title: A longitudinal study of anxiety and cognitive decline in dementia with Lewy bodies and Alzheimer's disease.
abstract: BACKGROUND
  Anxiety in dementia is common but not well studied. We studied the associations of anxiety longitudinally in Alzheimer's disease (AD) and dementia with Lewy bodies (DLB).
  
  
  METHODS
  In total, 194 patients with a first-time diagnosis of dementia were included (n = 122 patients with AD, n = 72 patients with DLB). Caregivers rated the patients' anxiety using the Neuropsychiatric Inventory, and self-reported anxiety was assessed with the anxiety and tension items on the Montgomery-Åsberg Depression Rating Scale. The Mini Mental State Examination was used to assess cognitive outcome, and the Clinical Dementia Rating (CDR)-Global and CDR boxes were used for dementia severity. Linear mixed effects models were used for longitudinal analysis.
  
  
  RESULTS
  Neither in the total sample nor in AD or DLB was caregiver-rated anxiety significantly associated with cognitive decline or dementia severity over a 4-year period. However, in patients with DLB, self-reported anxiety was associated with a slower cognitive decline than in patients with AD. No support was found for patients with DLB with clinical anxiety having a faster decline than patients with DLB without clinical anxiety. Over the course of 4 years, the level of anxiety declined in DLB and increased in AD.
  
  
  CONCLUSIONS
  Anxiety does not seem to be an important factor for the rate of cognitive decline or dementia severity over time in patients with a first-time diagnosis of dementia. Further research into anxiety in dementia is needed.
authors.affiliation: Department of Research and Innovation, Helse-Fonna HF Haugesund Hospital, Postbox 2170, 5504, Haugesund, Norway. monica.breitve@helse-fonna.no.|Old Age Department, Clinic of Psychiatry, Helse-Fonna HF Haugesund Hospital, Postbox 2170, 5504, Haugesund, Norway. monica.breitve@helse-fonna.no.|Faculty of Medicine, University of Bergen, Postbox 7804, 5020, Bergen, Norway. monica.breitve@helse-fonna.no.
authors.forename: Monica H
authors.initials: MH
authors.lastname: Breitve
authors.affiliation: Department of Clinical Psychology, University of Bergen, Christies Gate 12, 5015, Bergen, Norway. minna.hynninen@uib.no.|NKS Olaviken Psychogeriatric Hospital, Ulriksdal 8, 5009, Bergen, Norway. minna.hynninen@uib.no.
authors.forename: Minna J
authors.initials: MJ
authors.lastname: Hynninen
authors.affiliation: TIPS - Centre for Clinical Research in Psychosis, Stavanger University Hospital, 4011, Stavanger, Norway. bronnick@gmail.com.|Network for Medical Sciences, University of Stavanger, 4036, Stavanger, Norway. bronnick@gmail.com.
authors.forename: Kolbjørn
authors.initials: K
authors.lastname: Brønnick
authors.affiliation: Department of Research and Innovation, Helse-Fonna HF Haugesund Hospital, Postbox 2170, 5504, Haugesund, Norway. luiza.chwiszczuk@helse-fonna.no.|Faculty of Medicine, University of Bergen, Postbox 7804, 5020, Bergen, Norway. luiza.chwiszczuk@helse-fonna.no.|Neurological Department, Clinic of Medicine, Helse-Fonna HF Haugesund Hospital, Postbox 2170, 5504, Haugesund, Norway. luiza.chwiszczuk@helse-fonna.no.
authors.forename: Luiza J
authors.initials: LJ
authors.lastname: Chwiszczuk
authors.affiliation: Research Department, Stavanger University Hospital, Stavanger, Norway. bjorn.auestad@uis.no.|Department of Mathematics and Natural Sciences, University of Stavanger, 4011, Stavanger, Norway. bjorn.auestad@uis.no.
authors.forename: Bjørn H
authors.initials: BH
authors.lastname: Auestad
authors.affiliation: Centre for Age-Related Medicine, Stavanger University Hospital, Armauer Hansensvei 20, 4011, Stavanger, Norway. daarsland@gmail.com.|Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Centre for Alzheimer Research, Karolinska Institutet, 141 57, Huddinge, Sweden. daarsland@gmail.com.
authors.forename: Dag
authors.initials: D
authors.lastname: Aarsland
authors.affiliation: Department of Research and Innovation, Helse-Fonna HF Haugesund Hospital, Postbox 2170, 5504, Haugesund, Norway. arvid.rongve@helse-fonna.no.|Old Age Department, Clinic of Psychiatry, Helse-Fonna HF Haugesund Hospital, Postbox 2170, 5504, Haugesund, Norway. arvid.rongve@helse-fonna.no.|Faculty of Medicine, University of Bergen, Postbox 7804, 5020, Bergen, Norway. arvid.rongve@helse-fonna.no.
authors.forename: Arvid
authors.initials: A
authors.lastname: Rongve
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000453:epidemiology* / Q000523:psychology*; D001007:Anxiety / Q000453:epidemiology*; D017028:Caregivers; D005260:Female; D006801:Humans; D020961:Lewy Body Disease / Q000453:epidemiology* / Q000523:psychology*; D008137:Longitudinal Studies; D008297:Male; D008609:Mental Status Schedule; D009483:Neuropsychological Tests; D012720:Severity of Illness Index
references.citation: Fam Pract. 2013 Feb;30(1):25-30
references.pmid: 22915794
references.citation: Neurology. 2007 May 8;68(19):1596-602
references.pmid: 17485646
references.citation: Am J Geriatr Psychiatry. 2014 Dec;22(12):1382-90
references.pmid: 24745561
references.citation: Neurology. 2013 Aug 27;81(9):833-40
references.pmid: 23892702
references.citation: Neurology. 1994 Dec;44(12):2308-14
references.pmid: 7991117
references.citation: J Anxiety Disord. 2013 Jan;27(1):125-30
references.pmid: 23270995
references.citation: J Alzheimers Dis. 2006;9(3 Suppl):417-23
references.pmid: 16914880
references.citation: Dement Geriatr Cogn Disord. 2008;26(5):445-52
references.pmid: 18974647
references.citation: Arch Gerontol Geriatr. 2009 Sep-Oct;49(2):e101-4
references.pmid: 19084284
references.citation: Dement Geriatr Cogn Dis Extra. 2014 Dec 18;4(3):509-16
references.pmid: 25685141
references.citation: Mov Disord. 2012 Aug;27(9):1125-8
references.pmid: 22692724
references.citation: Int Psychogeriatr. 1997;9 Suppl 1:173-6; discussion 177-8
references.pmid: 9447441
references.citation: Clin Psychol Rev. 2008 Oct;28(7):1071-82
references.pmid: 18555569
references.citation: Psychosom Med. 2002 May-Jun;64(3):510-9
references.pmid: 12021425
references.citation: J Am Med Dir Assoc. 2015 May 1;16(5):380-7
references.pmid: 25687925
references.citation: Am J Geriatr Psychiatry. 2015 May;23(5):466-76
references.pmid: 25500120
references.citation: J Psychiatr Res. 1975 Nov;12(3):189-98
references.pmid: 1202204
references.citation: Psychogeriatrics. 2015 Dec;15(4):242-7
references.pmid: 25737233
references.citation: Br J Psychiatry. 1979 Apr;134:382-9
references.pmid: 444788
references.citation: Int Psychogeriatr. 2012 Nov;24(11):1771-8
references.pmid: 22687266
references.citation: Neurology. 2009 Oct 6;73(14):1127-33
references.pmid: 19805729
references.citation: J Gerontol A Biol Sci Med Sci. 1999 Jul;54(7):M348-52
references.pmid: 10462166
references.citation: Int Psychogeriatr. 2009 Dec;21(6):1142-7
references.pmid: 19615124
references.citation: Int J Geriatr Psychiatry. 2005 Oct;20(10):989-97
references.pmid: 16163751
references.citation: Int J Geriatr Psychiatry. 2003 Oct;18(10):951-9
references.pmid: 14533128
references.citation: Int J Geriatr Psychiatry. 2000 Dec;15(12):1125-9
references.pmid: 11180469
references.citation: Dement Geriatr Cogn Disord. 2008;25(1):1-8
references.pmid: 18025783
references.citation: Am J Geriatr Psychiatry. 2008 Oct;16(10):790-803
references.pmid: 18827225
references.citation: Clin Interv Aging. 2014;9:1051-61
references.pmid: 25031530
references.citation: Arch Gerontol Geriatr. 2008 Jan-Feb;46(1):101-6
references.pmid: 17467082
references.citation: J Neuropsychiatry Clin Neurosci. 2003 Spring;15(2):180-6
references.pmid: 12724459
references.citation: J Am Geriatr Soc. 1998 Feb;46(2):210-5
references.pmid: 9475452
references.citation: Psychol Med. 2013 May;43(5):911-20
references.pmid: 22954311
references.citation: Neurology. 1984 Jul;34(7):939-44
references.pmid: 6610841