Anxiety in Alzheimer's disease: Prevalence and comorbidity

Background Anxiety may be associated with psychiatric morbidity, disability , increased health care utilization, and mortality in Alzheimer's disease ( AD) patients as it is in the general adult population. However, the phenome nology of anxiety symptoms in AD and its relationship to dementia progressi on, comorbid depression, and the presence of other problematic behaviors ha ve not yet been examined. Method. Data on anxiety symptoms and their coexistence with other factors w ere obtained in 523 community-dwelling AD patients through interviews with their caregivers and direct physical examination. The prevalence of anxiety symptoms and their association to patient depression, other behavioral pro blems. gender, and age was investigated. Results. Anxiety symptoms were common, occurring in 70% of subjects. Anxiet y symptoms were significantly correlated with ADL impairment and other beha vioral disturbances. including wandering, sexual misconduct, hallucinations , verbal threats, and physical abuse. Comorbidity of anxiety-depression was also prevalent: 54% of the sample had both anxiety and depression symptoms . ADL impairment and problem behaviors were significantly associated with c omorbidity; however, the latter association was explained entirely by the p resence of anxiety. Conclusion. Anxiety symptoms were common and significantly related to ADL a nd additional neuropsychiatric problems in this sample. These results indic ate the need for additional research into the phenomenology of anxiety and comorbid anxiety-depression in AD and for the development and investigation of effective assessment and treatment of anxiety in AD clinical practice.