Rt. Schaub et M. Linden, Anxiety and anxiety disorders in the old and very old - Results from the Berlin Aging Study (BASE), COMP PSYCHI, 41(2), 2000, pp. 48-54
Within the context of the Berlin Aging Study, we examined the distribution
of anxiety symptoms and disorders in a representative community sample. The
participants were beyond the age of 70 years, thereby extending results fr
om other studies not covering this age range. Additionally, we analyzed the
distribution of anxiety symptoms and syndromes not fulfilling specified di
agnostic criteria. A sample of 258 old (70 to 84 years) and 258 very old (8
5 to 103 years) subjects were examined. Anxiety disorders as defined in DSM
-III-R and according to clinical judgment (diagnoses termed NOS) were asses
sed. In addition, items from the Geriatric Mental State-A (GMS-A) covering
a wide range of symptoms of anxiety were subjected to factor analysis. The
raw score distributions of anxiety subscales obtained by this procedure are
examined by age, gender, education, personal living situation, and psychia
tric comorbidity. The weighted overall prevalence of anxiety in the elderly
community is 4.5% (n = 17), including specified (n = 8) anxiety disorders
according to the DSM-III-R and unspecified (n = 9) disorders. Prevalence ra
tes in the younger old were 4.3% and in the older old 2.3%. Weighted preval
ence rates for males were 2.9% and for females 4.7%. The most common comorb
id disorders were affective dis orders in both age groups as well as both g
enders. Independently of the nosological level, 52.3% reported one or more
symptoms of anxiety. Factor analysis of anxiety-related symptoms yielded 5
independent subscales, reflecting hypochondriasis, panic, phobia, worries,
and vegetative anxiety. There were more phobic symptoms in the younger age
group (P < .001). Except for worries and hypochondriac symptoms, females sh
owed significantly higher anxiety in all other anxiety dimensions. There wa
s no relation between anxiety and cognitive status or socioeconomic status
(SES), Only for subjects living alone was more phobic-type anxiety found. A
nxiety disorders in old and very old persons are less frequent than other p
sychiatric disorders of old age, and do not increase with age. Gender diffe
rences can still be observed. The symptomatic structure of anxiety seems si
milar to that found in younger cohorts. Thus, anxiety disorders in old age
do not seem substantially different from those in younger age. Their relati
ve contribution to the spectrum of mental disorders seems to decrease, rath
er than increase, with age, while at the same time anxiety symptoms are an
almost daily experience, Copyright (C) 2000 by W.B. Saunders Company.