Abstract
Background: To assess the association between anxiety and risk of vascular dementia (VaD), as well as potential sex differences, in a community-based cohort. Methods: A random sample of 4057 dementia-free community participants aged 55 or older, from the longitudinal, community-based Zaragoza Dementia and Depression Project (ZARADEMP) study were followed for 4.5 years. Geriatric Mental State B (GMS)-Automated Geriatric Examination for Computer Assisted Taxonomy (AGECAT) was used for the assessment and diagnosis of anxiety, and a panel of research psychiatrists diagnosed the incident cases of VaD according to DSM-IV (Diagnostic and Statistical Manual of mental disordes). Multivariate survival analysis with competing risk regression model was performed. Results: In men, the incidence rate of VaD was significantly higher among anxiety subjects compared with non-anxiety subjects (incidence rate ratio (IRR) (95% confidence interval (CI)): 3.24 (1.13–9.35); p = 0.029), and no difference was observed in women (IRR (95%CI): 0.68 (0.19–2.23); p = 0.168). In the multivariate model, for men, cases of anxiety had 2.6-fold higher risk of VaD (subdistribution hazard ratio (SHR): 2.61; 95%CI: 0.88–7.74) when all potential confounding factors were controlled, with no statistical significance (p = 0.084), but a clinically relevant effect (Cohen’s d: 0.74). No association was found in women. Conclusions: In men, but not in women, risk of VaD was higher among individuals with anxiety, with a clinically relevant effect. Potential anxiety-related preventive interventions for VaD might be tailored to men and women separately.
Highlights
The analysis of risk factors of overall dementia and its most frequent types, Alzheimer disease (AD) and vascular dementia (VaD), has been put at stake in a report that includes psychological factors such as depression and anxiety [1]
Was used for the assessment and diagnosis of anxiety, and a panel of research psychiatrists diagnosed the incident cases of VaD according to DSM-IV (Diagnostic and Statistical Manual of mental disordes)
In men, the incidence rate of VaD was significantly higher among anxiety subjects compared with non-anxiety subjects (incidence rate ratio (IRR) (95% confidence interval (CI)): 3.24 (1.13–9.35); p = 0.029), and no difference was observed in women (IRR (95%confidence intervals (CIs)): 0.68 (0.19–2.23); p = 0.168)
Summary
The analysis of risk factors of overall dementia and its most frequent types, Alzheimer disease (AD) and vascular dementia (VaD), has been put at stake in a report that includes psychological factors such as depression and anxiety [1]. Our research group has recently reported that clinically relevant anxiety was associated with an almost four-fold increase in the risk of AD [2]. It has been shown that depression is a risk factor for VaD [6], the effect of anxiety on this risk is still under study. To assess the association between anxiety and risk of vascular dementia (VaD), as well as potential sex differences, in a community-based cohort. For men, cases of anxiety had 2.6-fold higher risk of VaD (subdistribution hazard ratio (SHR): 2.61; 95%CI: 0.88–7.74) when all potential confounding factors were controlled, with no statistical significance (p = 0.084), but a clinically relevant effect (Cohen’s d: 0.74). Conclusions: In men, but not in women, risk of VaD was higher among individuals with anxiety, with a clinically relevant effect. Potential anxiety-related preventive interventions for VaD might be tailored to men and women separately
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