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Late-onset agoraphobia: General population incidence and evidence for a clinical subtype

Published online by Cambridge University Press:  15 April 2020

K. Ritchie*
Affiliation:
Inserm U1061, Hôpital La Colombière, Montpellier
J. Norton
Affiliation:
Imperial College, LondonUK
*
*Auteur correspondant. Adresse e-mail :karen.ritchie@inserm.fr

Abstract

The general population prevalence and incidence of late-life agoraphobia was estimated and its clinical characteristics and risk factors described using data from the French ESPRIT study. One thousand nine hundred and sixty-eight persons aged 65 and above were randomly recruited from the electoral rolls of the district of Montpellier. Prevalent and incident agoraphobia diagnosed by a standardized psychiatric examination and validated by a clinical panel was assessed at base-line and over 4-year follow-up. The one-month prevalence of agoraphobia was estimated at 10.4% of whom 10.9% reported having the first-episode at age 65 or over. During the 4-year follow-up 11.2% of participants without agoraphobia at base line were classified as cases giving an incident rate of 32 per 1000 person-years. These 132 incident late-onset cases were associated with higher incident rates of anxiety disorders and suicidal ideation. Only two incident cases had past or concurrent panic attacks, which was not significantly different from non-cases. The principal base-line risk factors for incident cases derived from a multivariate model incorporating all significant risk factors were younger age of onset (OR = 0.94; 95% CI 0.90–0.99, P = 0.02), poorer visuospatial memory performance (OR = 1.60; 95% CI 1.02–2.49, P = 0.04), severe depression (OR = 2.62; 95% CI 1.34–5.10, P = 0.005) and trait anxiety (OR = 1.73; 95% CI 1.03–2.90, P = 0.04). No significant association was found with cardiac pathologies. We conclude that agoraphobia has high prevalence in the elderly and unlike younger cases, late-onset cases are not more common in women, and are not associated with panic attacks, suggesting a late-life subtype. Severe depression, trait anxiety and poor visuospatial memory are the principal risk factors for late-onset agoraphobia.

Type
Congrès français de psychiatrie: Rencontres avec l’expert
Copyright
Copyright © European Psychiatric Association 2015

Disclosure of interest

The author declares that she has no competing interest.

References

Further reading

Ritchie, KArtero, SBeluche, IAncelin, MLMann, ADupuy, AM, et al. Prevalence of DSM-IV psychiatric disorder in the French elderly population. Br J Psychiatry 2004;184:147–52.CrossRefGoogle ScholarPubMed
Bryant, CJackson, HAmes, D. The prevalence of anxiety in older adults: methodological issues and a review of the literature. J Affect Disord 2008;109:233–50.CrossRefGoogle Scholar
Hendriks, GJKeijsers, GPKampman, MHoogduin, CAOude Voshaar, RC. Predictors of outcome of pharmacological and psychological treatment of late-life panic disorder with agoraphobia. Int J Geriatr Psychiatry;27:146–50.CrossRefGoogle Scholar
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