Takeaway
- In older patients with anxiety, reliable improvement in anxiety symptoms following psychological intervention was associated with a lower incidence of all-cause dementia, Alzheimer’s disease, and vascular dementia up to 8 years later.
- These effects did not differ by anxiety disorder diagnosis.
Why This Matters
- Older people are still under-represented in psychological intervention services compared with younger people.
- Findings suggest that improving access to psychological intervention services for older people should be a key research and policy goal.
Study Design
- A prospective cohort study of 111,958 older patients (age ≥65 years) with anxiety and without dementia, identified using data from the nationally provided psychological intervention service in England from 2012 to 2019, Improving Access to Psychological Therapies.
- Primary outcome: all-cause dementia.
- Funding: Alzheimer’s Society and others.
Key Results
- Of 111,958 participants, 4510 (4.0%) were diagnosed with dementia.
- Patients with anxiety who showed reliable improvement in anxiety had lower rates of later dementia diagnosis than those who did not show reliable improvement (3.9% vs 5.1%).
- Reliable improvement in anxiety symptoms following psychological intervention was associated with a lower incidence of (adjusted HR; 95% CI):
- all-cause dementia (0.83; 0.78 to 0.88; P<0.0001);
- Alzheimer’s disease (0.85; 0.77 to 0.94; P=0.0009); and
- vascular dementia (0.80; 0.71 to 0.90; P<0.0003).
Limitations
- Study excluded patients with incident dementia within 1 year of the end of psychological intervention.
References
References
