Co-occurrence of depression and anxiety in elderly subjects aged 90 years and its relationship with functional status, quality of life and mortality

• Published in: International journal of geriatric psychiatry Vol. 24; no. 6; pp. 595 - 601
• Main Authors: Van der Weele, Gerda M., Gussekloo, Jacobijn, De Waal, Margot W. M., De Craen, Anton J. M., Van der Mast, Roos C.
• Format: Journal Article
• Language: English
• Published: Chichester, UK John Wiley & Sons, Ltd 01.06.2009; Psychology Press; Wiley Subscription Services, Inc
• Subjects: Activities of Daily Living; Aged; aged 90; Aged, 80 and over - psychology; Aging; Anxiety; Anxiety Disorders - epidemiology; Biological and medical sciences; Cognition Disorders - epidemiology; Comorbidity; depression; Depressive Disorder - epidemiology; Epidemiologic Methods; Female; functional status; Geriatric psychiatry; Geriatric psychology; Geriatrics; Humans; Loneliness - psychology; Male; Medical sciences; Mental depression; Mortality; Netherlands - epidemiology; nonagenarians; Older people; primary health care; Psychiatric Status Rating Scales; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Quality of life; Quality of Life - psychology; Netherlands; Human; Mood disorder; Affect affectivity; Primary health care; Mortality; Anxiety disorder; Depression; Epidemiology; aged 90; Functional capacity; Quality of life; functional status; Age 90-99; Anxiety; Autonomy; nonagenarians; Elderly; Public health
• ISSN: 0885-6230; 1099-1166; 1099-1166
• DOI: 10.1002/gps.2162

Objective To examine the prevalence of concurrent depression and anxiety and its relationship with functional status, quality of life and mortality in individuals at age 90. Methods In the Leiden 85‐plus Study, a population based cohort study, depression (15‐item Geriatric Depression Scale ≥5 points) and anxiety (Anxiety Screening Questionnaire ≥1 positive answer) were assessed in all 90‐year old subjects with ≥19 points on the Mini Mental State Examination (MMSE). Functional status included: cognitive function (MMSE) and disability in activities of daily living (Groningen Activity Restriction Scale). Quality of life included: loneliness (Loneliness Scale of De Jong‐Gierveld) and life satisfaction (Cantril's ladder). For all subjects mortality data were available up to a maximum age of 95.3 years. Results Of the subjects aged 90 years with MMSE ≥19 points (56 men, 145 women), 50 subjects (25%, 95% CI 19–31%) experienced depression and 25 subjects (12%, 95% CI 9–18%) anxiety; of them 34 (17%) experienced depression only, 9 (4%) anxiety only, and 16 (8%) both depression and anxiety. Presence of depression was associated with an overall decreased functional status and quality of life and with increased mortality. Within the depressed group, subjects with anxiety did not differ from subjects without anxiety, except for higher loneliness scores. Conclusion Among individuals aged 90 years, depression and anxiety and their co‐occurrence are highly prevalent. Anxiety does not add to poor functional status and increased mortality beyond that associated with depression, and is probably part of the phenomenology of depression in old age. Copyright © 2008 John Wiley & Sons, Ltd.