Co-occurrence of depression and anxiety in elderly subjects aged 90 years and its relationship with functional status, quality of life and mortality.
OBJECTIVE
To examine the prevalence of concurrent depression and anxiety and its relationship with functional status, quality of life and mortality in individuals at age 90.


METHODS
In the Leiden 85-plus Study, a population based cohort study, depression (15-item Geriatric Depression Scale >or=5 points) and anxiety (Anxiety Screening Questionnaire >or=1 positive answer) were assessed in all 90-year old subjects with >or=19 points on the Mini Mental State Examination (MMSE). Functional status included: cognitive function (MMSE) and disability in activities of daily living (Groningen Activity Restriction Scale). Quality of life included: loneliness (Loneliness Scale of De Jong-Gierveld) and life satisfaction (Cantril's ladder). For all subjects mortality data were available up to a maximum age of 95.3 years.


RESULTS
Of the subjects aged 90 years with MMSE >or=19 points (56 men, 145 women), 50 subjects (25%, 95% CI 19-31%) experienced depression and 25 subjects (12%, 95% CI 9-18%) anxiety; of them 34 (17%) experienced depression only, 9 (4%) anxiety only, and 16 (8%) both depression and anxiety. Presence of depression was associated with an overall decreased functional status and quality of life and with increased mortality. Within the depressed group, subjects with anxiety did not differ from subjects without anxiety, except for higher loneliness scores.


CONCLUSIONS
Among individuals aged 90 years, depression and anxiety and their co-occurrence are highly prevalent. Anxiety does not add to poor functional status and increased mortality beyond that associated with depression, and is probably part of the phenomenology of depression in old age.
Van der Weele
Gerda M
GM
Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands. g.m.van_der_weele@lumc.nl
Gussekloo
Jacobijn
J
De Waal
Margot W M
MW
De Craen
Anton J M
AJ
Van der Mast
Roos C
RC
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over / Q000523:psychology*; D001008:Anxiety Disorders / Q000453:epidemiology*; D003072:Cognition Disorders / Q000453:epidemiology; D015897:Comorbidity; D003866:Depressive Disorder / Q000453:epidemiology*; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008132:Loneliness / Q000523:psychology; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life / Q000523:psychology*