Background. Data on the course of anxiety in late life are scarce. The present study sets out to
investigate the course of anxiety, as measured by the HADS-A (Zigmond & Snaith, 1983) in
community dwelling older persons, and to evaluate predictive factors for change over 3 years in
anxiety symptoms following the vulnerability/stress model.
Method. Based on the first anxiety assessment, two cohorts were formed: subjects with and subjects
without anxiety symptoms. In the non-anxious cohort (N = 1602) we studied risk factors for the
development of anxiety symptoms; in the anxious cohort (N = 563) the same factors were evaluated
on their predictive value for restitution of symptoms. Risk factors included vulnerability factors
(demographics, health status, personality characteristics and social resources) and stressors (life
events occurring in between both anxiety assessments). Logistic regression models estimated the
effects of vulnerability factors, stress and their interaction on the likelihood of becoming anxious
and chronicity of anxiety symptoms.
Results. It was indicated that the best predictors for becoming anxious were being female, high
neuroticism, hearing/eyesight problems and life-events. Female sex and neuroticism also increased
the likelihood of chronicity of anxiety symptoms in older adults, but life events were not related to
chronicity. The main stressful event in late life associated with anxiety was death of one's partner.
Vulnerability factors and stress added on to each other rather than their interaction being associated
with development or chronicity of anxiety.
Conclusion. The vulnerability/stress model offers a useful framework for organizing risk factors for
development and chronicity of anxiety symptoms in older persons, but no support was attained for
the hypothesis that vulnerability and stress amplify each others effects. Finally, the results indicate
to whom preventive efforts should be directed: persons high in neuroticism, women, and those who
experience distressing life events.