Is anxiety a risk factor for dementia

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Is anxiety a risk factor for dementia?

• John Gallacher
• Tony Bayer
• Mark Fish
• Yoav Ben-Shlomo
• Frank Dunstan

Active ageing research group www.activeageing.co.
uk
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CaPS Methods

• Total cohort
• 2,959 men aged 45-59 at recruitment
• Measures at C2 (2nd examination C1 5 years)
• Trait anxiety (STAI)
• Vascular risk factors
• CHD
• Demographics
• Measures at C3 (C2 5 years)
• NART (pre-morbid cognitive function)
• Measures at C5 (C2 17 years men aged 67-81
  years)
• Cognitive impairment CIND, Dementia

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Statistical analysis

• Logistic regression
• Outcomes
• Overall impairment (CIND Dementia)
• CIND
• Dementia
• Adjustment for covariates
• age, sbp, cholesterol, alcohol consumption
• social class, marital status, smoking, diabetes,
  leisure activity
• Adjustment for pre-morbid cognitive function
• NART at C3

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Available data Sample size main analysismen
with complete covariate data
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Available data Sample size 20 analysismen with
complete covariate data and no evidence of
decline at baseline
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Distribution of Trait Anxiety
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Anxiety and cognitive impairment 31st-95th
centile in 982 men with complete data
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Anxiety and all cognitive impairment 31st-95th
centile in 755 men with complete data
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Anxiety and CIND 31st-95th centile in 755 men
with complete data
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Anxiety and Dementia 31st-95th centile in 755
men with complete data
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Anxiety and cognitive impairment 31st-95th
centile in 755 men with complete data and no
evidence of decline at baseline
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Conclusion

• Anxiety is associated with cognitive impairment
• Duration of follow-up (17 yrs) suggests causal
  association
• Insidious nature of cognitive decline means
  reverse causality cannot be ruled out
• No control for depression association may not be
  independent
• Analyses for dementia likely to be conservative
  due to survivor effect
• Some evidence that effect is stronger for
  non-vascular dementia

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Further work Age well, feel good

• Pilot Study
• October 2008-March 2009
• 3,000 older persons 60 years
• 15,000 mailed invitations
• Web links from interest groups
• Remote
• Recruitment (web)
• Consent (web)
• Assessment (web)
• Bio-sampling (mail)
• Follow-up (record linkage)

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www.activeageing.co.uk
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Anxiety and all cognitive impairment 31st-95th
centile in 755 men with complete data and no
evidence of decline at baseline
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Anxiety and CIND 31st-95th centile in 755 men
with complete data and no evidence of decline at
baseline
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Anxiety and dementia 31st-95th centile in 755
men with complete data and no evidence of
decline at baseline