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Anxiety, depression, and comorbid anxiety and depression: risk factors and outcome over two years

Published online by Cambridge University Press:  12 June 2012

Osvaldo P. Almeida ,
Brian Draper ,
Jane Pirkis ,
John Snowdon ,
Nicola T. Lautenschlager ,
Gerard Byrne ,
Moira Sim ,
Nigel Stocks ,
Ngaire Kerse  and
Leon Flicker
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Osvaldo P. Almeida*
Affiliation:
School of Psychiatry & Clinical Neurosciences, University of Western Australia, Crawley, Perth, WA, Australia Western Australian Centre for Health & Ageing, Centre for Medical Research, University of Western Australia, Crawley, Perth, WA, Australia Department of Psychiatry, Royal Perth Hospital, Perth, WA, Australia
Brian Draper
Affiliation:
School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
Jane Pirkis
Affiliation:
School of Population Health, University of Melbourne, Melbourne, VIC, Australia
John Snowdon
Affiliation:
Discipline of Psychiatry, Sydney Medical School, University of Sydney, Camperdown, NSW, Australia
Nicola T. Lautenschlager
Affiliation:
School of Psychiatry & Clinical Neurosciences, University of Western Australia, Crawley, Perth, WA, Australia Western Australian Centre for Health & Ageing, Centre for Medical Research, University of Western Australia, Crawley, Perth, WA, Australia Academic Unit for Psychiatry of Old Age, St Vincent's Health, Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia
Gerard Byrne
Affiliation:
School of Medicine, University of Queensland, Brisbane, QLD, Australia
Moira Sim
Affiliation:
School of Medical Sciences, Edith Cowan University, Joondalup, WA, Australia
Nigel Stocks
Affiliation:
Discipline of General Practice, University of Adelaide, Adelaide, SA, Australia
Ngaire Kerse
Affiliation:
School of Population Health, University of Auckland, Auckland, New Zealand
Leon Flicker
Affiliation:
Western Australian Centre for Health & Ageing, Centre for Medical Research, University of Western Australia, Crawley, Perth, WA, Australia School of Medicine and Pharmacology, University of Western Australia, Crawley, Perth, WA, Australia Department of Geriatric Medicine, Royal Perth Hospital, Perth, WA, Australia
Jon J. Pfaff
Affiliation:
School of Psychiatry & Clinical Neurosciences, University of Western Australia, Crawley, Perth, WA, Australia Western Australian Centre for Health & Ageing, Centre for Medical Research, University of Western Australia, Crawley, Perth, WA, Australia
*
Correspondence should be addressed to: Professor Osvaldo P. Almeida, Western Australian Centre for Health & Ageing (M573), Centre for Medical Research, University of Western Australia, 35 Stirling Highway, Crawley, Perth, WA 6009, Australia. Phone: +61 8 9224 2855; Fax: +61 8 9224 8009. Email: [email protected].
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Abstract

Background: This study aimed to determine: (1) the prevalence of depression, anxiety, and depression associated with anxiety (DA); (2) the risk factor profile of depression, anxiety, and DA; (3) the course of depression, anxiety, and DA over 24 months.

Methods: Two-year longitudinal study of 20,036 adults aged 60+ years. We used the Patient Health Questionnaire and the Hospital Anxiety and Depression Scale anxiety subscale to establish the presence of depression and anxiety, and standard procedures to collect demographic, lifestyle, psychosocial, and clinical data.

Results: The prevalence of anxiety, depression, and DA was 4.7%, 1.4%, and 1.8%. About 57% of depression cases showed evidence of comorbid anxiety, while only 28% of those with clinically significant anxiety had concurrent depression. There was not only an overlap in the distribution of risk factors in these diagnostic groups but also differences. We found that 31%, 23%, and 35% of older adults with anxiety, depression, and DA showed persistence of symptoms after two years. Repeated anxiety was more common in women and repeated depression in men. Socioeconomic stressors were common in repeated DA.

Conclusions: Clinically significant anxiety and depression are distinct conditions that frequently coexist in later life; when they appear together, older adults endure a more chronic course of illness.

Keywords

mood disorderanxiety disordermixed stateelderlyprognosisepidemiology
Type
Research Article
Information
International Psychogeriatrics , Volume 24 , Issue 10 , October 2012 , pp. 1622 - 1632
Copyright
Copyright © International Psychogeriatric Association 2012

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References

Almeida, O. P., Alfonso, H., Hankey, G. J. and Flicker, L. (2010). Depression, antidepressant use and mortality in later life: the Health In Men Study. PLoS One, 5, e11266.CrossRefGoogle ScholarPubMed
Almeida, O. P. et al. (2011). A practical approach to assess depression risk and to guide risk reduction strategies in later life. International Psychogeriatrics, 23, 280–291.CrossRefGoogle ScholarPubMed
Almeida, O. P. et al. (2012). A randomized trial to reduce the prevalence of depression and self-harm behavior in older primary care patients. Annals of Family Medicine, 10.CrossRefGoogle ScholarPubMed
Beekman, A. T., de Beurs, E., van Balkom, A. J., Deeg, D. J., van Dyck, R. and van Tilburg, W. (2000). Anxiety and depression in later life: co-occurrence and communality of risk factors. American Journal of Psychiatry, 157, 89–95.CrossRefGoogle ScholarPubMed
Bjelland, I., Dahl, A. A., Haug, T. T. and Neckelmann, D. (2002). The validity of the hospital anxiety and depression scale: an updated literature review. Journal of Psychosomatic Research, 52, 69–77.CrossRefGoogle ScholarPubMed
Cairney, J., Corna, L. M., Veldhuizen, S., Herrmann, N. and Streiner, D. L. (2008). Comorbid depression and anxiety in later life: patterns of association, subjective well-being, and impairment. American Journal of Geriatric Psychiatry, 16, 201–208.CrossRefGoogle ScholarPubMed
Draper, B. et al. (2008). Long-term effects of childhood abuse on the quality of life and health of older people: results from the Depression and Early Prevention of Suicide in General Practice Project. Journal of the American Geriatrics Society, 56, 262–271.CrossRefGoogle ScholarPubMed
Elley, C. R., Kerse, N. M. and Arroll, B. (2003). Why target sedentary adults in primary health care? Baseline results from the Waikato Heart, Health, and Activity Study. Preventive Medicine, 37, 342–348.CrossRefGoogle ScholarPubMed
Fillenbaum, G. G., Pieper, C. F., Cohen, H. J., Cornoni-Huntley, J. C. and Guralnik, J. M. (2000). Comorbidity of five chronic health conditions in elderly community residents: determinants and impact on mortality. Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 55, M84–M89.Google ScholarPubMed
Gale, C. R. et al. (2011). Factors associated with symptoms of anxiety and depression in five cohorts of community-based older people: the HALCyon (Healthy Ageing across the Life Course) Programme. Psychological Medicine, 41, 2057–2073.CrossRefGoogle ScholarPubMed
Kendell, R. and Jablensky, A. (2003). Distinguishing between the validity and utility of psychiatric diagnoses. American Journal of Psychiatry, 160, 4–12.CrossRefGoogle ScholarPubMed
Koenig, H. G., Westlund, R. E., George, L. K., Hughes, D. C., Blazer, D. G. and Hybels, C. (1993). Abbreviating the Duke Social Support Index for use in chronically ill elderly individuals. Psychosomatics, 34, 61–69.CrossRefGoogle ScholarPubMed
Kroenke, K., Spitzer, R. L. and Williams, J. B. (2001). The PHQ-9: validity of a brief depression severity measure. Journal of General Internal Medicine, 16, 606–613.Google Scholar
Kvaal, K., McDougall, F. A., Brayne, C., Matthews, F. E. and Dewey, M. E. (2008). Co-occurrence of anxiety and depressive disorders in a community sample of older people: results from the MRC CFAS (Medical Research Council Cognitive Function and Ageing Study). International Journal of Geriatric Psychiatry, 23, 229–237.CrossRefGoogle Scholar
Lindesay, J., Briggs, K. and Murphy, E. (1989). The Guy's/Age Concern survey. Prevalence rates of cognitive impairment, depression and anxiety in an urban elderly community. British Journal of Psychiatry, 155, 317–329.Google Scholar
National Health and Medical Research Council (2009). Australian guidelines to reduce health risks from drinking alcohol. Canberra: Commonwealth of Australia.Google Scholar
Pink, B. (2008). An Introduction to Socio-Economic Indexes for Areas (SEIFA) 2006, Australian Bureau of Statistics Catalogue No. 2039.0.Google Scholar
Pirkis, J. et al. (2009). The community prevalence of depression in older Australians. Journal of Affective Disorders, 115, 54–61.CrossRefGoogle ScholarPubMed
Prince, M. et al. (2007). No health without mental health. Lancet, 370, 859–877.Google Scholar
Schoevers, R. A., Deeg, D. J., van Tilburg, W. and Beekman, A. T. (2005). Depression and generalized anxiety disorder: co-occurrence and longitudinal patterns in elderly patients. American Journal of Geriatric Psychiatry, 13, 31–39.CrossRefGoogle ScholarPubMed
Snowdon, J. (2001). Is depression more prevalent in old age? Australian and New Zealand Journal of Psychiatry, 35, 782–787.CrossRefGoogle ScholarPubMed
Spitzer, R. L., Kroenke, K. and Williams, J. B. (1999). Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. Primary Care Evaluation of Mental Disorders. Patient Health Questionnaire. JAMA, 282, 1737–1744.CrossRefGoogle ScholarPubMed
Steffens, D. C. and McQuoid, D. R. (2005). Impact of symptoms of generalized anxiety disorder on the course of late-life depression. American Journal of Geriatric Psychiatry, 13, 40–47.CrossRefGoogle ScholarPubMed
Trollor, J. N., Anderson, T. M., Sachdev, P. S., Brodaty, H. and Andrews, G. (2007). Prevalence of mental disorders in the elderly: the Australian National Mental Health and Well-Being Survey. American Journal of Geriatric Psychiatry, 15, 455–466.CrossRefGoogle ScholarPubMed
Vink, D. et al. (2009). Onset of anxiety and depression in the aging population: comparison of risk factors in a 9-year prospective study. American Journal of Geriatric Psychiatry, 17, 642–652.CrossRefGoogle Scholar
Ware, J. E., Kosinski, M., Turner-Bowker, D. M. and Gandek, B. (2002). How to Score Version 2 of the SF-12 Health Survey. Lincoln, RI: QualityMetric Inc. Google Scholar
Wetherell, J. L., Gatz, M. and Pedersen, N. L. (2001). A longitudinal analysis of anxiety and depressive symptoms. Psychology of Aging, 16, 187–195.CrossRefGoogle ScholarPubMed
Williamson, M. K. et al. (2007). Recruiting and retaining GPs and patients in intervention studies: the DEPS-GP project as a case study. BMC Medical Research Methodology, 7, 42.CrossRefGoogle ScholarPubMed
Zigmond, A. S. and Snaith, R. P. (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica, 67, 361–370.Google Scholar
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