Co-occurrence of anxiety and depressive disorders in a community sample of older people: results from the MRC CFAS (Medical Research Council Cognitive Function and Ageing Study).
BACKGROUND
Few population-based studies have examined the whole range of subthreshold syndromes and disorders of anxiety and depression in older people.


OBJECTIVE
To investigate the co-occurrence of anxiety and depressive syndromes in older people. Associations between these conditions and personal and environmental factors are examined.


METHODS
MRC CFAS included 13,004, age 65 years and above, who completed the initial screening interview. A stratified random subsample of 2,640 participated in the assessment interview where the Geriatric Mental State Examination (GMS) was administered. The AGECAT diagnostic system was used to generate subthreshold and disorder-level of anxiety and depression as well as the combination of these into eight syndromes categories plus a group without any of the syndromes categories. Prevalences, unadjusted and adjusted odds ratios are calculated for the syndrome categories in relation to cross-sectional personal and environmental factors, and odds ratios of subthreshold and disorders level are estimated.


RESULTS
The overall prevalence of anxiety and depressive disorders are 3.1% and 9.7% respectively. The overall prevalence of either anxiety or depressive disorder (anxiety disorder with subthreshold depression, mixed anxiety and depressive disorder with subthreshold anxiety) where they overlapped is 8.4%. The highest Odds Ratios unadjusted and adjusted for age and gender, of anxiety and depressive disorders and significant for trend are found for increasing disability. Disability has a strong relationship with all the co-morbid syndrome categories. In all analyses women showed significant higher estimates than men.


CONCLUSIONS
Our study demonstrated high estimates where anxiety and depression occurred in parallel both as disorders and as subthreshold syndromes.
Kvaal
Kari
K
University Unit, Department of Geriatric Medicine, Ullevaal University Hospital, Oslo, Norway. Kari.Kvaal@iop.kcl.ac.uk
McDougall
Fiona A
FA
Brayne
Carol
C
Matthews
Fiona E
FE
Dewey
Michael E
ME
D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001008:Anxiety Disorders / Q000453:epidemiology*; D003866:Depressive Disorder / Q000453:epidemiology*; D004739:England / Q000453:epidemiology; D004812:Epidemiologic Methods; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D011569:Psychiatric Status Rating Scales; D012111:Residence Characteristics; D017678:Sex Distribution; D012959:Socioeconomic Factors; D014852:Wales / Q000453:epidemiology