title: Anxiety symptoms and decline in physical function over 5 years in the health, aging and body composition study.
abstract: OBJECTIVE
  To examine the relationship between anxiety and functional decline.
  
  
  METHODS
  A 5-year longitudinal cohort study of well-functioning adults.
  
  
  METHODS
  The Health, Aging and Body Composition (Health ABC) Study.
  
  
  METHODS
  Two thousand nine hundred forty adults aged 70 to 79 (48% male, 41% black), initially free of self-reported mobility difficulty.
  
  
  METHODS
  In 1997/98, presence of three anxiety symptoms (feeling fearful, tense or keyed up, or shaky or nervous) from the Hopkins Symptom Checklist were ascertained. Physical function was examined over 5 years using the Health ABC performance battery (continuous range 0-4) consisting of chair stands, usual and narrow course gait speed, and difficulty with standing balance and self-reported mobility, defined as difficulty walking one-quarter of a mile or difficulty climbing 10 steps.
  
  
  RESULTS
  Participants with anxiety symptoms had similar baseline physical performance scores. After adjustment for potential confounders, subjects with anxiety symptoms had similar declines in physical performance over 5 years as participants without anxiety symptoms. Adults with anxiety symptoms were more likely to report incident mobility difficulty, with a hazard ratio of 1.4 (95% confidence interval=1.3-1.6), compared with adults without anxiety symptoms. These results persisted after adjustment for depressive symptoms, demographics, comorbidity, and use of antianxiety, depressant, and sedative hypnotic medications.
  
  
  CONCLUSIONS
  Anxiety symptoms are not associated with declines in objectively measured physical performance over 5 years but are associated with declines in self-reported functioning. Future studies are needed to determine why anxiety has a differential effect on performance-based and self-reported measures of functioning.
authors.affiliation: Division of Geriatrics, Department of Psychiatry, University of California at San Francisco, San Francisco, California, USA. kala.mehta@ucsf.edu
authors.forename: Kala M
authors.initials: KM
authors.lastname: Mehta
authors.forename: Kristine
authors.initials: K
authors.lastname: Yaffe
authors.forename: Gretchen A
authors.initials: GA
authors.lastname: Brenes
authors.forename: Anne B
authors.initials: AB
authors.lastname: Newman
authors.forename: Ronald I
authors.initials: RI
authors.lastname: Shorr
authors.forename: Eleanor M
authors.initials: EM
authors.lastname: Simonsick
authors.forename: Hilsa N
authors.initials: HN
authors.lastname: Ayonayon
authors.forename: Susan M
authors.initials: SM
authors.lastname: Rubin
authors.forename: Kenneth E
authors.initials: KE
authors.lastname: Covinsky
mesh_terms: D001741:Black or African American; D000368:Aged; D000375:Aging / Q000502:physiology* / Q000523:psychology; D001007:Anxiety / Q000503:physiopathology*; D001823:Body Composition / Q000502:physiology*; D005260:Female; D015577:Geriatric Assessment; D006304:Health Status; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009043:Motor Activity / Q000502:physiology*; D012680:Sensitivity and Specificity; D012923:Social Class; D044465:White People