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Predictors of change in anxiety symptoms of older persons: results from the Longitudinal Aging Study Amsterdam

Published online by Cambridge University Press:  01 May 2000

E. DE BEURS ,
A. T. F. BEEKMAN ,
D. J. H. DEEG ,
R. VAN DYCK  and
W. VAN TILBURG
E. DE BEURS
Affiliation:
Department of Psychiatry and Institute for Research in Extramural Medicine, Vrije Universiteit, Amsterdam, The Netherlands
A. T. F. BEEKMAN
Affiliation:
Department of Psychiatry and Institute for Research in Extramural Medicine, Vrije Universiteit, Amsterdam, The Netherlands
D. J. H. DEEG
Affiliation:
Department of Psychiatry and Institute for Research in Extramural Medicine, Vrije Universiteit, Amsterdam, The Netherlands
R. VAN DYCK
Affiliation:
Department of Psychiatry and Institute for Research in Extramural Medicine, Vrije Universiteit, Amsterdam, The Netherlands
W. VAN TILBURG
Affiliation:
Department of Psychiatry and Institute for Research in Extramural Medicine, Vrije Universiteit, Amsterdam, The Netherlands
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Abstract

Background. Data on the course of anxiety in late life are scarce. The present study sets out to investigate the course of anxiety, as measured by the HADS-A (Zigmond & Snaith, 1983) in community dwelling older persons, and to evaluate predictive factors for change over 3 years in anxiety symptoms following the vulnerability/stress model.

Method. Based on the first anxiety assessment, two cohorts were formed: subjects with and subjects without anxiety symptoms. In the non-anxious cohort (N = 1602) we studied risk factors for the development of anxiety symptoms; in the anxious cohort (N = 563) the same factors were evaluated on their predictive value for restitution of symptoms. Risk factors included vulnerability factors (demographics, health status, personality characteristics and social resources) and stressors (life events occurring in between both anxiety assessments). Logistic regression models estimated the effects of vulnerability factors, stress and their interaction on the likelihood of becoming anxious and chronicity of anxiety symptoms.

Results. It was indicated that the best predictors for becoming anxious were being female, high neuroticism, hearing/eyesight problems and life-events. Female sex and neuroticism also increased the likelihood of chronicity of anxiety symptoms in older adults, but life events were not related to chronicity. The main stressful event in late life associated with anxiety was death of one's partner. Vulnerability factors and stress added on to each other rather than their interaction being associated with development or chronicity of anxiety.

Conclusion. The vulnerability/stress model offers a useful framework for organizing risk factors for development and chronicity of anxiety symptoms in older persons, but no support was attained for the hypothesis that vulnerability and stress amplify each others effects. Finally, the results indicate to whom preventive efforts should be directed: persons high in neuroticism, women, and those who experience distressing life events.

Type
Research Article
Information
Psychological Medicine , Volume 30 , Issue 3 , May 2000 , pp. 515 - 527
Copyright
© 2000 Cambridge University Press

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