Sooner or later: Age at onset of generalized anxiety disorder in older adults

School of Medicine, University of Queensland, Brisbane, Australia.
Depression and Anxiety (Impact Factor: 4.41). 01/2012; 29(1):39-46. DOI: 10.1002/da.20881
Source: PubMed


Generalized anxiety disorder (GAD) is a common disorder in older adults, with widespread and long-lasting consequences. In this study, we assessed the characteristics associated with lifetime GAD in community-dwelling adults according to their age at onset of the disorder.
Study sample was extracted from the 2007 National Survey of Mental Health and Well Being, a nationally representative cross-sectional survey that interviewed 8,841 Australians aged between 16 and 85 years using the Composite International Diagnostic Interview. Of the 3,178 participants aged 55-85 years, there were 227 (M = 63.7 years; 65% female) with a lifetime diagnosis of GAD who were the focus of our analyses.
Age at onset was defined as early (<26 years) or late (≥ 26 years), based on the median age at onset for the entire sample. The weighted prevalence estimates for 12-month and lifetime GAD were 2.8% (95% CI: 2.0, 3.7) and 7.0% (95% CI: 5.7, 8.3), respectively, with less than one-tenth of the participants being diagnosed after the age of 60 years. Having the first GAD episode earlier in life was significantly associated with physical abuse during childhood (OR = 0.34, 95% CI: 0.16, 0.75), lifetime diagnosis of dysthymia (OR = 0.34, 95% CI: 0.18, 0.67), and number of GAD episodes (OR = 0.29, 95% CI: 0.14, 0.58), after adjusting for current age and 12-month GAD.
In older adults, an earlier age at onset of GAD was associated with childhood physical abuse and worse clinical outcomes, thus appearing to be a marker for increased vulnerability to GAD.

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    • "Drawing on previous age of onset studies in the anxiety disorders literature (e.g. Segui et al., 2000; Dalrymple and Zimmerman, 2011; Gonçalves and Byrne, 2012), we hypothesized that early onset AG will be associated with family history of anxiety disorders and increased clinical severity and disability as compared to late onset. "
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    • "Epidemiological studies have shown that 40% individuals having experienced childhood maltreatment, whether retrospectively or prospectively ascertained, develop anxiety disorders [17]. An earlier age at onset of GAD is significantly related to maltreatment in childhood [19]. Hence, exploring the underpinnings of the relationship between childhood maltreatment and adolescent onset GAD would be helpful in identifying the potential risk markers for this disease. "
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