Generalized anxiety disorder in late life: lifetime course and comorbidity with major depressive disorder.
OBJECTIVE
Generalized anxiety disorder (GAD) in elderly persons is highly prevalent, but little is known about its course, age at onset, and relationship to comorbid major depressive disorder (MDD). The authors assessed the course and comorbidity of late-life GAD and MDD.


METHODS
Authors assessed elderly subjects in anxiety or depression intervention studies who had a lifetime history of GAD, with current MDD (N=57) or without (N=46). Subjects' lifetime course of illness was charted retrospectively.


RESULTS
The 103 subjects had a mean age of 74.1 years, and a mean age at onset of GAD of 48.8 years; 46% were late-onset. GAD episodes were chronic, and 36% were longer than 10 years. Of the comorbid GAD-MDD patients, most had different times of onset and/or offset of the disorders; typically, GAD preceded MDD.


CONCLUSIONS
Elderly subjects with GAD tended to have chronic symptoms lasting years-to-decades, without interruption, and many have late onset. Elderly persons with lifetime GAD and MDD tend to have different onset and offset of the two disorders. Findings characterize late-life GAD as a chronic disorder distinct from MDD.
Lenze
Eric J
EJ
Intervention Research Center in Late-Life Mood Disorders, Department of Psychiatry, University of Pittsburgh, PA 15213, USA. lenzeej@upmc.edu
Mulsant
Benoit H
BH
Mohlman
Jan
J
Shear
M Katherine
MK
Dew
Mary Amanda
MA
Schulz
Richard
R
Miller
Mark D
MD
Tracey
Barbara
B
Reynolds
Charles F
CF
D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000523:psychology*; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D005260:Female; D006801:Humans; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012074:Remission Induction; D012720:Severity of Illness Index