title: Multimorbidity is associated with anxiety in older adults in the Health and Retirement Study.
abstract: The present study determined whether the number of medical conditions was associated with increased occurrence of anxiety and whether triads of medical conditions were associated with anxiety in a nationally representative sample of older Americans. We determined whether multimorbidity findings were unique to anxiety as compared with depressive symptoms.
  
  
  
  A sample of 4219 participants (65 years or older) completed anxiety and depression measures in the Health and Retirement Study 2006 wave. The logistic regression models' outcome was elevated anxiety (≥12 on five-item Beck Anxiety Inventory) or depressive symptoms (≥12 on eight-item Center for Epidemiological Studies Depression Scale). The predictor variable was a tally of seven self-report of doctor-diagnosed conditions: arthritis, cancer, diabetes, heart conditions, high blood pressure, lung disease, and stroke. Analyses were adjusted for age, gender, and depressive or anxiety symptoms. Associations among elevated anxiety or depressive symptoms and 35 triads of medical conditions were examined using Bonferroni corrected chi-square analyses.
  
  
  
  Three or more medical conditions conferred a 2.30-fold increase in elevated anxiety (95% confidence interval: 1.44-4.01). Twenty triads were associated with elevated anxiety as compared with 13 associated with depressive symptoms. Six of seven medical conditions, with the exception being stroke, were present in the majority of triads.
  
  
  
  Number of medical conditions and specific conditions are associated with increased occurrence of elevated anxiety. Compared with elevated depressive symptoms, anxiety is associated with greater multimorbidity. As anxiety and depression cause significant morbidity, it may be beneficial to consider these mental health symptoms when evaluating older adults with multimorbidity. Published 2016. This article is a U.S. Government work and is in the public domain in the USA.
authors.affiliation: Geriatric Research Education and Clinical Center (GRECC), VA Palo Alto Health Care System, Palo Alto, CA, USA. cegould@stanford.edu.|Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA. cegould@stanford.edu.
authors.forename: Christine E
authors.initials: CE
authors.lastname: Gould
authors.affiliation: Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.|Mental Illness Research Education and Clinical Center (MIRECC), VA Palo Alto Health Care System, Palo Alto, CA, USA.|School of Psychology, University of Queensland, Brisbane, Australia.
authors.forename: Ruth
authors.initials: R
authors.lastname: O'Hara
authors.affiliation: Geriatric Research Education and Clinical Center (GRECC), VA Palo Alto Health Care System, Palo Alto, CA, USA.|Center for Primary Care and Outcomes Research (PCOR), Stanford University, Stanford, CA, USA.
authors.forename: Mary K
authors.initials: MK
authors.lastname: Goldstein
authors.affiliation: Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.|Mental Illness Research Education and Clinical Center (MIRECC), VA Palo Alto Health Care System, Palo Alto, CA, USA.|School of Psychology, University of Queensland, Brisbane, Australia.
authors.forename: Sherry A
authors.initials: SA
authors.lastname: Beaudreau
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001008:Anxiety Disorders / Q000453:epidemiology* / Q000523:psychology; D002908:Chronic Disease / Q000523:psychology*; D003866:Depressive Disorder / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D000076322:Multimorbidity; D012179:Retirement; D014481:United States / Q000453:epidemiology
keywords: anxiety; chronic conditions; comorbidity; depression; multimorbidity; older adults