Is Anxiety a Hidden Risk Factor for Dementia? Experts Weigh In
Anxiety—a relentless force that gnaws at the mind—manifests in a myriad of ways, both physically and psychologically. While its impact on mental well-being is well-documented, emerging research suggests it may also pose a formidable threat to cognitive health.
A groundbreaking study, published in July in the Journal of the American Geriatrics Society, has unveiled a startling revelation: older individuals, particularly those 70 and younger, who struggle with anxiety may harbor a heightened risk of developing dementia as they age. The implications are profound.
What’s particularly intriguing is that this association was observed in individuals grappling with both chronic, long-standing anxiety and those who developed it later in life. However, a silver lining emerged—once anxiety subsided, so too did the elevated dementia risk.
“The findings highlight anxiety as a potential target for dementia prevention and suggest that effectively treating anxiety might mitigate this risk,” stated study author Kay Khaing, MMed, a conjoint lecturer at Newcastle University’s School of Medicine and Public Health.
Experts have weighed in on this compelling link between anxiety and dementia, exploring what this could mean for the future of cognitive health interventions.
The Unsettling Link Between Anxiety and Dementia
The notion that anxiety and dementia are intertwined is not new. Decades of research have hinted at this connection, but recent findings solidify the relationship, according to Michele Nealon, PsyD, a licensed clinical psychologist and president of The Chicago School.
“Chronic anxiety, in particular, appears to be a formidable player in cognitive decline,” added Ozan Toy, MD, MPH, neuropsychiatrist and chief medical officer at Telepsychiatry.
However, past studies often failed to distinguish between longstanding anxiety and newly developed symptoms—until now. This latest research from The Journal of the American Geriatrics Society fills that gap.
Drawing from a sample of 2,132 Australians with an average age of 76 (some as young as their 50s), the study meticulously tracked mental health trends over five years. At the study’s outset and again at the five-year mark, participants were assessed for anxiety. Among them, 221 individuals exhibited persistent anxiety, while an additional 117 developed new-onset anxiety during the study period.
The findings were striking: those with new-onset anxiety were 3.2 times more likely to develop dementia than their anxiety-free counterparts, while those with chronic anxiety faced a 2.8-fold increase in risk. Yet, individuals whose anxiety had dissipated by the second check-in displayed no significant increase in dementia risk—a tantalizing suggestion that treating anxiety could be key in dementia prevention.
Does Anxiety Directly Cause Dementia?
The question looms large: is anxiety merely a harbinger of dementia, or does it actively set the stage for cognitive decline?
While studies like this one illuminate the connection, they stop short of proving causation, emphasized Stacey Podkovik, DO, a neurosurgery resident at Riverside University Health System.
One prevailing theory implicates the cardiovascular system. Anxiety is notorious for exacerbating heart disease, particularly in younger individuals, Podkovik explained. “We know cardiovascular disease is a significant risk factor for dementia. If we can reduce anxiety early on, we may simultaneously alleviate the chronic strain on cardiovascular health.”
Another hypothesis centers on stress hormones. Prolonged anxiety leads to heightened cortisol levels, which may degrade brain structures responsible for memory and cognition, Nealon noted.
Meanwhile, Toy pointed to neuroinflammation as another potential culprit. Chronic anxiety may sustain a prolonged inflammatory response in the brain, leading to neuronal damage—a known precursor to dementia.
Complicating matters further, anxiety rarely exists in isolation. Depression and sleep disturbances, both commonly intertwined with anxiety, also elevate dementia risk, Nealon explained. This overlap muddles the picture but underscores the likelihood that anxiety is part of a broader tapestry of cognitive vulnerability.
Yet, the most thought-provoking discovery from the study was that individuals whose anxiety resolved did not exhibit a heightened dementia risk.
“This could indicate that once the cascade of cognitive stressors is halted, the brain retains a remarkable capacity for resilience,” Toy suggested.
But there’s an alternative perspective: perhaps anxiety isn’t a precursor to dementia at all—perhaps it’s an early warning sign.
Toy theorized that new-onset anxiety may, in some cases, be an epiphenomenon—a symptom of the underlying neurodegenerative process rather than its cause.
“In early dementia, as individuals become increasingly aware of their memory slipping, anxiety is a natural response,” Toy explained. “Rather than anxiety fueling dementia, the initial cognitive decline might be what’s triggering the anxiety.”
Managing Anxiety to Safeguard Cognitive Health
The evidence, while compelling, is still evolving. Experts agree that more rigorous research is needed to unravel the complex interplay between anxiety and dementia.
However, if future studies reinforce anxiety as a significant risk factor, it could revolutionize dementia prevention strategies, Nealon emphasized.
“This would necessitate integrating mental health care into dementia prevention frameworks,” she said. “Routine anxiety screenings in midlife could become standard practice, and public health campaigns might prioritize early intervention.”
Although anxiety can manifest at any age, much of the research linking it to dementia focuses on individuals over 60. Still, early intervention—around age 40—could be ideal, Nealon suggested.
“The brain’s ability to adapt diminishes with age, leaving it increasingly vulnerable to the corrosive effects of chronic stress,” she noted. “Addressing anxiety earlier in life could help preserve long-term cognitive function.”
Encouragingly, the study’s findings suggest that even in later years, the brain retains a degree of plasticity. Treating anxiety appears to mitigate dementia risk, underscoring the importance of timely intervention.
“If the damaging effects of anxiety are curtailed before they take hold, the brain has a chance to recover,” Nealon explained. “This highlights the urgency of effective anxiety management.”
So, what does treatment entail?
According to Toy, an integrative approach combining psychotherapy—particularly cognitive behavioral therapy (CBT)—with medication, when necessary, is most effective. Beyond clinical interventions, lifestyle modifications play a crucial role: regular exercise, mindfulness practices, and social engagement all contribute to mental well-being and cognitive resilience.
“If someone is grappling with persistent anxiety, they should seek help,” Khaing urged. “Not only can anxiety be managed and alleviated, but doing so might also help safeguard cognitive health in the years to come.”