Anxiety symptoms in 74+ community-dwelling elderly: associations with physical morbidity, depression and alcohol consumption

Abstract

Objective: Anxiety among community-dwelling older adults has not been studied sufficiently. The aims of this cross-sectional population-based study were to estimate the point prevalence of clinically relevant anxiety symptoms and to describe their socio-demographic and clinical features, with particular focus on the association with somatic illnesses.

Methods: Three-hundred-sixty-six non-demented older adults (mean age 83.7±6.2, range 74-99 years) from the Faenza Project (Northern Italy) were assessed using the Cambridge Mental Disorders of the Elderly Examination-Revised (CAMDEX-R) and the Geriatric Anxiety Inventory short form (GAI-sf). Multi-adjusted regression analyses were used to estimate Odds Ratio (OR) and 95% Confidence Intervals (95% CI).

Results: Clinically relevant anxiety symptoms occurred in one out of five participants (point prevalence 21.0%) and were significantly associated with depression (OR 5.6 per rank; 95% CI: 3.1-10.1), physical morbidity (OR 3.5 per illness; 95% CI: 1.0-11.9) and female gender (OR 2.8; 95% CI: 1.4-5.5). Further, there were significant associations with a consumption of alcohol exceeding 1 alcoholic unit/day.

Conclusions: Anxiety symptoms are very common in older subjects, especially when medically ill. Depression and alcohol consumption often co-occur with late-life anxiety symptoms, thus requiring special attention in daily clinical practice.

Figure 1. Absolute number of subjects with overlapping anxiety symptoms, depression and physical morbidity.

As showed in the figure, anxiety symptoms co-occur with depression and physical morbidity in 25 older adults, 43,1% of the group with anxiety. Physical diseases are associated with anxiety symptoms in 29 subjects and with depression in 28 subjects. Anxiety symptoms were defined by the Geriatric Anxiety Inventory short form, using a cut-off score of three or more; depression was diagnosed according to ICD 10 Criteria; physical morbidity was defined as having at least one physical disease among anemia, diabetes, hypertension, coronary heart disease (CHD), cerebrovascular diseases, Parkinson’s Disease. Subjects with missing data for anxiety symptoms or depression or physical morbidity were excluded, leaving a total of 278 subjects.