Onset of anxiety and depression in the aging population: comparison of risk factors in a 9-year prospective study.
OBJECTIVE
To study the onset and compare risk factors for pure depression (DEP), pure anxiety (ANX), and comorbid anxiety-depression (ANXDEP) in the aging population.


METHODS
Prospective study with 3-year intervals over a 9-year period.


METHODS
Data of the Longitudinal Aging Study Amsterdam were used, which is a population-based study among older adults (55-85 years at baseline).


METHODS
Older adults free of depression and anxiety at baseline (N = 1,712).


METHODS
Clinically relevant levels of depression and anxiety were measured with the Center for Epidemiologic Studies Depression scale> or =16 and Hospital Anxiety and Depression Scale > or =7, respectively. A broad range of potential sociodemographic, health, and psychosocial risk factors for anxiety and/or depression were examined by using polytomous logistic regression analyses.


RESULTS
Within 9 years, 184 subjects (10.8%) developed DEP, 93 (5.4%) ANX, and 103 (6.0%) ANXDEP. Concerning sociodemographics, higher age and lower educational level were predictors for DEP. Health indicators were predictive for DEP and ANXDEP but not for ANX. Depressive symptoms at baseline were predictive for DEP, whereas initial anxiety symptoms were predictive for ANX and ANXDEP. Neuroticism increased the risk of DEP and ANXDEP. Mixed effects of psychosocial variables were found: DEP was associated with recent widowhood, whereas ANX and ANXDEP were associated with other life events such as having an ill partner.


CONCLUSIONS
Although onset of ANXDEP demonstrated communality in risk factors, comparing risk factors associated with DEP and ANX revealed more differences than similarities. This underlines the need to distinguish anxiety from depression in preventive strategies.
Vink
Dagmar
D
Knowledge Centre of Psychiatry in the Elderly, Zeist, The Netherlands.
Aartsen
Marja J
MJ
Comijs
Hannie C
HC
Heymans
Martijn W
MW
Penninx
Brenda W J H
BW
Stek
Max L
ML
Deeg
Dorly J H
DJ
Beekman
Aartjan T F
AT
D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000523:psychology*; D001007:Anxiety / Q000453:epidemiology* / Q000523:psychology; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006801:Humans; D007389:Internal-External Control; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D010555:Personality Inventory; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012111:Residence Characteristics; D012307:Risk Factors