Anxiety Disorders in Older Puerto Rican Primary Care Patients

Anxiety Disorders Center, The Institute of Living/Hartford Hospital's Mental Health Network, 200 Retreat Avenue, Hartford, CT 06106, USA.
American Journal of Geriatric Psychiatry (Impact Factor: 4.24). 03/2005; 13(2):150-6. DOI: 10.1176/appi.ajgp.13.2.150
Source: PubMed


Authors examined the frequency and comorbidity of anxiety disorders among aging Puerto Ricans seen in primary care.
A group of 303 middle-aged and older low-socioeconomic-status Puerto Ricans attending primary-care clinics were surveyed, using a Spanish-language diagnostic interview.
Twenty-four percent of participants met probable DSM criteria for at least one anxiety disorder in the previous year, especially generalized anxiety disorder, specific phobia, and panic attacks. Psychiatric comorbidity was common; the occurrence of most anxiety disorders increased the conditional risk of a comorbid disorder from 5- to 30-fold.
The present results suggest a need to screen at-risk patients in primary care settings serving this population.

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    • "Despite anxiety being one of the most common psychiatric conditions in later life (Gonçalves et al., 2011), only recently has interest gained momentum into anxiety among residents of aged care facilities (known variously as nursing homes, hostels, assisted living facilities, or long-term care/residential homes). This is surprising, particularly given that psychiatric disorders commonly precipitate admission into residential care (Luppa et al., 2010), and older residents represent an increasingly frail and medically ill group who are at increased risk for anxiety (Tolin et al., 2005; Gerolimatos et al., 2013). "
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    ABSTRACT: Objectives To synthesize and summarize the studies examining the prevalence rate of anxiety disorders and symptoms in older adults living in residential aged care. Methods Using the PRISMA guidelines, five electronic databases were searched using key terms and subject headings, as well as reference lists of relevant papers. The search was limited to literature published in English. Eligible studies examined the prevalence of anxiety disorders or symptoms in aged care residents aged 50+ years. Results A total of 2249 articles were identified, of which 18 studies (with a total of 5927 participants) were included in this review. The rate of overall anxiety disorders ranged from 3.2% to 20%, with the highest quality studies estimating a prevalence rate of 5% to 5.7%. Generalized anxiety disorder and specific phobias were found to be the most common anxiety disorders among aged care residents, while clinically significant anxiety symptoms were found to be more frequent (6.5% to 58.4%) than threshold disorders. Conclusions Anxiety disorders and anxiety symptoms are common in older aged care residents. Given the paucity and overall quality of research examining anxiety within this population and the heterogeneity found in studies, further research is needed to help clarify this issue.
    International Journal of Geriatric Psychiatry 11/2015; DOI:10.1002/gps.4378 · 2.87 Impact Factor
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    • "Third, because we examine test-retest invariance, temporal stability, and associations of latent factors over a 3 months interval for older adults using the DASS-21, the findings here could be unique to this time interval, to this age group, and to this version of the DASS. Fourth, despite the findings here supporting temporal stability over 3 months, it is highly probable that changes could be more noticeable across longer testretest intervals as there are existing data showing increased depression, anxiety and stress with age (Beekman et al. 1998; Tolin et al. 2005; Wittchen et al. 2001). Although we collected DASS-21 ratings at five different time points (initial, 3, 12, 18 and 24 months) over 24 months, the number of ratings available for the participants involved in the study at 12, 18 and 24 months were considered too low (206, 196 and 163, respectively) for longitudinal analyses beyond 3 months. "
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    ABSTRACT: This study examined the factor structure and test-retest invariance, and temporal stability and uniqueness of the latent factors (depression, anxiety, and stress) of the Depression Anxiety Stress Scales-21 (DASS-21; Lovibond & Lovibond, 1995) in group a of 269 older adults (age ranging from 60 to 85 years) from the general community. Participants completed the DASS-21 twice, 3 months apart. Confirmatory factor analysis (CFA) of their ratings at Time 1 indicated support for the original 3-factor oblique model (factors for depression, anxiety, and stress). Additional analyses showed support for test-retest invariance for both the measurement (configural, metric and thresholds) and structural (variances and covariances) components of this model. Results also indicated temporal stability and uniqueness of the latent factors. The practical, theoretical, research and clinical implications of the findings are discussed
    Journal of Psychopathology and Behavioral Assessment 06/2014; 36:308-317. DOI:10.1007/s10862-013-9391-0 · 1.55 Impact Factor
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    • "As in younger adulthood, late-life anxiety disorders have been found to be more prevalent among women (Beck and Averill, 2004) and medical populations (e.g. Tolin et al., 2005). Residents of long-term care facilities represent a sub-population of older adults who are particularly at risk for anxiety and other psychological disorders. "
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    ABSTRACT: Background: Accurate assessment of anxiety in later life is critical, as anxiety among older adults is associated with social and functional impairment and poorer quality of life. The Geriatric Anxiety Inventory (GAI) and the GAI-Short Form (GAI-SF) were designed to detect anxiety symptoms among community-dwelling older adults, but the usefulness of the GAI and GAI-SF in long-term care is unknown. The present study examined the psychometric properties of the GAI and GAI-SF among residents at a long-term care facility. Methods: Seventy-five nursing home residents completed the GAI and measures of depression, executive functioning, and adaptive functioning. The mean age of residents was 69.60 years (SD = 10.76). Psychiatric diagnoses included dementia, psychotic disorders, mood disorders, anxiety disorders, substance abuse, sleep disorders, and mental retardation. Results: Internal consistency of the GAI was good (α = 0.92) and the GAI-SF was adequate (α = 0.73). GAI and GAI-SF scores were moderately correlated with depression scores, and weakly correlated with adaptive functioning scores and executive functioning scores, suggesting discriminant validity. Logistic regression analyses were conducted with GAI and GAI-SF scores predicting an anxiety disorders diagnosis. Results provided support for the predictive validity of the GAI and GAI-SF. Sensitivity, specificity, and the percentage of individuals correctly classified at various cut-off scores were also calculated. Conclusions: Both the GAI and GAI-SF appear to be useful tools for assessing anxiety among nursing home residents with psychological disorders. The GAI-SF may be a viable replacement for the GAI as a screener for anxiety in long-term care.
    International Psychogeriatrics 06/2013; 25(9):1-10. DOI:10.1017/S1041610213000847 · 1.93 Impact Factor
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