Mood And Anxiety Disorders Affect Many Older Adults

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Mood and anxiety disorders appear to decline with age but the conditions remain common in older adults, especially women, according to a report in the May issue of Archives of General Psychiatry, one of the JAMA/Archives journals.

“Knowledge of the prevalence of mood and anxiety disorders and co-existing mood-anxiety disorder in older community-dwelling adults is important; these are hidden and undertreated but treatable disorders associated with poor health outcomes," says Amy L. Byers, Ph.D., M.P.H., of the University of California, San Francisco.

Byers and colleagues determined nationally representative estimates of mood, anxiety and combined mood and anxiety disorders using a sample of 2,575 survey participants age 55 and older. Of these, 43 percent were ages 55 to 64; 32 percent, 65 to 74 years; 20 percent, 75 to 84 years; and 5 percent, 85 years or older. A total of 5 percent of participants had a mood disorder, including major depressive disorder or bipolar disorder, within the previous year.

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Rates of anxiety disorders-such as panic disorder, agoraphobia, other phobias, generalized anxiety disorder and posttraumatic stress disorder-were 12 percent overall. About 3 percent had co-occurring mood and anxiety disorders.

"The study of nationally representative samples provides evidence for research and policy planning that helps to define community-based priorities for future psychiatric research," the authors write. "The findings of this study emphasize the importance of individual and co-existing mood and anxiety disorders when studying older adults, even the oldest cohorts. Further study of risk factors, course and severity is needed to target intervention, prevention and health care needs."

The strengths of the study, the researchers say, include a nationally representative sample, current DSM diagnostic assessment, and precise age stratification. The limitations of the study include underrepresentation of homeless, institutionalized, and non–English-speaking older adults; possible issue with stigma, whereby older adults with mental illness might be less inclined to participate in a mental health survey; and a lay-administered interview rather than a clinically administered assessment. Given these limitations, the derived estimates are likely to be conservative, the study authors say.

"Given the rapid aging of the US population, the potential public health burden of late-life mental health disorders will likely grow as well, suggesting the importance of continued epidemiologic monitoring of the mental health status of the young-old, mid-old, old-old, and oldest-old cohorts," the researchers conclude.

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