Anxiety and dementia

Anxiety is a normal feeling that everyone experiences now and again. In some people, however, these feelings can be very strong and persistent.

What is anxiety and how common is it in people with dementia?

Anxiety can interfere with a person’s everyday life. It is the main symptom of several different conditions, including generalised anxiety disorder, panic disorder, phobias and obsessive compulsive disorder.

About one in 10 people will experience an anxiety disorder at some point in their lives and many people will have more than one form.

Anxiety is more common in people with dementia than those without, affecting between 5% and 20%. Like depression, anxiety is thought to be more common in vascular dementia, and probably also in Parkinson’s disease dementia, than in Alzheimer’s disease.

Anxiety is common throughout the different stages of dementia.

What is generalised anxiety disorder (GAD)?

People with GAD feel anxious about a wide range of issues and situations. They find it hard to control their anxiety and they feel anxious most of the time.

What is panic disorder?

This is characterised by panic attacks in which the person will get sudden, intense attacks of anxiety. The attack may be accompanied by feelings of losing control (or ‘going crazy’) and feelings that they are about to die, as well as physical symptoms such as trembling and sweating.

What are phobias?

A phobia is an intense, irrational or disproportionate feeling of fear about a particular object or situation. Common phobias include social phobia (a fear of being around others) and agoraphobia (a fear of being in situations or environments such as public spaces, where escape might be difficult or that help wouldn’t be available if things go wrong).

What is obsessive-compulsive disorder (OCD)?

A person with OCD is unsettled by thoughts and obsessive worries that make them feel anxious. Their anxiety may be temporarily relieved when they carry out a compulsive behaviour or ritual (for example, washing their hands or carrying out an activity a certain number of times).

What are the symptoms of anxiety?

There is a large overlap in the symptoms of the different anxiety disorders. General symptoms of anxiety include:

  • psychological symptoms – feeling extremely worried, tired, uneasy and irritable, experiencing feelings of dread and having problems concentrating
  • physical symptoms – fast or irregular heartbeats (palpitations), shortness of breath, excessive sweating, dry mouth, trembling, dizziness, nausea, diarrhoea, stomach ache, headache, insomnia, frequent urination, excessive thirst, muscle tension or pains.

People with dementia and anxiety may also have behavioural changes including agitation, hoarding, seeking constant reassurance, not wanting to be left alone or closely following their carer or family member around. The person may also appear restless and pace or fidget.