title: Sooner or later: age at onset of generalized anxiety disorder in older adults.
abstract: BACKGROUND
  Generalized anxiety disorder (GAD) is a common disorder in older adults, with widespread and long-lasting consequences. In this study, we assessed the characteristics associated with lifetime GAD in community-dwelling adults according to their age at onset of the disorder.
  
  
  METHODS
  Study sample was extracted from the 2007 National Survey of Mental Health and Well Being, a nationally representative cross-sectional survey that interviewed 8,841 Australians aged between 16 and 85 years using the Composite International Diagnostic Interview. Of the 3,178 participants aged 55-85 years, there were 227 (M = 63.7 years; 65% female) with a lifetime diagnosis of GAD who were the focus of our analyses.
  
  
  RESULTS
  Age at onset was defined as early (<26 years) or late (≥ 26 years), based on the median age at onset for the entire sample. The weighted prevalence estimates for 12-month and lifetime GAD were 2.8% (95% CI: 2.0, 3.7) and 7.0% (95% CI: 5.7, 8.3), respectively, with less than one-tenth of the participants being diagnosed after the age of 60 years. Having the first GAD episode earlier in life was significantly associated with physical abuse during childhood (OR = 0.34, 95% CI: 0.16, 0.75), lifetime diagnosis of dysthymia (OR = 0.34, 95% CI: 0.18, 0.67), and number of GAD episodes (OR = 0.29, 95% CI: 0.14, 0.58), after adjusting for current age and 12-month GAD.
  
  
  CONCLUSIONS
  In older adults, an earlier age at onset of GAD was associated with childhood physical abuse and worse clinical outcomes, thus appearing to be a marker for increased vulnerability to GAD.
authors: School of Medicine, University of Queensland, Brisbane, Australia. d.goncalves@uqconnect.edu.au
authors: Daniela C
authors: DC
authors: Gonçalves
authors: Gerard J
authors: GJ
authors: Byrne
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D001008:Anxiety Disorders / Q000145:classification / Q000453:epidemiology*; D001315:Australia / Q000453:epidemiology; D002648:Child; D002649:Child Abuse / Q000523:psychology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013315:Stress, Psychological