Will Anxiety Give You Dementia?

Anxiety isn’t a cause of dementia, but it may be a warning sign. You can, however, turn your worry into motivation to maintain your health. Here’s how.

If you’re an anxious middle-aged woman, chances are you’ve wondered about your chances of developing dementia. It turns out that your anxiety may be a danger sign.

A 2020 meta-analysis, covering 36 studies, concluded that people with a history of anxiety (or depression) are more likely to develop any form of dementia.

For example, in a 4.5-year study of more than 4,800 people in Spain aged 55 or older (not living in an institution), those with significant anxiety were three times more likely to develop dementia over the study period.

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In an earlier study, scientists examined 800 women, aged 38 to 54 years, in 1968, and again in 1974, 1980, 1992, 2000, and 2005. The study tested their “neuroticism” and sociability by standard measures, and how much recent distress they had felt. “Neuroticism” is largely anxiety, but it can include other kinds of moodiness.

Over the 38-year span, about 19 percent of the women developed dementia, mainly with Alzheimer's disease. Women who scored the highest on neuroticism were twice as likely to develop Alzheimer’s, though not because they were female: Lead researcher Ingmar Skoog, from the University of Gothenburg in Sweden, and others have said they don’t think the results would be different for men.

Take a deep breath: science has not shown that you or anyone else who worries is doomed. Your choices count: Eating habits, sleep, exercise, and many other factors could ultimately explain the link. In this study, researchers kept track of stressful events and found that they explained only some of the connection between dementia and anxiety.

One British study with both men and women found that high anxiety or depression was linked to dying with dementia, even after accounting for smoking, alcohol abuse, years of schooling, or physical ailments like heart disease or diabetes. The researchers suggested one explanation: Chronic unhappiness may raise levels of the stress hormone cortisol, and that may in turn damage the hippocampus, a part of the brain that is critical for memory. Anxiety is also a symptom of the disease.

You can’t change your family history or genes, which have much to do with your chance of developing dementia. But there are ways to lower your risk.

• Exercise. There is early evidence that physical exercise can delay declines in cognitive skills and cut your chances of developing diseases that contribute to dementia, such as diabetes.  
• Eat healthily. The science is young, but eating cold water fish abundant in a type of fat called omega-3s may help prevent dementia.
• Get enough sleep. People who sleep fewer than five hours a night may be twice as likely to develop dementia, compared to those who sleep from six to eight hours.
• Manage blood pressure and high cholesterol. Both of these health problems are risk factors for Alzheimer’s. High homocysteine (an amino acid) in the blood is another risk factor; this can be checked and treated with folic acid.
• Protect yourself against head injuries, which are linked to dementia. Drive only when you are rested, buckle your seat belt, wear a helmet for biking or skiing, and ("fall-proof") your home.
• Get vaccinated against the flu, polio, diphtheria, and tetanus. These shots may also help protect you from dementia.
• Don’t sign onto scary myths, for example that silver dental fillings or cooking with aluminum pans will increase your dementia risk.
• Build pleasurable activities into your daily routines. Yoga, gardening, or listening to music aren’t luxuries if they help maintain your health.
• Tackle the mental habits that feed anxiety. Do you have a tendency to replay painful events, and focus on the causes and meaning of problems, rather than practical solutions? Susan Nolen-Hoeksema, the author of “Women Who Think Too Much: How to Break Free of Overthinking and Reclaim Your Life,” argued that rumination explained why women are twice as likely as men to become depressed. You might think you’re problem-solving, she argued, but you actually end up delaying action. Women who ruminate take 39 days longer to bring symptoms of breast cancer to a doctor.

Learn that it’s okay to distract yourself when you have a problem. The answer might come to you after a break. Even better, develop self-compassion. If you’re hung up on a recent painful event, you might try writing exercises, as long as you make sure you’re kind to yourself.

Some research shows that expressive writing exercises can make ruminators feel worse, but exercises focused on self-compassion help. Cognitive-behavioral therapy is also often recommended for treating anxiety, and studies support its effectiveness.

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