Anxiety occurs in up to 75% of people living with dementia or cognitive impairment.
Despite its high prevalence, anxiety continues to be poorly recognised within this population.
Treatment options for anxiety in people with cognitive impairment are scarce, with traditional interventions not adapted to dementia-specific needs.
Psychotherapies have demonstrated early success as a treatment option that accounts for these unique needs. They are almost exclusively delivered in person, creating a major barrier to access anxiety interventions – especially for those living in rural and remote communities.
This article introduces a newly developed program, My Anxiety Care, to address the shortcomings of existing psychotherapies. My Anxiety Care offers a digitalised platform to access anxiety treatment remotely through online telehealth services. The program is tailored specifically to help people living with cognitive impairment who experience anxiety.
What is the link between dementia and anxiety?
When someone is diagnosed with dementia, it is natural to experience a range of emotions. While it is normal to occasionally feel stressed or worried, persistent and overwhelming feelings of worry are not a normal part of dementia – they may be signs of anxiety. It is important to seek support when experiencing these persistent anxious feelings. This could feel like having a constant worry in the back of your mind, having a racing heart or feeling shaky, or avoiding situations that make you worried or fearful.
What is a healthy stress response?
Our body has a natural, healthy stress response. A healthy stress response is important to our survival - it signals to us when we need to fight a potential threat or escape to safety. This is known as the fight or flight response.
When we perceive a threat, a structure in our brain called the amygdala sends a signal to our brain’s hormone production centre, the hypothalamus. This triggers our fight or flight response, by releasing stress hormones such as adrenaline and cortisol. An increase in adrenaline increases our heart rate, causes butterflies in our stomach, and makes our breathing shallow. An increase in cortisol keeps us on high alert in case of another threat.
Once the threat has passed, our cortisol levels drop, and the parasympathetic nervous system helps calm our body and mind.
What is anxiety?
Anxiety occurs when the stress response does not switch off properly, even when the danger has passed. People with anxiety often experience ongoing worry, feel on edge, or avoid those stress- and fear-inducing situations.
Anxiety is a common challenge faced by people living with cognitive impairment, affecting up to 75% of people living with dementia or mild cognitive impairment.
Common symptoms of anxiety include:
Emotional: feeling on edge, irritable, fearful, dread and worry
Behavioural: being easily distracted, avoiding situations due to fear, repetitive worrisome thoughts, and being easily startled
Cognitive: persistent negative thoughts and intrusive worries, difficulties with concentration, focus, and memory
Physical: increased heart rate, sweating, shaking, feeling of nausea and dizziness, muscle tension or pains, and having trouble sleeping
If you or somebody you know experience any of these symptoms, you may consider seeking support.
How can we treat anxiety?
Traditionally, anxiety has been treated with medication. However, psychotherapies such as Cognitive Behavioural Therapy and Mindfulness-Based Therapy have been found to be effective in reducing anxiety across the lifespan.
Cognitive Behavioural Therapy (CBT):
Helps identify and challenge negative thought patterns
Teaches skills to manage anxious feelings and improve quality of life
Mindfulness-Based Therapy (MBT):
Encourages staying present in the moment to reduce reactivity to stress
Teaches relaxation techniques, like breathing exercises and meditation
These anxiety treatment options are very effective in reducing symptoms of anxiety. However, they are traditionally delivered face-to-face – a barrier for effective treatment for those living with dementia, particularly when living in remote locations.
We aim to provide effective anxiety care and management for people living with cognitive impairment without needing to provide therapy face-to-face.
We introduce My Anxiety Care: a technology-based therapy program for people with anxiety and cognitive impairment
At the University of Queensland Centre for Clinical Research, Professor Nadeeka Dissanayaka and her research team have developed a technology assisted psychotherapy program, My Anxiety Care, to address lack of access to anxiety treatments for people living with cognitive impairment.
My Anxiety Care is a six-week therapy program designed to reduce anxiety and improve quality of life for people living with dementia or cognitive impairment. Delivered entirely via telehealth (videoconferencing), the program allows participants to access support from the comfort of their own home.
How Does My Anxiety Care Work?
My Anxiety Care combines:
Techniques from Cognitive Behavioural
Therapy and Mindfulness-Based Therapy
Education on the causes of anxiety
Practical strategies for sleep hygiene and relaxation
My Anxiety Care is tailored specifically for individuals with cognitive impairment and is delivered by trained psychologists and counsellors who understand the unique needs of people living with dementia.
Early investigation into My Anxiety Care has highlighted its potential benefits, with all participants able to complete the program, and reporting a reduction in anxiety. This is one of the first studies to show effective remote therapy for anxiety in people living with cognitive impairment. This early investigative study can be found here: pilot study.
The Dementia and Neuro Mental Health Research unit are currently conducting a nationwide randomised control trial that explores the effectiveness and implementation of My Anxiety Care. They are currently seeking volunteers with dementia or mild cognitive impairment who experience anxiety to take part in this research study. My Anxiety Care will be tested in a randomised control trial. This means that if you are eligible to participate in the study, you will be randomly assigned to either an intervention group or a control group. If you are selected to the intervention group, you will be asked to attend 6 weekly sessions of psychotherapy. If you are in the control group, you will continue your usual care. Please also note that this study is accepting Australian residents only.
Want to get involved?
The My Anxiety Care project is being funded by the Medical Research Future Fund (MRFF) Dementia, Ageing & Aged Care.
To learn more or express interest in participating, please contact the research team:
📧 [email protected]
📞 0419 638 766 or (07) 3346 5577
Professor Dissanayaka and Clinical Geropsychologist, Professor Nancy Pachana answer most frequently asked questions about My Anxiety Care:
By participating in this trial, you could help shape new ways to treat anxiety and improve quality of life for people living with dementia.
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