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Anxiety is a frequent symptom of Alzheimer's disease, affecting over half of the patients in some cohorts.

Benzodiazepines appear efficacious at treating anxiety and insomnia when patients symptomatology lacks psychotic features. Unfortunately, a paradoxical effect has been noted in Alzheimer's patients, in which the administration of benzodiazepines leads to increased confusion, disorientation, and ultimately, even greater agitation and anxiety.

Unfortunately, the experimental evidence to support the use of benzodiazepines in the setting of dementia is very weak.

(see Devanand DP,1997)

Many behavioral "problems" in demented patients are not directly caused by cognitive decline, but instead may be attributed to other factors such as health, medication and physical and social environment. Coexisting illnesses, impaired vision or hearing, psychotropic medications, understimulation or overstimulation, lack of familiar cues in the environment and lack of meaningful activities and social relationships can causes a wide variety of responses in demented patients, including wandering, anxiety, paranoia, difficulty with personal care, incontinence, sleep difficulties and aggression. The Mayo clinic article by Carlson, et al., explains how "problem" behavior is often an attempt to communicate by patients who are losing language and reasoning skills. This useful article lists many nonpharmacologic strategies for managing behavioral disturbances by identifying and addressing the causes.