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Anxiety as a Predictor for Cognitive Decline and Dementia: A Systematic Review and Meta-Analysis
Gulpers B, Ramakers I, Hamel R, Köhler S, Oude Voshaar R, Verhey F.. The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry, 2016-07-04
Topic: Risk, prevention and care in population studies
Background Because anxiety is postulated as a risk factor for dementia, we performed a systematic review and meta-analysis to investigate whether anxiety predicts cognitive decline and/or dementia, taking the stage of cognitive decline as well as setting into account. Methods A systematic literature search up to January 2015 was performed to identify all longitudinal studies on the association between anxiety and cognition. Data extraction and methodological quality assessment were conducted independently by two authors. Where possible, pooled relative risks were calculated to examine anxiety as a possible risk factor for cognitive decline cognitive impairment and dementia in community studies (objective 1), as well as for conversion to dementia patients referred to memory clinics (objective 2). Results Twenty studies met inclusion criteria. Data on cognitive decline were too heterogeneous for meta-analysis. Anxiety predicted incident cognitive impairment (4 studies, relative risk [RR]: 1.77, 95% confidence interval [CI]: 1.38-2.26, z = 4.50, p Conclusions Anxiety is associated with an increased risk for cognitive impairment and dementia in the community. Stronger associations were driven by higher age, suggesting that it is a prodromal symptom. Causal biological pathways have also been described, which could explain the risk for incident cognitive impairment in the community. Future studies should include mediating mechanism when studying anxiety as a predictor for cognitive decline and/or dementia.
Key findings
- Results Twenty studies met inclusion criteria.
- Anxiety predicted incident cognitive impairment (4 studies, relative risk [RR]: 1.77, 95% confidence interval [CI]: 1.38-2.26, z = 4.50, p Conclusions Anxiety is associated with an increased risk for cognitive impairment and dementia in the community.
- Stronger associations were driven by higher age, suggesting that it is a prodromal symptom.
Why it matters
This meta-analysis found that anxiety was associated with an increased risk of cognitive impairment and dementia in the community, with stronger links at higher age suggesting it may be a prodromal symptom. It does not show that treating anxiety prevents dementia.
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Study details
- Study designsystematic review
- Evidence strengthHigh
How this study scored 64/100
Published in a peer-reviewed journal, and it is a systematic review of all the studies on the question. Scored zero for sample size, effect reported and studied in people because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry) |
| Journal's citation record | 2 / 4 | American Journal of Geriatric Psychiatry: journal h-index 178 (OpenAlex, 2026-10-29) |
| Study design | 12 / 12 | A systematic review of all the studies on the question |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2016 — within 20 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | A review of other studies — randomisation is not credited here |
| Times cited | 6 / 7 | Cited 408 times (OpenAlex, 2026-10-10) |
| Citations per year | 4 / 5 | 34.0 citations a year over 12 year(s) since 2016 |
| Impact for its field and year | 3 / 6 | Cited 3.3× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 2 / 6 | Cited by 8 other studies in this library |
| Still being cited | 3 / 4 | Cited 112 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 4 / 4 | Last-listed author Frans R.J. Verhey: h-index 111 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | University of Groningen: institution h-index 1,383 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 4 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 27591161) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 64 / 100 | — |
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Gulpers, B., Ramakers, I., Hamel, R., Köhler, S., Oude Voshaar, R., & Verhey, F. (2016). Anxiety as a Predictor for Cognitive Decline and Dementia: A Systematic Review and Meta-Analysis. The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry. https://doi.org/10.1016/j.jagp.2016.05.015
Vancouver
Gulpers B, Ramakers I, Hamel R, Köhler S, Oude Voshaar R, Verhey F. Anxiety as a Predictor for Cognitive Decline and Dementia: A Systematic Review and Meta-Analysis. The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry. 2016. doi:10.1016/j.jagp.2016.05.015. PMID: 27591161.
BibTeX
@article{gulpers2016-27591161,
author = {Gulpers, B. and Ramakers, I. and Hamel, R. and Köhler, S. and Oude Voshaar, R. and Verhey, F.},
title = {{Anxiety as a Predictor for Cognitive Decline and Dementia: A Systematic Review and Meta-Analysis}},
journal = {The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry},
year = {2016},
doi = {10.1016/j.jagp.2016.05.015},
pmid = {27591161},
url = {https://doi.org/10.1016/j.jagp.2016.05.015}
}
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