Anxiety is frequent in people with dementia, with more than two thirds of people experiencing at least one anxiety symptom, although the frequency of General Anxiety disorder is much lower, probably in the range of 5-10%. The most common symptoms are worry, fearfulness, insomnia, tension, restlessness, physical complaints and fidgeting. Fifty-percent of anxiety symptoms in people with dementia occur in the context of depression. Anxiety can also accompany irritability or restlessness; although it frequently ocurrs as a sole symptom. Anxiety is prevalent in all the major late onset dementias, but appears to be significantly more common in people with vascular dementia. Anxiety has been described as particularly frequent in early dementia where anxieties about social situations are predominant; but also increases in frequency as the dementia becomes severe. Compared to other mood or behavioral symptoms, anxiety has received very little attention; a major oversight when considering the high frequncy of these symptoms and the distress that often results. Nothing is known about the underlying mechanisms and there are no specific treatment studies; although a careful evaluation for and treatment of concurrent depression would seem pertinent.
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