Anxiety and Risk of Vascular Dementia in an Elderly Community Sample: The Role of Sex.

To assess the association between anxiety and risk of vascular dementia (VaD), as well as potential sex differences, in a community-based cohort. A random sample of 4057 dementia-free community participants aged 55 or older, from the longitudinal, community-based Zaragoza Dementia and Depression Project (ZARADEMP) study were followed for 4.5 years. Geriatric Mental State B (GMS)-Automated Geriatric Examination for Computer Assisted Taxonomy (AGECAT) was used for the assessment and diagnosis of anxiety, and a panel of research psychiatrists diagnosed the incident cases of VaD according to DSM-IV (). Multivariate survival analysis with competing risk regression model was performed. In men, the incidence rate of VaD was significantly higher among anxiety subjects compared with non-anxiety subjects (incidence rate ratio (IRR) (95% confidence interval (CI)): 3.24 (1.13-9.35); = 0.029), and no difference was observed in women (IRR (95%CI): 0.68 (0.19-2.23); = 0.168). In the multivariate model, for men, cases of anxiety had 2.6-fold higher risk of VaD (subdistribution hazard ratio (SHR): 2.61; 95%CI: 0.88-7.74) when all potential confounding factors were controlled, with no statistical significance ( = 0.084), but a clinically relevant effect (Cohen's d: 0.74). No association was found in women. In men, but not in women, risk of VaD was higher among individuals with anxiety, with a clinically relevant effect. Potential anxiety-related preventive interventions for VaD might be tailored to men and women separately.