Anxiety of Alzheimer's disease: prevalence, and comorbidity.

BACKGROUND: Anxiety may be associated with psychiatric morbidity, disability, increased health care utilization, and mortality in Alzheimer's disease (AD) patients as it is in the general adult population. However, the phenomenology of anxiety symptoms in AD and its relationship to dementia progression, comorbid depression, and the presence of other problematic behaviors have not yet been examined. METHOD: Data on anxiety symptoms and their coexistence with other factors were obtained in 523 community-dwelling AD patients through interviews with their caregivers and direct physical examination. The prevalence of anxiety symptoms and their association to patient depression, other behavioral problems, gender, and age was investigated. RESULTS: Anxiety symptoms were common, occurring in 70% of subjects. Anxiety symptoms were significantly correlated with ADL impairment and other behavioral disturbances, including wandering, sexual misconduct, hallucinations, verbal threats, and physical abuse. Comorbidity of anxiety-depression was also prevalent: 54% of the sample had both anxiety and depression symptoms. ADL impairment and problem behaviors were significantly associated with comorbidity; however, the latter association was explained entirely by the presence of anxiety. CONCLUSION: Anxiety symptoms were common and significantly related to ADL and additional neuropsychiatric problems in this sample. These results indicate the need for additional research into the phenomenology of anxiety and comorbid anxiety-depression in AD and for the development and investigation of effective assessment and treatment of anxiety in AD clinical practice.

Effects of low level lead exposure on cognitive function in children: a review of behavioral, neuropsychological and biological evidence.

Low level lead exposure, at levels currently found in significant numbers of children in the U.S., has been associated with decreases in IQ and other cognitive test scores in children, as well as with decreases in developmental test scores in infants. The precise nature of the cognitive deficits is not clear. This paper reviews epidemiological and developmental neurocognitive effects of lead and addresses methodological issues that may have contributed to differences in interpretation of previous research. In an attempt to provide a rationale for the lead-related deficits reported for humans, we have reviewed studies of lead-related behavioral and electrophysiological effects seen in animals as well as findings from studies that have examined the effects of lead exposure on neurochemical subcellular and cellular mechanisms. Based on these data, future strategies are suggested for determining the possible effects of low-level lead exposure on neurocognitive functioning in children.