Cited by 255Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesAging, Health, and DisabilityMental Health Treatment and Access

The burden of late-life generalized anxiety disorder: effects on disability, health-related quality of life, and healthcare utilization

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Porensky, Emily K., Dew, Mary Amanda, Karp, Jordan F., Skidmore, Elizabeth, Rollman, Bruce L., Shear, M Katherine, Lenze, Eric J.·2009·The American Journal of Geriatric Psychiatry

Abstract

Objective To describe the burden of Generalized Anxiety Disorder (GAD), a common anxiety disorder in older adults.Design Cross-sectional.Setting Late-life depression and anxiety research clinic in Pittsburgh, PA.Participants One hundred sixty-four older adults with GAD and 42 healthy comparison participants with no lifetime history of psychiatric disorder were recruited from primary care and mental health settings as well as advertisements.Measurements Participants were evaluated with the Late Life Function and Disability Index to assess disability, the MOS 36-Item Short Form Survey Instrument to assess health-related quality of life (HRQOL), and the Cornell Service Index to assess healthcare utilization.Results Older adults with GAD were more disabled, had worse HRQOL, and had greater healthcare utilization, than nonanxious comparison participants, even in the absence of psychiatric comorbidity. After controlling for medical burden and depressive symptoms, higher severity of anxiety symptoms was associated with greater disability and poorer HRQOL in several domains. The greatest decrements in HRQOL and function were observed in measures assessing role functioning, including social function.Conclusion This study, the largest ever of GAD in older adults, provides evidence of the significant burden of this disorder in late life. Given the high prevalence and chronicity of GAD in the elderly, these data provide a public health imperative for finding and implementing effective management strategies for this typically undiagnosed and untreated disorder.

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  • GAD is common among older adults and substantially lowers their quality of life.

    “Generalized anxiety disorder (GAD) is a prevalent condition resulting in substantial impairment in quality of life among older adults (de Beurs, et al., 1999; Gum, King-Kallimanis, & Kohn, 2009; Porensky et al., 2009; Wetherell et al., 2004).”
  • Guidance on managing TR-GAD in older people (and indeed in working-age people) is lacking.

    “As noted in Chapter 1, guidance on managing TR-GAD in older people (and indeed in working-age people) is lacking.”

    From Acceptance and commitment therapy for older people with treatment-resistant generalised anxiety disorder: The FACTOID feasibility study (2021) · cites this paper as [7]

    The Conclusion calls for effective management strategies for late-life GAD, but does not say that guidance for treatment-resistant GAD is lacking. The Methods and Discussion address older adults with GAD, not TR-GAD guidance for either older or working-age adults (searched: treatment-resistant, TR-GAD, and management guidance). (LLM, conf=0.75)

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Authors
Porensky, E. K., Dew, M. A., Karp, J. F., Skidmore, E., Rollman, B. L., Shear, M. K., & Lenze, E. J.
Affiliations
  • Washington University in St. Louis (US)
  • University of Pittsburgh (US)
  • Columbia University (US)
Corresponding author
Porensky, Emily K.
Venue
The American Journal of Geriatric Psychiatry
Publisher
Elsevier BV
Published
2009-06
Volume
17
Issue
6
Pages
473-482
ISSN
1064-7481 (ISSN-L)
OpenAlex
W1996696671
Cited by
255
References
54
Citations by year
2026: 12 · 2025: 7 · 2024: 20 · 2023: 18 · 2022: 7 · 2021: 19 · 2020: 15 · 2019: 19 · 2018: 10 · 2017: 22 · 2016: 10 · 2015: 18 · 2014: 19 · 2013: 14 · 2012: 10
FWCI
18.62
Type
journal article
Language
en
Open access
Locations
  • American Journal of Geriatric Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute of Mental Health (P30-MH 71944, P30MH071944, R01MH070547)
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
Keywords
generalized anxiety disorder, older adults, disability, health-related quality of life, health care utilization, role functioning, social functioning, anxiety symptom severity, MOS SF-36
MeSH terms
Activities of Daily Living, Aged, Aged, 80 and over, Anxiety Disorders, Cross-Sectional Studies, Depression, Disability Evaluation, Female, Health Services, Health Status, Humans, Male, Middle Aged, Psychiatric Status Rating Scales, Quality of Life, Surveys and Questionnaires, Severity of Illness Index, Comorbidity, Case-Control Studies, Cost of Illness

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