860 – Late-life Agoraphobia: a Hidden Cause Of Social Isolation And Suicidal Risk?

Abstract

Agoraphobia in the elderly has received little attention, being considered to be principally a disorder of young adulthood. Clinical reports have suggested, however, that this form of phobia is commonly overlooked in the elderly; unwillingness to go outside the home being easily attributed to poor health and loss of social networks. Undetected agoraphobia in the elderly is highly unlikely to improve spontaneously, however, treatment of agoraphobia with cognitive-behavioural therapies and psychotropics has been proven to be highly successful at all ages.

As part of the ESPRIT study of life-time psychiatric disorder, 1968 persons aged 65 and above were randomly recruited from the electoral rolls of the district of Montpellier. Prevalent and incident agoraphobia diagnosed by a standardized psychiatric examination and validated by a clinical panel was assessed at base-line and over 4 year follow-up.

Results show agoraphobia to have a high prevalence in the elderly and unlike younger cases, late-onset cases are not more common in women, and are not associated with panic attacks, suggesting a late-life sub-type. Severe depression, trait anxiety and poor visuospatial memory are the principal risk factors for late-onset agoraphobia. Our findings argue in favor of a late-life sub-type.