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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Available from: David L Streiner, Jul 02, 2015
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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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    ABSTRACT: The primary objectives of this study were to examine the likelihood of anxiety disorders among respondents with common physical health conditions and to explore the associations between this comorbidity and older adults' perceived mental and physical health. The sample consisted of older adults from the Canadian Community Health Survey 1.2 (n=12,792). Trained lay interviewers assessed psychiatric disorders based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria. Physical health conditions were based on self-reported diagnoses by health professionals. Multiple logistic regressions examined whether suffering from a physical health condition increased the odds of any assessed anxiety disorder (panic, agoraphobia, social phobia and posttraumatic stress disorder). Multiple linear regressions examined associations between self-rated health and comorbid physical health conditions and anxiety. After adjusting for confounding variables, the presence of chronically painful conditions (i.e., arthritis, back pain and migraine) and of other commonly occurring diseases (i.e., allergies, cataracts and gastrointestinal, lung and heart disease) were positively associated with anxiety. The comorbidity of anxiety with allergies, cataracts, arthritis and lung disease resulted in poorer self-rated physical and/or mental health after adjusting for confounding variables. Health problems in older adults are associated with increased odds of anxiety, and this comorbidity is associated with poorer self-reported health than medical problems or anxiety alone. These findings have important clinical implications for health professionals.
    General hospital psychiatry 09/2011; 33(6):556-64. DOI:10.1016/j.genhosppsych.2011.07.005 · 2.90 Impact Factor
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    • "Depression and caregiver burden may also impact dementia anxiety, and, in fact, may be more important than background variables in predicting dementia anxiety. Given the high rates of comorbidity between depression and anxiety (Cairney et al., 2008) and the importance of caregiver burden as a predictor of anxiety in general (Grunfeld et al., 2004), there is a strong possibility that both of these factors may be associated with dementia anxiety among caregivers. "
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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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