The outcome of anxiety disorders in older people at 6-year follow-up: Results from the Longitudinal Aging Study Amsterdam

Department of Psychiatry and Institute for Research in Extramural Medicine, Vrije Universiteit Medical Centre/GGZ, Buitenamstel, Amsterdam, The Netherlands.
Acta Psychiatrica Scandinavica (Impact Factor: 5.61). 07/2005; 111(6):420-8. DOI: 10.1111/j.1600-0447.2005.00531.x
Source: PubMed


To examine long-term outcome of late-life anxiety disorders and utilization of mental health care services.
A cohort of subjects (aged > or = 55 years) with an anxiety disorder (n = 112) was identified in the Longitudinal Aging Study Amsterdam (n = 3107). At 6 year follow-up, the rate of persistence and prognostic factors for persistence of anxiety were established.
Six years after baseline 23% of our sample met the criteria for an anxiety disorder. Another 47% suffered from subclinical anxiety symptoms. Persistence of anxiety was associated with a high score on neuroticism at baseline. Use of benzodiazepines was high (43%), while use of mental health care facilities (14%) and anti-depressants (7%) remained low in those with persistent anxiety.
Results indicate that those high in neuroticism are at greater risk for persistence of anxiety. Efforts to enhance appropriate referral of anxious older adults do not seem to have had the desired effect.

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    • "Physical health, social support, socio-demographic, and recent stressful life events are additional domains relevant to the anxiety state of older adults. Chronic physical illness (Smit et al., 2007) and disability (de Beurs et al., 1999) have been linked to late-life anxiety, although a longitudinal study did not find that chronic disease or functional limitation contributed to anxiety outcome (Schuurmans et al., 2005). Higher ratings of perceived social support have been associated with a modestly decreased risk (Cairney et al., 2008b), and recent life events may contribute to an elevated risk, of late-life anxiety disorders (Beekman et al., 2000). "
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    • "Prospective studies have shown that the majority of community-dwelling older adults with depression or an anxiety disorder at baseline continued to suffer from depression or anxiety symptoms up to six years later (Beekman et al., 2002; Schuurmans et al., 2005), the consequences of which can be severe. Late-life depression is also associated with increased healthcare utilization and expenditures (Luppa et al., 2008), and anxiety and depression result in large financial burdens to the individual as well as society (Greenberg et al., 2003; Greenberg et al., 1999). "
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    • "However, this hypothesis awaits scientific testing. Neuroticism was found to be predictive of a detrimental naturalistic long-term outcome of anxiety disorders in older adults by our research group (Schuurmans et al., 2005). For the present study, we hypothesized that neuroticism might also affect treatment outcome for late-life anxiety disorders. "
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