Diagnostic Accuracy of Tools to Identify Anxiety Symptoms and Disorders in Persons with Dementia: a Systematic Review Update.

Abstract

Limited anxiety tools validated against a diagnostic gold standard in the context of dementia have been identified. A systematic review update was completed to identify publications since 2017 describing tools to detect anxiety in persons with dementia compared to a diagnostic gold standard. The original search strategy was replicated in MEDLINE, Embase, and PsycINFO. Pooled prevalence and diagnostic accuracy estimates were calculated based on three or more studies presenting comparable information from either the original or updated review search. No pooled estimates were calculated in the original review given limited evidence. One study evaluating the Rating Anxiety in Dementia (RAID) scale, Neuropsychiatric Inventory, and Hamilton Anxiety Rating Scale met review inclusion criteria. The pooled prevalence of generalized anxiety disorder (GAD) (n=3, 36.7%, 95% Confidence Interval (CI): 24.3-49.2%) and diagnostic accuracy outcomes for the RAID scale (≥11 cut-off) to detect GAD (n=3, sensitivity: 89%, 95% CI: 78-95%; specificity: 73%, 95% CI: 60-82%) were calculated using data from two studies identified in the original review and the newly included study from the review update. The RAID scale has the most evidence and adequate sensitivity to support its use in identifying anxiety in persons with dementia. Validated tools to detect anxiety in persons with dementia remain understudied.