Anxiety symptoms and decline in physical function over 5 years in the health, aging and body composition study

Abstract

Objectives: To examine the relationship between anxiety and functional decline.

Design: A 5-year longitudinal cohort study of well-functioning adults.

Setting: The Health, Aging and Body Composition (Health ABC) Study.

Participants: Two thousand nine hundred forty adults aged 70 to 79 (48% male, 41% black), initially free of self-reported mobility difficulty.

Measurements: In 1997/98, presence of three anxiety symptoms (feeling fearful, tense or keyed up, or shaky or nervous) from the Hopkins Symptom Checklist were ascertained. Physical function was examined over 5 years using the Health ABC performance battery (continuous range 0-4) consisting of chair stands, usual and narrow course gait speed, and difficulty with standing balance and self-reported mobility, defined as difficulty walking one-quarter of a mile or difficulty climbing 10 steps.

Results: Participants with anxiety symptoms had similar baseline physical performance scores. After adjustment for potential confounders, subjects with anxiety symptoms had similar declines in physical performance over 5 years as participants without anxiety symptoms. Adults with anxiety symptoms were more likely to report incident mobility difficulty, with a hazard ratio of 1.4 (95% confidence interval=1.3-1.6), compared with adults without anxiety symptoms. These results persisted after adjustment for depressive symptoms, demographics, comorbidity, and use of antianxiety, depressant, and sedative hypnotic medications.

Conclusion: Anxiety symptoms are not associated with declines in objectively measured physical performance over 5 years but are associated with declines in self-reported functioning. Future studies are needed to determine why anxiety has a differential effect on performance-based and self-reported measures of functioning.

Figures

Figure 1

5-year change in the Health, Aging and Body Composition (Health ABC) Study physical performance score by presence of anxiety symptoms. y-axis: Health ABC performance score (range 0–4).