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Differences in Anxiety Among Patients With Early- Versus Late-Onset Alzheimer’s Disease
Natalie C. Kaiser, Ph.D.; Li-Jung Liang, Ph.D.; Rebecca J. Melrose, Ph.D.; Stacy S. Wilkins, Ph.D., ABPP; David L. Sultzer, M.D.; Mario F. Mendez, M.D., Ph.D.
The Journal of Neuropsychiatry and Clinical Neurosciences 2014;26:73-80. doi:10.1176/appi.neuropsych.12100240
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This research was supported by National Institutes of Health Grant #R01AG034499-3 (M. Mendez PI); Dept. of Veterans Affairs VA Merit Review (two separate awards; one to M. Mendez and one to D. Sultzer); Career Development Award to R. Melrose; National Institute of Mental Health #R01-MH56031 (D. Sultzer, PI); GRECC Fellowship Award to N. Kaiser.

From the VA Greater Los Angeles Healthcare System, Los Angeles, CA (NCK, SSW, DLS, MFM), and the David Geffen School of Medicine, UCLA, Los Angeles, CA (L-JL, RJM, DLS).

Send correspondence to: Natalie C. Kaiser, Ph.D.; e-mail: Natalie.Kaiser@va.gov

Copyright © 2014 by the American Psychiatric Association

Received October 08, 2011; Accepted October 14, 2011.


The authors sought to evaluate the incidence and correlates of anxiety in early-onset Alzheimer’s disease (EOAD) versus the more typical late-onset AD (LOAD). A group of 23 EOAD and 22 LOAD patients were compared by the Neuropsychiatric Inventory Anxiety subscale. Demographic and disease-related relationships with anxiety were evaluated, as well as types of anxiety symptoms that were endorsed. EOAD patients had significantly more anxiety symptoms than LOAD patients. Among those with EOAD, anxiety was associated with male gender, higher Mini-Mental State Exam score, and separation from caregivers. Among LOAD patients, anxiety was associated with psychotic and activating psychiatric symptoms. These results have implications for the management and alleviation of anxiety in AD.

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FIGURE 1. Differential Relationship of the Mini-Mental State Exam (MMSE) With Anxiety in Early- vs. Late-Onset Alzheimer’s Disease

Percentage of individuals with (dark gray bar) and without (light gray bar) anxiety.

aIndicates significant between-group differences with respect to presence/absence of anxiety.

bIndicates significant between-group differences with respect to MMSE score. Error bars represent the standard error. Missing data for Neuropsychiatric Inventory Anxiety: N=2 (8%) for early-onset cohort and N=2 for late-onset cohort (9.1%).

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TABLE 1.Demographics of Early- and Late-Onset Alzheimer’s Disease Patients and Caregivers
Table Footer Note

Values are mean (standard deviation), unless otherwise indicated.

Table Footer Note

*p <0.005; **p <0.01; ***p <0.001.

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TABLE 2.Type of Anxiety Symptoms Experienced in EOAD and LOAD Patients
Table Footer Note

EOAD: early-onset Alzheimer’s disease; LOAD: late-onset Alzheimer’s disease.

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TABLE 3.Spearman Correlations Between Diagnosis Groups: Anxiety Subscale × Other Neuropsychiatric Inventory Subscales
Table Footer Note

EOAD: early-onset Alzheimer’s disease; LOAD: late-onset Alzheimer’s disease.

Table Footer Note

*p <0.05; **p <0.01; ***p <0.001.



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