In specific, research supports the fact that a large number of older adults living in AL have dementia and other psychiatric disorders (Lyketsos, 2002), and that psychological and behavioural symptoms associated with dementia are common among residents in this setting (Sloane et al., 2005). . Of importance, psychotropic medications are frequently prescribed to residents in AL, but often without a psychiatric diagnosis to explain its use (Aud &. Rantz, 2005. Boustani et al., 2005). Furthermore, AL residents who experience cognitive, behavioural impairments are at greater risk for placement in nursing facilities (Aud, 2004. Aud &. Rantz, 2005. Phillips et al., 2003). In short, the level and type of dementia care provided in AL is an area of interest and concern for older adults and their family members, clinicians, researchers, and policy-makers alike.
Although anxiety and anxiety-related symptoms are often the focus of clinical care (Mahoney et al., 2000), a limited number of studies have focused explicitly on anxiety-related symptoms in dementia. More often, anxiety is considered one of several behavioural and psychological symptoms in dementia (BPSD). For example, a review of BPSD evaluated with the NPI in three European studies found that frequency of anxiety was between 34% and 39%, making it one of the four most common behaviours observed across studies along with apathy, depression, and irritability (Robert et al., 2005).
Among the studies that focus specifically on anxiety, Mega and colleagues examined the relationship between cognitive impairment in older adults with Alzheimer’s disease (AD) and behavioural abnormalities as measured by the NPI. A substantial number of subjects exhibited apathy (72%), agitation (60%), and anxiety (48%). Agitation, apathy, dysphoria, and aberrant motor behaviour were associated with cognitive impairment, but the anxiety was not (Mega, Cummings, Fiorello, &. Gornbein, 1996).