Target groups for the prevention of late-life anxiety
Open accessAbstract
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.
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Anxiety symptoms tend to run a chronic course and put people at risk for developing anxiety disorders.
“Furthermore, anxiety symptoms tend to run a chronic course [7] and put people at risk for developing anxiety disorders [15].”
From An Internet-based Acceptance and Commitment Therapy intervention for older adults with anxiety complaints: study protocol for a cluster randomized controlled trial. (2018) · cites this paper as [15]
Citation [15] is attached to the claim that anxiety symptoms put people at risk of developing anxiety disorders, not to the preceding chronic-course claim. The Risk indicators and Model with all risk indicators sections identify sub-threshold anxiety as a risk indicator for later anxiety. However, the Anxiety section defines new cases by a HADS-A score of at least 8, rather than a diagnosed disorder, and the study concerns older adults. (LLM, conf=0.87)
Experimental — accuracy not yet measuredUntreated anxiety symptoms in older adults tend to be chronic and aggravated over time.
“This treatment gap is worrying as untreated anxiety symptoms in older adults tend to be chronic and aggravated over time [10].”
From Blended Acceptance and Commitment Therapy Versus Face-to-face Cognitive Behavioral Therapy for Older Adults With Anxiety Symptoms in Primary Care: Pragmatic Single-blind Cluster Randomized Trial. (2021) · cites this paper as [10]
The ‘Factors significantly associated’ section identifies sub-threshold anxiety as a risk factor for developing clinically relevant anxiety, which supports the possibility of worsening symptoms. The paper does not establish that untreated symptoms generally persist or worsen over time; it does not assess outcomes by treatment status. (LLM, conf=0.76)
Experimental — accuracy not yet measured
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- Authors
- Smit, F., Comijs, H., Schoevers, R., Cuijpers, P., Deeg, D., & Beekman, A.
- Affiliations
- Trimbos Institute (NL)
- Amsterdam UMC Location Vrije Universiteit Amsterdam (NL)
- Mentrum (NL)
- Corresponding author
- Smit, Filip
- Venue
- British Journal of Psychiatry
- Publisher
- Royal College of Psychiatrists
- Published
- 2007-05
- Volume
- 190
- Issue
- 5
- Pages
- 428-434
- ISSN
- 0007-1250 (ISSN-L)
- 1472-1465
- OpenAlex
- W2163888265
- Cited by
- 65
- References
- 34
- Citations by year
- 2024: 6 · 2023: 1 · 2022: 1 · 2021: 2 · 2020: 3 · 2019: 2 · 2018: 5 · 2017: 4 · 2016: 1 · 2015: 3 · 2014: 1 · 2013: 1 · 2012: 4
- FWCI
- 10.99
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The British Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (publishedVersion, other-oa)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion, other-oa)
- VU Research Portal (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Funders
- ZonMw
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- late-life anxiety, prevention, risk factors, target groups, depression, chronic disease, sense of mastery, self-rated health, educational attainment, attributable fraction
- MeSH terms
- Aged, Aged, 80 and over, Anxiety Disorders, Chronic Disease, Depressive Disorder, Educational Status, Epidemiologic Methods, Female, Humans, Male, Middle Aged, Preventive Psychiatry, Psychiatric Status Rating Scales, Risk Factors, Cohort Studies, Incidence, Age of Onset, Risk Assessment
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