Skip to main content Accessibility help
×
Home

Target groups for the prevention of late-life anxiety

  • Filip Smit (a1), Hannie Comijs (a2), Robert Schoevers (a3), Pim Cuijpers (a4), Dorly Deeg (a2) and Aartjan Beekman (a5)...

Abstract

Background

Anxiety disorders in older people are highly prevalent, yet there is little evidence to guide targeted prevention strategies.

Aims

To identify subgroups at increased risk of developing anxiety in later life.

Method

Anxiety was measured with the Hospital Anxiety and Depression anxiety sub-scale in 1931 people aged 55–85 years followed over 3 years. Risk factors were identified that had a high combined attributable fraction, indicative of substantial health gains when the adverse effect of the risk factors can be contained.

Results

Factors significantly associated with increased risk of developing anxiety included sub-threshold anxiety depression, two or more chronic illnesses, poor sense of mastery, poor self-rated health and low educational level.

Conclusions

The identified risk groups are small, thus providing prevention with a narrow focus, and health gains are likely to be more substantial than in groups not exposed to these risk factors. Nevertheless, more research is needed to produce evidence on target groups where prevention has optimal impacts.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Target groups for the prevention of late-life anxiety
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Target groups for the prevention of late-life anxiety
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Target groups for the prevention of late-life anxiety
      Available formats
      ×

Copyright

Corresponding author

Dr Filip Smit, Trimbos Institute, Netherlands Institute of Mental Health and Addiction, PO Box 725, 3500 AS, Utrecht, The Netherlands, Tel: + 31 30 2959254, fax: + 31 30 2971111, email: FSmit@Trimbos.NL

Footnotes

Hide All

Declaration of interest

None.

Footnotes

References

Hide All
American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders (4th edn) (DSM-IV). APA.
Beekman, A. T. F., Deeg, D. J. H., Van Limbeek, J., et al (1997) Criterion validity of the Center for Epidemiologic Studies Depression scale (CES-D): results from a community-based sample of older adults in the Netherlands. Psychological Medicine, 27, 231235.
Beekman, A. T. F., Bremmer, M. A., Deeg, D. J. H., et al (1998) Anxiety disorders in later life: a report from the Longitudinal Aging Study Amsterdam. International Journal of Geriatric Psychiatry, 13, 171726.
Beekman, A. T. F., Geerlings, S. W., Deeg, D. J. H., et al (2002) The natural history of late-life depression: a 6-year prospective study in the community. Archives of General Psychiatry, 59, 605611.
Berkman, L. F., Berkman, C. S., Karl, S., et al (1986) Depressive symptoms in relation to physical health and functioning in the elderly. American Journal of Epidemiology, 124, 372388.
Brown, G. W. & Harris, T. O. (1978) Social Origins of Depression. Tavistock.
Cuijpers, P., Van Straten, A. & Smit, F. (2005) Preventing the incidence of new cases of mental disorders: a meta-analytic review. Journal of Nervous and Mental Disease, 193, 119125.
De Beurs, E., Beekman, A. T. F., Van Balkom, A. J. L. M., et al (1999) Consequences of anxiety in older persons: its effect on disability, well-being and use of health services. Psychological Medicine, 29, 583593.
De Beurs, E., Beekman, A., Geerlings, S., et al (2001) On becoming depressed or anxious in late life: similar vulnerability factors, but different effects of stressful life events. British Journal of Psychiatry, 179, 424431.
Feldner, M. T., Zvolensky, M. J. & Schmidt, N. B. (2004) Prevention of anxiety psychopathology: acritical review of the empirical literature. Clinical Psychology: Science and Practice, 11, 405424.
Flint, A. J. (1994) Epidemiology and comorbidity of anxiety disorders in the elderly. American Journal of Psychiatry, 151, 640649.
Greenberg, P. E., Sisitsky, T., Kessler, R. C., et al (1999) The economic burden of anxiety disorders in the 1990s. Journal of Clinical Psychiatry, 60, 427435.
Greenland, S. & Drescher, K. (1993) Maximum likelihood estimation of the attributable fraction from logistic models. Biometrics, 49, 865872.
Jorm, A. F. (2000) Does old age reduce the risk for anxiety and depression? A review of epidemiological studies across the life span. Psychological Medicine, 30, 1122.
Kriegsman, D. M., Penninx, B. W., Van Eijk, J. T., et al (1996) Self-reports and general practitioner information on the presence of chronic diseases in community dwelling elderly. A study on the accuracy of patients' self-reports and on determinants of inaccuracy. Journal of Clinical Epidemiology, 49, 14071417.
Lemon, S. C., Roy, J., Clark, M. A., et al (2003) Classification and regression tree analysis in public health: methodological review and comparison with logistic regression. Annals of Behavioral Medicine, 26, 72181.
Löthgren, M. (2004) Economic evidence in anxiety disorders: a review. European Journal of Health Economics, 5 (suppl. 1), S20S24.
Mendlowicz, M. V. & Stein, M. B. (2000) Quality of life in individuals with anxiety disorders. American Journal of Psychiatry, 157, 669682.
Miettinen, O. S. (1974) Proportion of disease caused or prevented by a given exposure, trait, or intervention. American Journal of Epidemiology, 99, 325332.
Morgenstern, H. & Bursic, E. S. (1982) A method for using epidemiologic data to estimate the potential impact of an intervention on the health status of a target population. Journal of Community Health, 7, 292309.
Mrazek, P. J. E. & Haggerty, R. J. E. (1994) Reducing Risk for Mental Disorders: Frontiers for Preventive Intervention Research. National Academy Press.
Mykletun, A., Stordal, E. & Dahl, A. A. (2001) Hospital Anxiety and Depression (HAD) scale: factor structure, item analyses and internal consistency in a large population. British Journal of Psychiatry, 179, 540544.
Pearlin, L. J. & Schooler, C. (1978) The structure of coping. Journal of Health and Social Behavior, 19, 221.
Radloff, L. S. (1977) The CES-D scale: a self-report depression scale for research in the general population. Applied Psychological Measures, 1, 385401.
Rothman, K. J. & Greenland, S. (1998) Modern Epidemiology (2nd edn). Lippincott-Raven.
Schoevers, R. A., Beekman, A. T. F., Deeg, D. J. H., et al (2003) Comorbidity and risk-patterns of depression, generalised anxiety disorder and mixed anxiety-depression in later life: results from the Amstel study. International Journal of Geriatric Psychiatry, 18, 9941001.
Schoevers, R. A., Deeg, D. J. H., Van Tilburg, W., et al (2005) Depression and generalised anxiety disorder: co-occurrence and longitudinal patterns in elderly patients. American Journal of Geriatric Psychiatry, 13, 3139.
Schoevers, R. A., Smit, F., Deeg, D. J. H., et al (2006) Prevention of late-life depression in primary care: do we know where to begin? American Journal of Psychiatry, 163, 16111621.
Smit, F., Beekman, A. T. F., Cuijpers, P., et al (2004) Selecting key-variables for depression prevention: results from a population-based prospective epidemiological study. Journal of Affective Disorders, 81, 241249.
Smit, F., Cuijpers, P., Oostenbrink, J., et al (2006a) Costs of common mental disorders: implications for curative and preventive psychiatry. Journal of Mental Health Policy and Economics, 9, 193200.
Smit, F., Ederveen, A., Cuijpers, P., et al (2006b) Opportunities for cost-effective prevention of late-life depression: an epidemiological approach. Archives of General Psychiatry, 63, 290296.
Smit, F., Willemse, G., Koopmanschap, M., et al (2006c) Cost-effectiveness of preventing depression in primary care patients: randomised trial. British Journal of Psychiatry, 188, 330336.
Snaith, R. P. (2003) The hospital anxiety and depression scale. Health and Quality of Life Outcomes, 1, 29.
Van Hout, H. P. J., Beekman, A. T. F., De Beurs, E., et al (2004) Anxiety and the risk of death in older men and women. British Journal of Psychiatry, 185, 399404.
Van Sonsbeek, J. L. A. (1988) Methodological and substantial aspects of the OECD indicator of chronic functional limitations. Maandbericht Gezondheid, 88, 417.
Willemse, G., Smit, F., Cuijpers, P., et al (2004) Minimal-contact psychotherapy for sub-threshold depression in primary care: randomised trial. British Journal of Psychiatry, 185, 416421.
Zigmond, A. S. & Snaith, R. P. (1983) The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67, 361370.

Target groups for the prevention of late-life anxiety

  • Filip Smit (a1), Hannie Comijs (a2), Robert Schoevers (a3), Pim Cuijpers (a4), Dorly Deeg (a2) and Aartjan Beekman (a5)...

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed

Target groups for the prevention of late-life anxiety

  • Filip Smit (a1), Hannie Comijs (a2), Robert Schoevers (a3), Pim Cuijpers (a4), Dorly Deeg (a2) and Aartjan Beekman (a5)...
Submit a response

eLetters

No eLetters have been published for this article.

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *