Article

Comorbid Depression and Anxiety in Later Life: Patterns of Association, Subjective Well-being, and Impairment

Health Systems Research and Consulting Unit, Centre for Addiction and Mental Health, Department of Psychiatry, Sunnybrook and Women's College Health Sciences Centre, University of Toronto, Toronto, ON.
American Journal of Geriatric Psychiatry (Impact Factor: 3.52). 04/2008; 16(3):201-8. DOI: 10.1097/JGP.0b013e3181602a4a
Source: PubMed

ABSTRACT Very little epidemiological work has examined comorbidity between depression and anxiety disorders in community-dwelling older adults, despite the fact these disorders are known to co-occur in younger adults and that this co-occurrence is associated with greater clinical severity. In this study, the authors examine psychiatric comorbidity and associated impairment of four disorders (major depression, panic disorder, social phobia, and agoraphobia) in a community-based sample of adults aged 55 and older.
Population-based sample of older adults (N=12,792) from the Canadian Community Health Survey-Mental Health and Well-Being (CCHS 1.2).
The World Mental Health Composite International Diagnostic Interview was used to identify cases of 12-month disorder. Descriptive analysis and regression analysis is used to examine patterns of association between disorders and related impairment.
Among adults aged 55 years and older, 4.4% met the criteria for at least one disorder and 0.8% had two or more. Social phobia was the most common comorbid disorder among respondents with depression, and depression was the most common comorbid disorder among respondents with any of the anxiety disorders. Respondents who report comorbid disorders reported significantly lower well-being and greater impairment.
Although comorbidity between physical health conditions and depression, and between dementias and depression, are well documented among older adults, these results suggest that comorbid depression and anxiety are also prevalent in later life. The significant impact of comorbidity on function and well-being underlines the need to screen for comorbid disorders in this population.

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    • "The method of sample selection for household interviews and the description of the CCHS 1.2 field procedures appear elsewhere [21]. As is the case in previous research [22] [23], our analyses were restricted to participants 55 years of age or older (n=12,792) to enhance statistical power and because the traditional age cutoff of 65 years is increasingly irrelevant as individuals often retire significantly earlier than age 65 years or long after it [24]. 1.1. "
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    • "In addition to socio-demographic characteristics of younger age, female gender, and lower income (Vink et al., 2008), a number of mental illnesses are associated with late-life anxiety. Depression is a common co-morbid psychiatric condition; in community-dwelling older adults, 23.0–47.5% of those with major depression also satisfy criteria for an anxiety disorder, and 25.1–31.0% of elders with an anxiety disorder meet criteria for major depression (Beekman et al., 2000; Cairney et al., 2008a). Anxious and depressed individuals suffer from a more severe and unremitting course than occurs when anxiety and depression present independently (Rapaport, 2001; Andreescu et al., 2007). "
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