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

Background. Data on the course of anxiety in late life are scarce. The pres ent study sets out to investigate the course of anxiety, as measured by the HADS-A (Zigmond & Snaith, 1983) in community dwelling older persons, and t o evaluate predictive factors for change over 3 years in anxiety symptoms f ollowing the vulnerability/stress model. Method. Based on the first anxiety assessment, two cohorts were formed: sub jects 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 vulner ability factors (demographics, health status, personality characteristics a nd social resources) and stressors (life events occurring in between both a nxiety assessments). Logistic regression models estimated the effects of vu lnerability factors, stress and their interaction on the likelihood of beco ming anxious and chronicity of anxiety symptoms. Results. It was indicated that the best predictors for becoming anxious wer e 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 chro nicity. The main stressful event in late life associated with anxiety was d eath of one's partner. Vulnerability factors and stress added on to each ot her rather than their interaction being associated with development or chro nicity of anxiety. Conclusion. The vulnerability/stress model offers a useful framework for or ganizing risk factors for development and chronicity of anxiety symptoms in older persons, but no support was attained for the hypothesis that vulnera bility and stress amplify each others effects. Finally, the results indicat e to whom preventive efforts should be directed: persons high in neuroticis m, women, and those who experience distressing life events.