title: The relationship of preparation for future care to depression and anxiety in older primary care patients at 2-year follow-up.
abstract: BACKGROUND
  : Preparation for future care needs has been hypothesized to help older adults adjust to inevitable life and health transitions and thereby decrease the likelihood of developing depression or anxiety.
  
  
  METHODS
  : A total of 190 primary care patients aged 65 years or more completed semistructured research interviews and mail-back surveys at study intake and 2 years later. Interviews included the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, the Hamilton Depression Rating Scale, Clinical Anxiety Scale and a measure of preparation for future care. Multiple regression analyses were used to determine the independent association of preparation for future care at intake with depression and anxiety severity at 2-year follow-up.
  
  
  RESULTS
  : Patients who had made more concrete plans at intake were less likely to meet criteria for depression diagnosis at follow-up. They also had lower anxiety severity scores. Patients who had avoided thinking about future care needs had greater depression symptom severity at follow-up. Findings were independent of potential confounds, including illness burden.
  
  
  CONCLUSIONS
  : Failure to prepare for future care is a novel putative risk marker for depression and anxiety in older adulthood. Clinicians should be aware that the lack of care planning and frank avoidance may pose a risk for depression and anxiety older their patients. Future research should explore the mechanisms of care planning's effects on subsequent mood.
authors.affiliation: Department of Psychiatry, University of Rochester School of Medicine and Dentistry, Rochester, NY 14620, USA. silvia sorensen@urmc.rochester.edu
authors.forename: Silvia
authors.initials: S
authors.lastname: Sörensen
authors.forename: Wingyun
authors.initials: W
authors.lastname: Mak
authors.forename: Benjamin
authors.initials: B
authors.lastname: Chapman
authors.forename: Paul R
authors.initials: PR
authors.lastname: Duberstein
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Lyness
mesh_terms: D000368:Aged; D001007:Anxiety / Q000175:diagnosis / Q000451:nursing / Q000523:psychology*; D003657:Decision Making; D003863:Depression / Q000175:diagnosis / Q000451:nursing / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006285:Health Planning / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D011320:Primary Health Care / Q000706:statistics & numerical data; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012307:Risk Factors