Consequences of anxiety in older persons: its effect on disability, well-being and use of health services.
BACKGROUND
Although anxiety is quite prevalent in late life, its impact on disability, well-being, and health care utilization of older persons has not been studied. Older persons are a highly relevant age group for studying the consequences of anxiety, since their increasing numbers put an extra strain on already limited health care resources.


METHODS
Data of a large community-based random probability sample (N = 659) of older subjects (55-85 year) in the Netherlands were used to select three groups: subjects with a diagnosed anxiety disorder, subjects with merely anxiety symptoms and a reference group without anxiety. These groups were compared with regard to their functioning, subjective well-being, and use of health care services, while controlling for potentially confounding variables.


RESULTS
Anxiety was associated with increased disability and diminished well-being. Older persons with a diagnosed anxiety disorder were equally affected in their functioning as those with merely anxiety symptoms. Although use of health services was increased in anxiety sufferers, their use of appropriate care was generally low.


CONCLUSIONS
Anxiety has a clear negative impact on the functioning and well-being of older subjects. The similarity of participants with an anxiety disorder and those having merely anxiety symptoms regarding quality of life variables and health care use was quite striking. Finally, in spite of its grave consequences for the quality of life, appropriate care for anxiety is seldom received. Efforts to improve recognition, disseminate effective treatments in primary care, and referring to specialized care may have positive effects on the management of anxiety in late life.
Department of Psychiatry and Institute for Research in Extramural Medicine, Vrije Universiteit, Amsterdam, The Netherlands.
E
E
de Beurs
A T
AT
Beekman
A J
AJ
van Balkom
D J
DJ
Deeg
R
R
van Dyck
W
W
van Tilburg
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D001008:Anxiety Disorders / Q000175:diagnosis / Q000523:psychology*; D003156:Community Mental Health Services / Q000706:statistics & numerical data*; D006233:Persons with Disabilities / Q000523:psychology*; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011569:Psychiatric Status Rating Scales