Ask the Experts: Mood, anxiety disorders, and dementia

Question:
How do mood and anxiety disorders increase the risks of dementia?

Answered by: Dr. Philip Muskin

It is not clear why mood and anxiety disorders predict dementia. One strong possibility is that an underlying biological mechanism connects the disorders. Depression, for some people, may be an early sign of dementia.

Anxiety may be the result of cognitive impairments that are very mild at first. That is to say, the subtle biological changes that result in the depressive or anxiety disorders, eventually disrupt the function of the brain and result in dementia.

For most of the dementias, the vast majority of which are Alzheimer Dementia, symptoms appear many years after the biological processes have begun. It is possible that the disorders are related by chance, i.e., that the genes responsible for the disorders happen to sit relatively close to each other on chromosomes.

Thus people who have depression or anxiety, which will show up earlier in life than does dementia, are also likely to get dementia.

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Philip Muskin, M.D.
Chief: Consultation-Liaison Psychiatry

Dr. Muskin’s research and publications include mood disorders and AIDS, the psychodynamics of the failure of empathy towards patients with AIDS, panic disorder, treatment of anxiety and depression in medically ill patients, maladaptive denial of physical illness, personality disorders in the primary care setting, the role of religiosity in patients’ decisions regarding do-not-resuscitate status, the psychodynamics of physician-assisted suicide, and the impact of intercessory prayer on medical outcomes.