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: 4.24). 04/2008; 16(3):201-8. DOI: 10.1097/JGP.0b013e3181602a4a
Source: PubMed


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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    • "However, the diagnosis and accurate assessment of anxiety in late life is especially challenging because of several complicating factors, including the co-occurrence of anxiety with physical health problems and psychiatric problems, such as depression or personality disorders (e.g., Cairney et al. 2008; Coolidge et al. 2000), higher rates of cognitive impairment among older adults (Wolitzky-Taylor et al. 2010; Yochim et al. 2013) and changes in life circumstances not faced by younger adults (Wolitzky-Taylor et al. 2010). "
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    ABSTRACT: Anxiety occurs frequently among older adults, and can have deleterious impacts on the quality of daily life. Due to the dearth of well-validated elder-specific anxiety screening instruments available in the German language, this study aimed to translate the Geriatric Anxiety Scale (GAS), a reliable and valid 30-item self-report screening instrument for assessing anxiety based on DSM-IV-TR diagnostic criteria (Segal et al 2010), into German, and to validate the new measure. The German version of the GAS was developed through a translation and back translation process, with careful attention paid to culturally-sensitive expressions of anxiety in the German older adult population. The final version of the German GAS was tested in a sample of 242 community-dwelling older adults (M age = 72.0 years, SD = 6.9 years; 59% women) who completed either an online (26%) or a paper-pencil (74%) version of the questionnaire. The findings confirmed the successful translation of the GAS into German and provided psychometric support for the new measure. The validation of the factor structure based on confirmatory factor analyses was in support of a unidimensional structure of the GAS-G. Correlational analyses with inventories measuring anxiety related and non-anxiety related personality traits additionally confirmed the convergent and discriminant validity of the GAS for use as an assessment measure for anxiety among German older adults.
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    • "Mental health problems and psychiatric disorders are associated with lower levels of subjective health and quality of life among individuals.[123] Studies among diverse samples have consistently shown that the presence of anxiety,[456] depression,[789] and problem alcohol use[10] are all inversely correlated with perceived well-being, self-rated health and life satisfaction. "
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