76, for roughly 10 years.
- Participants whose anxiety had resolved did not show an increased risk of dementia compared with those without current or past anxiety.
Source: Wiley
Overview: Published in the Journal of the American Geriatrics Society, this prospective cohort study examined how different patterns of anxiety—chronic, resolved, and new onset—relate to the subsequent development of all-cause dementia. Using long-term follow-up and statistical methods that account for competing risks, the authors explored whether anxiety might be an independent risk factor that could be targeted to prevent or delay dementia.
The study analyzed 2,132 adults enrolled in the Hunter Community Study in Australia. Participants had a mean age of 76 at baseline and were followed for an average of 10 years. Anxiety symptoms were assessed with the Kessler Psychological Distress Scale (K10), a widely used measure of psychological distress and anxiety symptoms. Dementia diagnoses were identified using International Classification of Diseases, 10th Revision (ICD-10) codes.
Researchers categorized participants by anxiety pattern over time: chronic anxiety (persistent symptoms across assessments), resolved anxiety (symptoms present earlier but not at follow-up), and new-onset anxiety (symptoms developing during the study). To estimate the association between these anxiety patterns and dementia risk, the team used the Fine–Gray subdistribution hazard model, which allows for the competing risk of death—an important consideration in studies of older adults.
Findings and Interpretation
Both chronic and new-onset anxiety were significantly associated with higher risk of all-cause dementia. Specifically, chronic anxiety was associated with a hazard ratio (HR) of 2.80 (95% CI 1.35–5.72), and new-onset anxiety with an HR of 3.20 (95% CI 1.40–7.45). The average time to dementia diagnosis among those who developed dementia was approximately 10 years (SD = 1.7).
Notably, in subgroup analyses the associations were particularly pronounced for participants younger than 70 when anxiety began: chronic anxiety in this group showed an HR of 4.58 (95% CI 1.12–18.81), while new-onset anxiety showed an HR of 7.21 (95% CI 1.86–28.02). In contrast, individuals whose anxiety had resolved by follow-up did not have an elevated dementia risk compared with those who never experienced anxiety.
The investigators conducted sensitivity analyses to account for missing data and to address possible reverse causation (the possibility that early cognitive decline causes anxiety rather than anxiety causing dementia). These additional checks produced similar results, strengthening the confidence in the observed associations.
Conclusions and Implications
The study concludes that chronic and new-onset anxiety are associated with a higher risk of developing all-cause dementia, particularly when anxiety appears before age 70. By contrast, anxiety that resolved over the follow-up did not increase dementia risk, suggesting that effective management of anxiety symptoms could reduce long-term dementia risk. As the corresponding author Kay Khaing, MMed, of the University of Newcastle noted, these findings imply that anxiety may be an actionable risk factor for dementia prevention and that timely identification and treatment of anxiety symptoms warrants consideration in strategies to lower dementia risk.
About this research news
Author: Sara Henning-Stout
Source: Wiley
Contact: Sara Henning-Stout – Wiley
Image credit: Neuroscience News
Original Research (open access): “The effect of anxiety on all cause dementia: a longitudinal analysis from the Hunter Community Study” by Kay Khaing et al., Journal of the American Geriatrics Society.
Abstract (summary)
Background: Anxiety is common in older adults, but the impact of anxiety chronicity—whether symptoms are persistent, resolved, or newly developed—on dementia risk has been unclear. This study aimed to investigate the longitudinal relationship between different anxiety trajectories and all-cause dementia.
Methods: The analysis included 2,132 participants from the Hunter Community Study (mean age 76). Anxiety symptoms were measured with the K10 scale, and dementia diagnoses were identified using ICD-10 codes. The Fine–Gray subdistribution hazard model was used to estimate dementia risk while accounting for death as a competing risk.
Results: Chronic and new-onset anxiety were both associated with increased risk of all-cause dementia (HR 2.80 and HR 3.20, respectively), with an average time to diagnosis of about 10 years. Resolved anxiety showed no increased risk. The associations were strongest in participants who developed anxiety before age 70. Sensitivity analyses addressing missing data and reverse causation supported the main findings.
Conclusion: Persistent and newly developed anxiety are linked to higher dementia risk, particularly among those under 70 at anxiety onset, while resolved anxiety does not confer increased risk. These results support the idea that timely recognition and treatment of anxiety may be a promising approach for reducing dementia risk in older adults.