Hostname: page-component-cd9895bd7-dk4vv Total loading time: 0 Render date: 2024-12-24T02:16:13.183Z Has data issue: false hasContentIssue false

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

Published online by Cambridge University Press:  24 February 2011

C. R. Gale*
Affiliation:
MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK Centre for Cognitive Ageing and Cognitive Epidemiology, Department of Psychology, University of Edinburgh, Edinburgh, UK
A. Aihie Sayer
Affiliation:
MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
C. Cooper
Affiliation:
MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
E. M. Dennison
Affiliation:
MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
J. M. Starr
Affiliation:
Centre for Cognitive Ageing and Cognitive Epidemiology, Department of Psychology, University of Edinburgh, Edinburgh, UK Geriatric Medicine Unit, University of Edinburgh, Royal Victoria Hospital, Edinburgh, UK
L. J. Whalley
Affiliation:
Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
J. E. Gallacher
Affiliation:
Department of Epidemiology, Statistics and Public Health, Centre for Health Sciences Research, Cardiff University, Cardiff, UK
Y. Ben-Shlomo
Affiliation:
Department of Social Medicine, University of Bristol, Bristol, UK
D. Kuh
Affiliation:
MRC Unit for Lifelong Health and Ageing, University College London, London, UK
R. Hardy
Affiliation:
MRC Unit for Lifelong Health and Ageing, University College London, London, UK
L. Craig
Affiliation:
Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
I. J. Deary
Affiliation:
Centre for Cognitive Ageing and Cognitive Epidemiology, Department of Psychology, University of Edinburgh, Edinburgh, UK
*
*Address for correspondence: C. R. Gale, Ph.D., MRC Lifecourse Epidemiology Unit (University of Southampton), Southampton General Hospital, Southampton SO16 6YD, UK. (Email: [email protected])

Abstract

Background

Symptoms of anxiety and depression are common in older people, but the relative importance of factors operating in early and later life in influencing risk is unclear, particularly in the case of anxiety.

Method

We used data from five cohorts in the Healthy Ageing across the Life Course (HALCyon) collaborative research programme: the Aberdeen Birth Cohort 1936, the Caerphilly Prospective Study, the Hertfordshire Ageing Study, the Hertfordshire Cohort Study and the Lothian Birth Cohort 1921. We used logistic regression to examine the relationship between factors from early and later life and risk of anxiety or depression, defined as scores of 8 or more on the subscales of the Hospital Anxiety and Depression Scale, and meta-analysis to obtain an overall estimate of the effect of each.

Results

Greater neuroticism, poorer cognitive or physical function, greater disability and taking more medications were associated in cross-sectional analyses with an increased overall likelihood of anxiety or depression. Associations between lower social class, either in childhood or currently, history of heart disease, stroke or diabetes and increased risk of anxiety or depression were attenuated and no longer statistically significant after adjustment for potential confounding or mediating variables. There was no association between birth weight and anxiety or depression in later life.

Conclusions

Anxiety and depression in later life are both strongly linked to personality, cognitive and physical function, disability and state of health, measured concurrently. Possible mechanisms that might underlie these associations are discussed.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Alati, R, Lawlor, DA, Mamun, AA, Williams, GM, Najman, JM, O'Callaghan, M, Bor, W (2007). Is there a fetal origin of depression? Evidence from the Mater University Study of Pregnancy and its outcomes. American Journal of Epidemiology 165, 575582.CrossRefGoogle Scholar
Anonymous (1984). Caerphilly and Speedwell collaborative heart disease studies. The Caerphilly and Speedwell Collaborative Group. Journal of Epidemiology and Community Health 38, 259262.CrossRefGoogle Scholar
Baldwin, RC, O'Brien, J (2002). Vascular basis of late-onset depressive disorder. British Journal of Psychiatry 180, 157160.CrossRefGoogle ScholarPubMed
Beekman, AT, Copeland, JR, Prince, MJ (1999). Review of community prevalence of depression in later life. British Journal of Psychiatry 174, 307311.CrossRefGoogle ScholarPubMed
Beekman, ATF, de Beurs, E, van Balkom, AJ, Deeg, DJH, van Dyck, R, van Tilburg, W (2000). Anxiety and depression in later life: co-occurrence and communality of risk factors. American Journal of Psychiatry 157, 8995.CrossRefGoogle ScholarPubMed
Beekman, ATF, Penninx, BWJH, Deeg, DJH, Ormel, J, Braam, AW, van Tilburg, W (1997). Depression and physical health in later life: results from the Longitudinal Aging Study Amsterdam (LASA). Journal of Affective Disorders 46, 219231.CrossRefGoogle ScholarPubMed
Bohnert, KM, Breslau, N (2008). Stability of psychiatric outcomes of low birth weight: a longitudinal investigation. Archives of General Psychiatry 65, 10801086.CrossRefGoogle ScholarPubMed
Bokov, A, Chaudhuri, A, Richardson, A (2004). The role of oxidative damage and stress in aging. Mechanisms of Ageing and Development 125, 811826.CrossRefGoogle ScholarPubMed
Bosma, H, van de Mheen, HD, Mackenbach, JP (1999). Social class in childhood and general health in adulthood: questionnaire study of contribution of psychological attributes. British Medical Journal 318, 1822.CrossRefGoogle ScholarPubMed
Braam, AW, Prince, MJ, Beekman, AT, Delespaul, P, Dewey, ME, Geerlings, SW, Kivela, S-L, Lawlor, BA, Magnusson, H, Meller, I, Peres, K, Reischies, FM, Roelands, M, Schoevers, RA, Saz, P, Skoog, I, Turrina, C, Versporten, A, Copeland, JR (2005). Physical health and depressive symptoms in older Europeans. Results from EURODEP. British Journal of Psychiatry 187, 3542.CrossRefGoogle ScholarPubMed
Brenes, GA, Kritchevsky, SB, Mehta, KM, Yaffe, K, Simonsick, EM, Ayonayon, HN, Rosano, C, Rubin, SM, Satterfield, S, Penninx, BW (2007). Scared to death: results from the Health, Aging, and Body Composition study. American Journal of Geriatric Psychiatry 15, 262265.CrossRefGoogle ScholarPubMed
Briggs, RC, Gossman, MR, Birch, R, Drews, JE, Shaddeau, SA (1989). Balance performance among noninstitutionalized elderly women. Physical Therapy 69, 748756.CrossRefGoogle ScholarPubMed
Bryant, C, Jackson, H, Ames, D (2008). The prevalence of anxiety in older adults: methodological issues and a review of the literature. Journal of Affective Disorders 109, 233250.CrossRefGoogle Scholar
Cole, MG, Dendukuri, N (2003). Risk factors for depression among elderly community subjects: a systematic review and meta-analysis. American Journal of Psychiatry 160, 11471156.CrossRefGoogle ScholarPubMed
Colman, I, Ploubidis, GB, Wadsworth, ME, Jones, PB, Croudace, TJ (2007). A longitudinal typology of symptoms of depression and anxiety over the life course. Biological Psychiatry 62, 12651271.CrossRefGoogle ScholarPubMed
Costa, PT, McCrae, RR (1992). NEO PI-R Professional Manual. Psychological Assessment Resources: Odessa, FL.Google Scholar
Crawford, JR, Deary, IJ, Starr, J, Whalley, LJ (2001). The NART as an index of prior intellectual functioning: a retrospective validity study covering a 66-year interval. Psychological Medicine 31, 451458.CrossRefGoogle ScholarPubMed
de Beurs, E, Beekman, A, Geerlings, S, Deeg, DJ, van Dyck, R, van Tilburg, W (2001). On becoming depressed or anxious in late life: similar vulnerability factors but different effects of stressful life events. British Journal of Psychiatry 179, 426431.CrossRefGoogle ScholarPubMed
de Beurs, E, Beekman, AT, Deeg, DJ, van Dyck, R, van Tilburg, W (2000). Predictors of change in anxiety symptoms of older persons: results from the Longitudinal Aging Study Amsterdam. Psychological Medicine 30, 515527.CrossRefGoogle ScholarPubMed
Deary, IJ, Whiteman, MC, Starr, JM, Whalley, LJ, Fox, HC (2004). The impact of childhood intelligence on later life: following up the Scottish Mental Surveys of 1932 and 1947. Journal of Personality and Social Psychology 86, 130147.CrossRefGoogle ScholarPubMed
Deeks, JJ, Altman, DG, Bradburn, MJ (2001). Statistical methods for examining heterogeneity and combining results from several studies in meta-analysis. In Systematic Reviews in Health Care. Meta-analysis in Context (ed. Egger, M., Davey Smith, G. and Altman, D. G.), pp. 285312. BMJ Books: London.CrossRefGoogle Scholar
Dufouil, C, Fuhrer, R, Dartigues, JF, Alperovitch, A (1996). Longitudinal analysis of the association between depressive symptomatology and cognitive deterioration. American Journal of Epidemiology 144, 634641.CrossRefGoogle ScholarPubMed
Gale, CR, Allerhand, M, Sayer, AA, Cooper, C, Dennison, EM, Starr, JM, Ben-Shlomo, Y, Gallacher, JE, Kuh, D, Deary, IJ (2010). The structure of the Hospital Anxiety and Depression Scale in four cohorts of community-based, healthy older people: the HALCyon program. International Psychogeriatrics 22, 559571.CrossRefGoogle ScholarPubMed
Gale, CR, Deary, IJ, Boyle, SH, Barefoot, J, Mortensen, LH, Batty, GD (2008). Cognitive ability in early adulthood and risk of five specific psychiatric disorders in mid life: the Vietnam Experience Study. Archives of General Psychiatry 65, 14101418.CrossRefGoogle Scholar
Gale, CR, Hatch, SL, Batty, GD, Deary, IJ (2009). Intelligence in childhood and risk of psychological distress in adulthood: the 1958 National Child Development Survey and the 1970 British Cohort Study. Intelligence 37, 592599.CrossRefGoogle Scholar
Gale, CR, Martyn, CN (2004). Birth weight and later risk of depression in a national birth cohort. British Journal of Psychiatry 184, 2833.CrossRefGoogle Scholar
Gallo, JJ, Lebowitz, BD (1999). The epidemiology of common late-life mental disorders in the community: themes for the new century. Psychiatric Services 50, 11581166.CrossRefGoogle ScholarPubMed
Gaysina, D, Hotopf, M, Richards, M, Colman, I, Kuh, D, Hardy, R (2011). Symptoms of depression and anxiety and change in body mass index from adolescence to adulthood: results from a British birth cohort. Psychological Medicine 41, 175184.CrossRefGoogle ScholarPubMed
Heim, A (1968). The AH4 test. NFER-Nelson: Windsor.Google Scholar
Hendrie, HC, Albert, MS, Butters, MA, Gao, S, Knopman, DS, Launer, LJ, Yaffe, K, Cuthbert, BN, Edwards, E, Wagster, MV (2006). The NIH Cognitive and Emotional Health Project. Report of the Critical Evaluation Study Committee. Alzheimer's and Dementia 2, 1232.CrossRefGoogle ScholarPubMed
Hettema, JM, Neale, MC, Myers, JM, Prescott, CA, Kendler, KS (2006). A population-based twin study of the relationship between neuroticism and internalizing disorders. American Journal of Psychiatry 163, 857864.CrossRefGoogle ScholarPubMed
Higgins, JP, Thompson, SG, Deeks, JJ, Altman, DG (2003). Measuring inconsistency in meta-analyses. British Medical Journal 327, 557560.CrossRefGoogle ScholarPubMed
Holt, RI, Phillips, DI, Jameson, KA, Cooper, C, Dennison, EM, Peveler, RC (2009). The relationship between depression and diabetes mellitus: findings from the Hertfordshire Cohort Study. Diabetic Medicine 26, 641648.CrossRefGoogle ScholarPubMed
Inskip, HM, Dunn, N, Godfrey, KM, Cooper, C, Kendrick, T (2008). Is birth weight associated with risk of depressive symptoms in young women? Evidence from the Southampton Women's Survey. American Journal of Epidemiology 167, 164168.CrossRefGoogle ScholarPubMed
Jacka, FN, Overland, S, Stewart, R, Tell, GS, Bjelland, I, Mykletun, A (2009). Association between magnesium intake and depression and anxiety in community-dwelling adults: the Hordaland Health Study. Australian and New Zealand Journal of Psychiatry 43, 4552.CrossRefGoogle ScholarPubMed
Kennedy, GJ, Kelman, HR, Wisniewsky, W, Metz, H, Bijur, P (1989). Hierarchy of characteristics associated with depressive symptoms in an urban elderly sample. American Journal of Psychiatry 146, 220225.Google Scholar
Kivimäki, M, Lawlor, DA, Singh-Manoux, A, Batty, GD, Ferrie, JE, Shipley, MJ, Nabi, H, Sabia, S, Marmot, MG, Jokela, M (2009). Common mental disorder and obesity: insight from four repeat measures over 19 years: prospective Whitehall II cohort study. British Medical Journal 339, b3765.CrossRefGoogle Scholar
Lahey, BB (2009). Public health significance of neuroticism. American Psychologist 64, 241256.CrossRefGoogle ScholarPubMed
Lenze, EJ, Rogers, JC, Martire, LM, Mulsant, BH, Rollman, BL, Dew, MA, Schulz, R, Reynolds, CF (2001). The association of late-life depression and anxiety with physical disability: a review of the literature and prospectus for future research. American Journal of Geriatric Psychiatry 9, 113135.CrossRefGoogle ScholarPubMed
Malouff, JM, Thorsteinsson, EB, Schutte, NS (2005). The relationship between the five-factor model of personality and symptoms of clinical disorders: a meta-analysis. Journal of Psychopathology and Behavioral Assessment 27, 101114.CrossRefGoogle Scholar
Martin, LT, Kubzansky, LD, Lewinn, KZ, Lipsitt, LP, Satz, P, Buka, SL (2007). Childhood cognitive performance and risk of generalized anxiety disorder. International Journal of Epidemiology 36, 769775.CrossRefGoogle ScholarPubMed
Mather, AA, Cox, BJ, Enns, MW, Sareen, J (2009). Associations of obesity with psychiatric disorders and suicidal behaviors in a nationally representative sample. Journal of Psychosomatic Research 66, 277285.CrossRefGoogle Scholar
McEwen, BS (2006). Protective and damaging effects of stress mediators: the role of the brain. Dialogues in Clinical Neuroscience 8, 367381.CrossRefGoogle ScholarPubMed
Mehta, KM, Simonsick, EM, Penninx, BW, Schulz, R, Rubin, SM, Satterfield, S, Yaffe, K (2003). Prevalence and correlates of anxiety symptoms in well-functioning older adults: findings from the Health, Aging and Body Composition Study. Journal of the American Geriatrics Society 51, 499504.CrossRefGoogle ScholarPubMed
Mehta, KM, Yaffe, K, Brenes, GA, Newman, AB, Shorr, RI, Simonsick, EM, Ayonayon, HN, Rubin, SM, Covinsky, KE (2007). Anxiety symptoms and decline in physical function over 5 years in the Health, Aging and Body Composition Study. Journal of the American Geriatrics Society 55, 265270.CrossRefGoogle ScholarPubMed
Nelson, HE, Willison, JR (1991). National Adult Reading Test (NART), 2nd edn. NFER-Nelson: Windsor, UK.Google Scholar
Ng, F, Berk, M, Dean, O, Bush, AI (2008). Oxidative stress in psychiatric disorders: evidence base and therapeutic implications. International Journal of Neuropsychopharmacology 11, 851876.CrossRefGoogle ScholarPubMed
OPCS (1990). Standard Occupational Classification, Vol. 1 Structure and Definition of Major, Minor and Unit Groups. HMSO: London.Google Scholar
Osler, M, Nordentoft, M, Andersen, AM (2005). Birth dimensions and risk of depression in adulthood: cohort study of Danish men born in 1953. British Journal of Psychiatry 186, 400403.CrossRefGoogle ScholarPubMed
Penninx, BW, Guralnik, J, Ferrucci, L, Simonsick, EM, Deeg, DJ, Wallace, RB (1998). Depressive symptoms and physical decline in community-dwelling older persons. Journal of the American Medical Association 279, 17201726.CrossRefGoogle ScholarPubMed
Poulton, R, Caspi, A, Milne, BJ, Thomson, WM, Taylor, A, Sears, MR, Moffitt, TE (2002). Association between children's experience of socioeconomic disadvantage and adult health: a life-course study. Lancet 360, 16401645.CrossRefGoogle Scholar
Raven, JC (1965). Guide to Using the Mill Hill Vocabulary Scale with Progressive Matrices. H. K. Lewis: London.Google Scholar
Raven, JC, Court, JH, Raven, J (1977). Manual for Raven's Progressive Matrices and Vocabulary Scales. H. K. Lewis: London.Google Scholar
Rivenes, AC, Harvey, SB, Mykletun, A (2009). The relationship between abdominal fat, obesity, and common mental disorders: results from the HUNT study. Journal of Psychosomatic Research 66, 269275.CrossRefGoogle ScholarPubMed
Schoevers, RA, Beekman, AT, Deeg, DJ, Jonker, C, van Tilburg, W (2003). Comorbidity and risk-patterns of depression, generalised anxiety disorder and mixed anxiety-depression in later life: results from the AMSTEL study. International Journal of Geriatric Psychiatry 18, 994–1001.CrossRefGoogle ScholarPubMed
Schoon, I, Sacker, A, Bartley, M (2003). Socio-economic adversity and psychosocial adjustment: a developmental-contextual perspective. Social Science and Medicine 57, 10011015.CrossRefGoogle ScholarPubMed
Spielberger, CD, Gorsuch, RL, Lushene, PR, Vagg, PR, Jacobs, AG (1983). Manual for the State-Trait Anxiety Inventory (Form Y). Consulting Psychologists Press Inc.: Palo Alto, CA.Google Scholar
Syddall, HE, Sayer, AA, Dennison, EM, Martin, HJ, Barker, DJ, Cooper, C (2005). Cohort Profile: The Hertfordshire Cohort Study. International Journal of Epidemiology 34, 12341242.CrossRefGoogle ScholarPubMed
Syddall, HE, Simmonds, SJ, Martin, HJ, Watson, C, Dennison, EM, Cooper, C, Sayer, AA (2009). Cohort profile: The Hertfordshire Ageing Study (HAS). International Journal of Epidemiology 39, 3643.CrossRefGoogle ScholarPubMed
Thompson, C, Syddall, H, Rodin, I, Osmond, C, Barker, DJ (2001). Birthweight and risk of depressive disorder in late life. British Journal of Psychiatry 179, 450455.CrossRefGoogle ScholarPubMed
Townsend, P (1979). Poverty in the United Kingdom. Pelican: Harmondsworth.CrossRefGoogle Scholar
Vink, D, Aartsen, MJ, Schoevers, RA (2008). Risk factors for anxiety and depression in the elderly: a review. Journal of Affective Disorders 106, 2944.CrossRefGoogle ScholarPubMed
Wulsin, LR, Vaillant, GE, Wells, VE (1999). A systematic review of the mortality of depression. Psychosomatic Medicine 61, 6–17.CrossRefGoogle ScholarPubMed
Yang, Y, George, LK (2005). Functional disability, disability transitions, and depressive symptoms in late life. Journal of Aging and Health 17, 263292.CrossRefGoogle ScholarPubMed
Zigmond, AS, Snaith, RP (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica 67, 361370.CrossRefGoogle ScholarPubMed