The burden of late-life generalized anxiety disorder: effects on disability, health-related quality of life, and healthcare utilization
Open accessAbstract
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).”
From Acceptance and Commitment Therapy for generalized anxiety disorder in older adults: a preliminary report. (2011) · cites this paper as Porensky et al., 2009
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.
- ORCID
- 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)
- PMC
- PMC3408215
- 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
- green
- www.ncbi.nlm.nih.gov
- 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
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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