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As a caregiver or loved one of someone living with Alzheimer’s disease, you may notice changes in how they think, feel, and act over time. These changes can be difficult to witness, especially when they seem to cause your loved one anxiety or distress.
Members of myALZteam share how challenging it can be to see their loved ones with dementia experience anxiety. One member shared, “My husband is going through a lot of anxiety. He won’t take anything for it. I hate to watch him suffer!” Another member asked for tips for managing a loved one’s anxiety: “My mom is all of a sudden afraid to walk. She resists us helping her. Any suggestions? Her anxiety level is very high.”
For many people, anxiety and dementia are closely connected. Understanding the connection between anxiety and dementia can help you manage them and help improve your loved one’s quality of life.
Anxiety affects around 40 percent of people living with Alzheimer’s disease. There isn’t just one cause. Someone living with Alzheimer’s disease or other types of dementia can experience anxiety due to many different causes.
A person who has recently been diagnosed with Alzheimer’s disease may experience anxiety because they worry about how they and their family will cope with their cognitive decline. In the early stages of Alzheimer’s, they may still recognize their memory loss and worry about what will happen in the future.
As dementia progresses and a person experiences more Alzheimer’s symptoms, anxiety may become more tied to confusion and disorientation. A person may feel uneasy when they don’t recognize familiar people and surroundings or they are asked to do something they don’t understand, like going to appointments, taking medications, or moving into an assisted living facility.
Brain changes in Alzheimer’s may also contribute to anxiety. Alzheimer’s disease and other types of dementia can often damage parts of the brain responsible for emotional regulation, which can trigger anxiety, stress, and depression.
Changes to certain parts of the brain can also result in hallucinations (hearing or seeing things that aren’t there) or delusions (false ideas or beliefs). These can also trigger anxiety symptoms.
A person with dementia may experience anxiety related to medication side effects. Suddenly stopping a medication — especially one taken for mental health symptoms, such as antidepressants — can also trigger anxiety.
If you notice anxiety in a loved one with dementia, there are steps you can take to give them the support they need. People living with dementia may show a wide range of anxiety symptoms. Even if they don’t describe feeling anxious, loved ones and caregivers can often notice the signs.
Although anxiety is often thought of as a mental health problem, it often causes physical symptoms. This happens because stress and anxiety activate the autonomic nervous system. The autonomic nervous system controls automatic processes like breathing and heart rate. It becomes activated when a person feels stressed or in danger, producing a fight-or-flight response.
A person with dementia might show physical anxiety symptoms, such as:
A person with dementia may feel confused about why they’re experiencing physical symptoms like these, which can make their anxiety worse.
You may notice signs of anxiety in a loved one with dementia through their behavior. Behavioral signs of anxiety can include:
Some people are at a higher risk of developing anxiety symptoms when they have Alzheimer’s disease. A person with dementia is more likely to experience anxiety symptoms if they:
There are many ways to treat or manage anxiety. If a loved one with dementia shows signs of anxiety, talk to their healthcare team.
You can help someone with dementia manage their anxiety by identifying their main triggers — factors that cause anxiety or make symptoms worse.
Once you know the triggers, take steps to address them. This can look a little different for everyone. For example, if a person with dementia appears to feel anxious when they’re alone, include them in social activities. If boredom is a trigger, plan activities to keep their mind occupied. Creating a calm home environment and following a predictable daily routine can also help reduce anxiety.
Some people with dementia and anxiety may benefit from professional therapy, such as cognitive behavioral therapy (CBT) or music therapy.
Doctors might prescribe short-term medications to help manage severe anxiety. It’s important to remember that medications for anxiety can come with side effects.
Your loved one’s doctor may also prescribe other medications to address specific dementia-related symptoms that contribute to anxiety, such as a sedative to help with sleep problems. They might adjust current medications if any medication side effects are worsening anxiety.
Some research suggests that anxiety could increase the risk of developing dementia later in life. One meta-analysis found that people with anxiety had a 24 percent higher risk of dementia compared with people without anxiety. However, more research is needed to confirm whether anxiety causes dementia or if it’s an early symptom.
Anxiety has also been linked to a faster progression of mild cognitive impairment (MCI). MCI involves mild cognitive decline that doesn’t always affect daily functioning. It can progress to more serious memory loss, but not always.
One reason people with anxiety may be at a higher risk for Alzheimer’s disease is that anxiety could contribute to brain changes linked with the disease. While a direct cause-and-effect relationship is difficult to prove, a few studies have found some associations.
Anxiety is linked to high levels of a toxic protein called beta-amyloid, which can build up in the brain to form beta-amyloid plaques. Amyloid deposits or plaques develop when amyloid proteins clump together, and they can affect brain function. Amyloid plaques are a sign of Alzheimer’s disease.
Another protein in the brain, tau, can also contribute to Alzheimer’s disease. Tau can form abnormal structures in the brains of people with Alzheimer’s and clump together into tau tangles. Tau tangles make it hard for brain cells to communicate. Research indicates that anxiety and negative thinking can increase tau tangles in the brain.
Although antianxiety medications can reduce anxiety symptoms and often improve a person’s quality of life, some medications for anxiety may increase the risk of Alzheimer’s disease. For example, use of benzodiazepines, such as alprazolam (Xanax), should generally be limited to as needed or once a month, because frequent use can increase the risk of dementia.
Keep in mind that managing anxiety is still important for managing your dementia risk. If you’re concerned about dementia, talk to your doctor about the best options for treating anxiety.
If you spend a lot of time with someone with dementia who also has anxiety, you can support them in ways beyond medication. You can:
If you notice a loved one’s anxiety symptoms are getting worse, be sure to tell their doctor. Their healthcare team can adjust the care plan as needed and provide additional tips for reducing anxiety at home.
On myALZteam, people share their experiences with Alzheimer’s disease, get advice, and find support from others who understand.
Have you noticed signs of anxiety from a loved one with dementia? Let others know in the comments below.
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