Relationship between anxiety and agitation in dementia

Abstract

Anxiety and agitation are common in people with dementia. Their consequences can be severe, including increased mortality rates and institutionalization. Despite the importance of these symptoms there is little literature in this area. Some studies have assumed that agitation is the outward manifestation of anxiety, while others have attempted to differentiate between them. The aim of this study was to investigate the relationship between anxiety and agitation in people with mild-to-moderate dementia. A secondary aim was to compare two measures of anxiety which have been used in people with dementia. A cross-sectional correlation design was used. Participants were 40 older adults with dementia. Agitation, anxiety, depression, and level of cognitive impairment were measured. The main finding from the study was that anxiety and agitation are associated in dementia. The degree of correlation did not support the use of agitation as a measure of anxiety. Anxiety symptoms of autonomic sensitivity were not correlated with agitation and could be used to differentiate between the two if this was required. The use of the Rating for Anxiety in Dementia (RAID) was supported as a measure of anxiety in people with dementia.

Acknowledgements

This paper was based on the doctoral dissertation by the first author. The authors would like to thank the clients, carers and staff who took part in this study, for their time and willingness to help. Professor Ed Miller for his guidance and help with the statistics, Gail Scothern for her help setting up the study and recruiting participants, and to Neil Sabin and Ian James for their encouragement and comments on drafts of this paper.