Anxiety Symptoms and Risk of Dementia Progression in Mild Cognitive Impairment: A Systematic Review and Meta-Analysis.

INTRODUCTION: Anxiety is among the earliest and most common neuropsychiatric symptoms in cognitive impairment. Emerging evidence suggests that anxiety may elevate the risk of cognitive decline in mild cognitive impairment (MCI). This systematic review and meta-analysis was performed to quantitatively synthesize evidence from cohort studies on the association between anxiety symptoms and dementia conversion in MCI. METHODS: A systematic literature search was performed in Medline and other relevant databases to find cohort studies examining the association between anxiety symptoms and dementia progression in MCI. RESULTS: Fifteen cohort studies were included in the systematic review, of which fourteen were included in meta-analyses. Anxiety was significantly associated with an increased risk of all cause dementia, HR = 1.25; 95% CI, 1.11-1.41; p < 0.001, and Alzheimer's disease, HR = 1.32; 95% CI, 1.16-1.49; p < 0.001, while pooled odds ratios did not show a significant association OR = 1.15; 95% CI, 0.84-1.57; p = 0.39. CONCLUSION: Anxiety symptoms may be associated with an elevated risk of dementia conversion in MCI. Further large-scale prospective cohort studies are needed to determine the strength and clinical importance of these findings.