anxietyMy client who is 92 yrs old with early Dementia is shouting less at night and more calm. After 4 weeks of taking care of her and with introduction of nutritional supplementation rich in calcium and magnesium, she did not shout last night. I also spent some time massaging her head and face after I massage her legs between the hours of  6 to 7 pm. We still need to get a protective top mattress cover for her hospital bed to prevent bed sores and provide more comfort. I also served cooked – boiled sweet potatoes last night. When I shop for her food, I include eggs, nutrition drink, blueberries, lemon, avocados, bananas, oranges, salmon, veggies for soups (cilantro, carrots, celery, onions, garlic).

I prefer the quality supplements, LIFEPAK and AGELOC products at :

http://www.clubalthea.pxproducts.com

Connie

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Nervous system nutrients

Our nervous system requires several dozen minerals, vitamins, fatty acids and amino acids to function at all properly. Deficiencies of nutrients such as calcium, magnesium, zinc, omega-3 fatty acids, and vitamins A, B-complex, C, D3 and E are common, especially if you eat refined foods.

Anxiety and demographic characteristics

Sex

Although anxiety symptoms and disorders tend to be more common in women within the non-demented elderly (Stanley & Beck, 2000), most studies using dementia samples did not find sex differences: only two of thirteen studies found greater levels of anxiety among women with AD (Bungener et al., 1996; Ferretti et al., 2001). These two studies, however, used anxiety scales that have not been previously validated in individuals with dementia. Thus, the bulk of the evidence suggests a lack of relationship between sex and anxiety in individuals with dementia (Ballard, Boyle, & Bowler, 1996; Ballard et al., 2000; Hwang et al., 2004; Mendez, McMurtray, Chen, Shapira, Mishkin, & Miller, 2006; Orrell & Bebbington, 1996; Ownby, Harwood, Barker, & Duara, 2000; Paulsen, Ready, Hamilton, Mega, & Cummings, 2001; Porter et al., 2003; Shankar et al., 1999; Teri et al., 1999; Tsang et al., 2003).

Age

Of the nine studies we identified, one found greater anxiety in older patients (Bungener et al., 1996). This study, already cited above, used anxiety scales that have not been validated in dementia. Another study (Ferretti et al., 2001) found greater anxiety in older patients in one sample but not the other; moreover, the association between anxiety and age disappeared after controlling for other variables of interest. The other studies found no relationship between age and anxiety (Ballard et al., 1996; Ballard et al., 2000; Mendez et al., 2006; Orrell & Bebbington, 1996; Paulsen et al., 2001; Shankar et al., 1999; Tsang et al., 2003).

Education

The two studies we identified found no relationship between anxiety and years of education in FTD (Mendez et al., 2006) and AD (Ownby et al., 2000).

 Race/ethnicity

Two studies (Chen, Borson, & Scanlan, 2000; Ortiz, Fitten, Cummings, Hwang, & Fonseca, 2006) examined the prevalence of anxiety symptoms in individuals with dementia of different ethnic groups. In one study (Chen et al., 2000), African-Americans with dementia had lower anxiety than Asians and Hispanics with dementia, even after controlling for dementia severity, age, sex, and education. In another study (Ortiz et al., 2006), Hispanics with dementia had higher anxiety than Caucasians with dementia, even after controlling for age, sex and education. In contrast, Hispanics and Caucasians without dementia did not differ in anxiety symptoms. Thus, current data suggest that anxiety may be more prevalent in Hispanics and Asians with dementia than African-Americans and Caucasians with dementia.

Anxiety and dementia subtype

Six studies (Aarsland, Cummings, & Larsen, 2001; Ballard et al., 2000; Lyketsos et al., 2000; Porter et al., 2003; Skoog, 1993; Sultzer, Levin, Mahler, High, & Cummings, 1993) compared anxiety prevalence in distinct, well-defined types of dementia (see Table 2). In one study (Skoog, 1993), rates of OCD, phobia, and GAD did not differ between AD and vascular dementia (VaD). Among four studies that examined rates of anxiety symptoms in AD and VaD, two found greater anxiety in VaD (Ballard et al., 2000; Porter et al., 2003), and the other two did not find any significant difference (Lyketsos et al., 2000; Sultzer et al., 1993). In both studies with null findings, anxiety was qualitatively greater in the AD group. Moreover, in one study (Sultzer et al., 1993), sample size was relatively small (N=28 in each group), and in the other study (Lyketsos et al., 2000), rates of anxiety symptoms were unusually low (8% in the AD group and 18% in the VaD group). Thus, anxiety symptoms appear greater in VaD than in AD. Compared to AD, rates of anxiety symptoms may be greater in fronto-temporal dementia (Porter et al., 2003) and similar in dementia associated with Parkinson’s disease (Aarsland et al., 2001).

Anxiety and dementia severity

Five studies examined the relationship between anxiety symptoms and dementia severity (see Table 3). Two studies (Chen et al., 2000; Sclan et al., 1996) found lower anxiety at the profound/terminal stages of dementia, and two others (Lyketsos et al., 2000; Shankar et al., 1999) found no significant effect of dementia severity. The latter two studies, however, did not distinguish between severe and profound/terminal dementia. A fifth study (Forsell & Winblad, 1997) found lower anxiety at the moderate/severe stages. Results of this study are questionable, however, because dementia type was not reported and the instrument used to assess anxiety, the Comprehensive Psychopathological Rating Scale (Asberg, Montgomery, Perris, Schalling, & Sedvall, 1978), has not been validated in dementia. Thus, findings suggest that anxiety is relatively stable across the range of dementia severity, until the profound/terminal stage, where it decreases.