#127 - Anxiety + Dementia: Anxiety Treatment is Essential to Reducing Dementia Risk

Anxiety increases dementia risk by 24% (about the same rate as diabetes) —but treatment for anxiety corrects this. Learn why early detection and treatment in older adults is critical to brain health.

In this episode, I unpack the groundbreaking connection between anxiety and dementia. You’ll learn why anxiety is not a normal part of aging—and why your role as a therapist, social worker, psychologist, or aging life care expert is critical in reducing long-term cognitive decline.

You’ll walk away with four actionable steps you can take to make a meaningful difference in the lives of older clients—and possibly prevent dementia in the process.

This isn't just about reducing symptoms. It's about restoring dignity, peace of mind, and protecting brain health—now and for years to come.

Here’s what you’ll learn:
✅ How anxiety affects the aging brain and increases dementia risk
✅ Why anxiety is often missed or misdiagnosed in older adults
✅ How to screen, normalize, and treat anxiety in therapy
✅ The importance of collaborative care and early detection
✅ How you can adapt your practice to better serve older clients

👉 Get the full list of research and clinical tools I mention here: https://www.mentalhealthandaging.com/podcast/anxiety-dementia-what-therapists-must-know/

PROFESSIONALS: Grab your free guide to working with older adults here


Attention Social Workers, Therapists, Counselors, Psychologists, Aging Life Care Experts... Click here to get Continuing Education Credits

Transcript

If you think anxiety is just another part of getting older, think again. Anxiety is not a normal part of aging, and when anxiety goes undetected and untreated, the risk for dementia goes up. Let's get into it. I'm Dr. Regina Koepp. I'm a board certified clinical psychologist, Geropsychologist and founder of the Center for Mental Health and Aging.

I created the Center for Mental Health and Aging to ensure that you as mental health providers have the tools that you need to meet the mental health needs of older adults.

My goal is each week to give you a mental health and aging tip, and this is because there is a lot of misinformation about what's typical with aging and not as it relates to mental health conditions. And so today we're talking about anxiety and the link between anxiety and dementia.

So let's talk about why anxiety matters so much for brain health and what you can do as a therapist, social worker, psychologist, LMFT, you name it, what you can do in your therapy practice to help bolster the brain and reduce risk for dementia.

In a meta-analysis that was put out in 2020, researchers found that people with anxiety had a 24% increased risk of developing dementia compared to people without an anxiety disorder. This risk was equivalent to conditions like diabetes.

They also found that when that anxiety was treated that effectively, the risk associated with anxiety for dementia essentially went away. And so it's really important that we are identifying anxiety. Treating it as early as possible because when we let anxiety build and build without treatment, it becomes harder to treat.

So at this time, the link between anxiety and dementia is correlational, not causal. So researchers aren't saying anxiety causes dementia. Right now the link is correlational. But here's the thing. Every few years, the Lancet Commission puts out a report of modifiable risk factors for dementia.

And so basically, this report says these are things that cause dementia, where if we treat them, it could reduce our risk. So these are causational risk factors. This isn't all of the risk factors. These are the ones that we can do something about, and a lot of them have to do with lifestyle. On that list is depression and social isolation and substance use or alcohol use.

And so I suspect that on that list, the next time the Lancet Commission comes around, my hunch. I don't know if this is gonna be true or not, but my hunch is anxiety is gonna be on that list based on the research that's coming out now, but currently in 2024 and where we're at now in 2025, anxiety only correlates with dementia it doesn't cause dementia.

But this gives us, as clinicians a window of opportunity because we can help to treat anxiety. When we do, not only do people have a better quality of life, this may help to prevent dementia down the road leading to a better quality of life for years to come.

So how does anxiety increase the risk for dementia? So chronic anxiety contributes to inflammation in the body, to heightened levels of cortisol and to neurological changes in the brain that can make the brain vulnerable,

especially in the hippocampus, which is essential for memory. Anxiety can also lead to sleep disruption, strains in relationships, and withdrawal from relationships. Reduced physical activity and difficulty managing medical conditions, all which increase the risk for dementia disorders.

Yet anxiety, especially among older adults, often goes undetected and untreated sometimes due to this false belief that we have as a society, that anxiety is normal as we age, which it's not, or because we misattribute the symptoms of anxiety to other conditions like physical health conditions when the etiology might be more anxiety related.

Or more than 80% of people 65 and older have a chronic health condition. And so it might be also that chronic health condition is triggering anxiety symptoms or vice versa. And we misattribute the anxiety symptoms for physical ones.

Misattribution is a common reason that mental health conditions go undetected and untreated among older adults. And so now that we know better, we're doing better.

And here's why this is important for therapists when anxiety goes undetected and untreated. The condition compounds, it becomes harder to treat. It makes the person more vulnerable to physical health and brain health conditions. And so it's really important that we're taking anxiety symptoms seriously and educating our colleagues, our patients, our clients and family and the general public.

Here's the good news. Mental health conditions are treatable among older adults. And so as a therapist, the earlier you can detect it and treat it the better. Not only are you gonna be helping the person at this point in time, you'll be helping their brain and their psyche for years to come.

That's where you come in. You can educate your older clients about anxiety and provide treatment for it and help the person live a better quality of life now, and it will pay off later.

So if you found this tip helpful, I would love to invite you to my continuing education courses that dive deeper into meeting the mental health needs of older adults. In therapy. So check out my continuing education courses below. You'll get CE credits and improve your practice to meet the mental health needs of older adults. So it's really a win-win.

So here are four meaningful steps that you can take to make a difference in treating anxiety among older adults. The first is that you can screen for anxiety with the older clients that you serve.

Be looking for things like sleep disturbance, somatic complaints. Older adults often describe their mental health symptoms as physical complaints, and it really might be both because. Like I mentioned earlier, more than 80% of people 65 and older have a chronic health condition, and so this will require some fine tuning, like helping your older clients fine tune.

Is it physical health concern, mental health concern, or both? Often both. And so just fine tuning and getting curious and diving deeper will help in this process.

Normalize and educate, dispel myths about what's typical with aging and not. So anxiety is not typical with aging. Older adults do indeed benefit from psychotherapy and mental health care. And so to normalize and educate, also to let them know they're not alone. It makes sense that they're having an anxiety response to all sorts of medical uncertainty, or it makes sense that they're having an anxiety response to these big life changes.

And so normalize, educate, and then provide hope and recommendations for care. Like we know that we can help manage your anxiety symptoms with psychotherapy. Let me explain how that works and so on. Then provide therapy. Do what you do best, which is to provide psychotherapy to people and make sure that you're modifying your practice for older adults.

And then number four is to collaborate and partner with healthcare teams. So because there is an overlap between mental health and physical health, and people 65 and older have significant physical health conditions. It's critical that you're collaborating with healthcare providers on the treatment of older adults in terms of mental health care.

It takes a little bit more time, but it pays off. There is a return on your investment of time. It really helps to stabilize care, to provide continuity of care, to provide better care. It pays off over time when you have a solid relationship with the physician and the client understands that you're working collaboratively . And also sometimes, depending on the conditions, depending on the needs, you want a bigger team than just yourself. When working with older adults and in fact.

The research shows that collaborative care is an evidence-based treatment model for working with older adults with mental health concerns. So it does take a little bit more time on the, at the beginning, but the reward is great down the road.

Anxiety is a matter of mental health, physical health, and brain health. The earlier we can treat the anxiety, the better for the person. Now and in the future, and as a therapist, you have a really important role in detecting and treating anxiety when it shows up. We aren't just reducing suffering. We're helping to prevent cognitive decline and promote quality of life for years to come.

It is only with your help that we will meet the mental health needs of older adults. And so I invite you to modify your practice to meet those mental health needs in some of our continuing education training programs below. We offer CE courses for social workers, psychologists, therapists, l MFTs, counselors, you name it. Checkout our highly rated continuing education courses below.

 If you like this mental health and aging tip, will you subscribe and leave a review? It really does help people to find these resources so that we can make sure more people have accurate information about mental health and aging.

Regina Koepp: I'm Dr. Regina Koepp and I'll see you for our next mental health and aging tip.