By Deborah Koh, B.A.
As the world’s population ages dramatically and rates of dementia increase, public concern is growing as well, leading to a phenomenon known as Dementia-Related Anxiety (DRA).
DRA is defined as an anxiety response to the possibility of getting dementia, regardless of one’s age and cognitive abilities. It is a byproduct of what might seem a good thing—increased awareness of dementia—but that awareness can, in turn, only make dementia seem more threatening. These worries can sometimes spiral out of control.
Hallmark signs of DRA include devoting excessive amounts of time and attention on small memory lapses and viewing these changes as symptoms of dementia, experiencing uncontrollable thoughts and anxiety about getting dementia and regularly looking for signs of dementia in one’s own body or behavior. When someone repeatedly interprets normal memory lapses as a symptom of dementia, it is only natural for a person to eventually come to believe that his or her memory is truly impaired. In fact, individuals with high DRA may continue to report serious complaints about their memory even when objective, cognitive tests indicate no signs of cognitive decline beyond normal age-related change. However, this does not change how distressing these concerns may be. The fear and anxiety that these individuals face are very real, and the effects are very real as well.
The telltale signs of DRA (excessive and uncontrollable anxiety about getting dementia, hypervigilance about memory changes and symptom-seeking) are associated with having more negative attitudes about one’s own aging, lower life satisfaction and lower likelihood of engaging in health-promoting behaviors like staying active, maintaining a balanced diet and getting regular physical exams. At this stage of DRA research, it is unclear what these associations mean. Does DRA cause outcomes like lower life satisfaction or does having lower life satisfaction make a person vulnerable to DRA? Despite this uncertainty, it is apparent that DRA is, in some way, related to outcomes that are detrimental to physical, mental and emotional functioning; in other words, there is a cost to worrying too much.
It is helpful to consider if and how DRA might be impacting you. Can you identify the source of your excessive anxiety? If so, you may be able to remove stressors that are within your control. Many people believe the myth that dementia is part of the normal aging process when, in fact, it is not. It is completely normal to forget where you put your car keys or have trouble remembering that word on the tip of your tongue; dementia, however, is when you experience significant decline in memory, language, reasoning, mood and behavior in ways that can eventually impair all aspects of daily functioning. In these cases, an important first step is to seek information about the normal age-related changes one might expect in older adulthood. It may help to have a discussion with friends and family about your concerns and ask for their cooperation in monitoring your memory concerns and complaints.
The good news is that DRA itself is not necessarily harmful. Like many things in life, it exists on a spectrum along which a healthy balance can be achieved. Researchers suggest moderate levels of DRA can motivate one to be more engaged in health-promoting behaviors and future planning. The phenomenon of DRA is relatively new, and researchers are still exploring the specific factors that lead some people to experience higher levels of DRA than others. As this field unfolds, the best advice is to do all you can to stay healthy and to be aware of worries that make it difficult for you to do so. As one famous quote says, “My life has been full of terrible misfortunes, most of which never happened” (Montaigne).
Deborah Koh is a UCCS clinical psychology doctoral student and psychology trainee at the UCCS Aging Center. For more information, contact her at firstname.lastname@example.org or call the Aging Center at 719-255-8002.