Anxiety and Depression in the Portuguese Older Adults: Prevalence and Associated Factors

Rute Dinis de Sousa, Ana Maria Rodrigues, Maria João Gregório, Jaime Da Cunha Branco, Maria João Gouveia, Helena Canhão, Sara Simões Dias, Rute Dinis de Sousa, Ana Maria Rodrigues, Maria João Gregório, Jaime Da Cunha Branco, Maria João Gouveia, Helena Canhão, Sara Simões Dias

Abstract

Anxiety and depression in the elderly individuals have been studied around the world, and some authors consider them among the most serious problems faced by modern societies. With recent economic crisis-very important in Southern European countries-isolation, loneliness, and exclusion of the active society, mental problems are probably raising and associated with distinct factors. In this cross-sectional analysis, nested in a longitudinal population-based cohort study, we analyze anxiety and depression prevalence, and their related factors, in a representative cohort of Portuguese seniors. We used data retrieved from second wave of follow-up of EpiDoC Cohort-EpiDoC 2 study, which is composed by 10,661 adults, representative of adult Portuguese population. This study included all ≥65 years old EpiDoC 2 study participants, who responded to Hospital Anxiety and Depression Scale (HADS), n = 1,680. Sociodemographic, lifestyles, self-reported non-communicable diseases, health-related quality of life (EQ-5D-3D), physical function (HAQ), and health resources consumption data were collected. Anxiety and depression were assessed with HADS. Anxiety and depression prevalence were estimated. Multivariable logistic regression was used to assess anxiety and depression score determinants. The estimated prevalence of anxiety among Portuguese elderly is 9.6% and depression is 11.8%. Seniors with anxiety and seniors with depression have a higher probability to self-report higher levels of physical disability (OR = 3.10; 96% CI 2.12-4.52; OR = 3.08, 95% CI 2.29-4.14, respectively) and lower levels of quality of life (OR = 0.03, 95% CI 0.01-0.09; OR = 0.03, 95% CI 0.01-0.06, respectively). Female gender (OR = 2.77, 95% CI 1.53-5.00), low educational level (OR = 2.30, 95% CI 1.22-4.36), allergic (OR = 2.02, 95% CI 1.14-3.55), and rheumatic disease (OR = 2.92, 95% CI 1.74-4.90) were significantly and independently associated with the presence of anxiety symptoms. Physical inactivity (OR = 1.64, 95% CI 1.11-2.42) and low educational level (OR = 2.40, 95% CI 1.41-4.09) were significantly and independently associated with depression symptoms. Subjects that reported to drink alcohol daily or occasionally were negatively associated with depression symptoms. Anxiety and depression are frequent among Portuguese elderly. These prevalence rates suggest that preventing mental illness in senior population is a crucial need. A well-designed prevention strategy might have an effective action in raising the well-being of elderly.

Keywords: anxiety; depression; function; lifestyles; non-communicable chronic diseases; older; quality of life.

Figures

Figure 1
Figure 1
Flowchart describing population eligible for this study.

References

    1. United Nations, Department of Economic and Social Affairs, Population Division. World Population Prospects: The 2017 Revision, Key Findings and Advance Tables. New York: (2017). Working Paper No. ESA/P/WP/248.
    1. PORDATA. Indicadores de Envelhecimento – Portugal. (2016). Available from:
    1. Wolitzky-Taylor KB, Castriotta N, Lenze EJ, Stanley MA, Craske MG. Anxiety disorders in older adults: a comprehensive review. Depress Anxiety (2010) 27(2):190–211.10.1002/da.20653
    1. Chapman DP, Perry GS. Depression as a major component of public health for older adults. Prev Chronic Dis (2008) 5(1):A22.
    1. Blazer DG, II, Hybels CF. Origins of depression in later life. Psychol Med (2005) 35(9):1241–52.10.1017/S0033291705004411
    1. Castro-Costa E, Dewey M, Stewart R, Banerjee S, Huppert F, Mendonca-Lima C, et al. Prevalence of depressive symptoms and syndromes in later life in ten European countries: the SHARE study. Br J Psychiatry (2007) 191:393–401.10.1192/bjp.bp.107.036772
    1. Flint AJ. Epidemiology and comorbidity of anxiety disorders in the elderly. Am J Psychiatry (1994) 151(5):640–9.10.1176/ajp.151.5.640
    1. Schoevers RA, Beekman AT, Deeg DJ, Jonker C, van Tilburg W. Comorbidity and risk-patterns of depression, generalised anxiety disorder and mixed anxiety-depression in later life: results from the AMSTEL study. Int J Geriatr Psychiatry (2003) 18:994–1001.10.1002/gps.1001
    1. Vink D, Aartsen MJ, Schoevers RA. Risk factors for anxiety and depression in the elderly: a review. J Affect Disord (2008) 106(1–2):29–44.10.1016/j.jad.2007.06.005
    1. Lenze EJ, Wetherell JL. A lifespan view of anxiety disorders. Dialogues Clin Neurosci (2011) 13(4):381–99.
    1. Branco JC, Rodrigues AM, Gouveia N, Eusebio M, Ramiro S, Machado PM, et al. Prevalence of rheumatic and musculoskeletal diseases and their impact on health-related quality of life, physical function and mental health in Portugal: results from EpiReumaPt – a national health survey. RMD Open (2016) 2(1):e000166.10.1136/rmdopen-2015-000166
    1. Gouveia N, Rodrigues AM, Ramiro S, Machado P, da Costa LP, Mourao AF, et al. EpiReumaPt: how to perform a national population based study – a practical guide. Acta Reumatol Port (2015) 40(2):128–36.
    1. Rodrigues AM, Gouveia N, da Costa LP, Eusebio M, Ramiro S, Machado P, et al. EpiReumaPt – the study of rheumatic and musculoskeletal diseases in Portugal: a detailed view of the methodology. Acta Reumatol Port (2015) 40(2):110–24.
    1. Lei n° 67/98 – Lei da Proteção de Dados Pessoais, 67 (1998).
    1. Pais-Ribeiro J, Silva I, Ferreira T, Martins A, Meneses R, Baltar M. Validation study of a Portuguese version of the Hospital Anxiety and Depression Scale. Psychol Health Med (2007) 12(2):225–35; quiz 35–7.10.1080/13548500500524088
    1. Zigmond AS, Snaith RP. The Hospital Anxiety and Depression Scale. Acta Psychiatr Scand (1983) 67(6):361–70.10.1111/j.1600-0447.1983.tb09716.x
    1. Snaith RP. The Hospital Anxiety and Depression Scale. Health Qual Life Outcomes (2003) 1:29.10.1186/1477-7525-1-29
    1. WHO. Physical Status: The Use and Interpretation of Anthropometry Report of a WHO Expert Committee. Geneve: World Health Organization; (1995).
    1. Ferreira L, Ferreira P, Pereira L, Oppe M. EQ-5D Portuguese population norms. Qual Life Res (2014) 23(2):425–30.10.1007/s11136-013-0488-4
    1. Ferreira L, Ferreira P, Pereira L, Oppe M. The valuation of the EQ-5D in Portugal. Qual Life Res (2014) 23(2):413–23.10.1007/s11136-013-0448-z
    1. Benito-Garcia E, Santos M, Ramiro S, Medeiros S, Cordeiro R, Canas da Silva JA, et al. Propridades psicométricas da versão portuguesa do HAQ. Acta Reumatol Port (2006) 31:126–7.
    1. Santos R, Reis P, Rebelo L, Costa Dias F, Miranda Rosa C, Viana de Queiroz M. “Health assessment questionnaire” (versão curta): adaptação para língua portuguesa e estudo da sua aplicabilidade. Acta Reumatol Port (1996) 76:15–20.
    1. World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA (2013) 310(20):2191–4.10.1001/jama.2013.281053
    1. Bryant C, Jackson H, Ames D. The prevalence of anxiety in older adults: methodological issues and a review of the literature. J Affect Disord (2008) 109(3):233–50.10.1016/j.jad.2007.11.008
    1. Almeida J, Xavier M, Cardoso G, Pereira M, Gusmão R, Corrêa B, et al. Estudo epidemiológiológico nacional de saúde mental – 1° relatório. Lisbon: Faculdade de Ciências Médicas, Universidade Nova de Lisboa; (2013).
    1. Hoogendijk EO, Deeg DJH, Poppelaars J, van der Horst M, Broese van Groenou MI, Comijs HC, et al. The Longitudinal Aging Study Amsterdam: cohort update 2016 and major findings. Eur J Epidemiol (2016) 31(9):927–45.10.1007/s10654-016-0192-0
    1. Byrne G. What happens to anxiety disorders in later life? Rev Bras Psiquiatr (2002) 24(Supl I):74–80.10.1590/S1516-44462002000500014
    1. Lenze EJ, Rogers JC, Martire LM, Mulsant BH, Rollman BL, Dew MA, et al. The association of late-life depression and anxiety with physical disability: a review of the literature and prospectus for future research. Am J Geriatr Psychiatry (2001) 9(2):113–35.10.1097/00019442-200105000-00004
    1. Brenes GA, Guralnik JM, Williamson JD, Fried LP, Simpson C, Simonsick EM, et al. The influence of anxiety on the progression of disability. J Am Geriatr Soc (2005) 53(1):34–9.10.1111/j.1532-5415.2005.53007.x
    1. Sivertsen H, Bjorklof GH, Engedal K, Selbaek G, Helvik AS. Depression and quality of life in older persons: a review. Dement Geriatr Cogn Disord (2015) 40(5–6):311–39.10.1159/000437299
    1. Brenes GA. Anxiety, depression, and quality of life in primary care patients. Prim Care Companion J Clin Psychiatry (2007) 9(6):437–43.10.4088/PCC.v09n0606
    1. Valvanne J, Juva K, Erkinjuntti T, Tilvis R. Major depression in the elderly: a Population Study in Helsinki. Int Psychogeriatr (1996) 8(3):437–43.10.1017/S1041610296002797
    1. McCall NT, Parks P, Smith K, Pope G, Griggs M. The prevalence of major depression or dysthymia among aged Medicare Fee-for-Service beneficiaries. Int J Geriatr Psychiatry (2002) 17(6):557–65.10.1002/gps.642
    1. Beekman AT, Bremmer MA, Deeg DJ, van Balkom AJ, Smit JH, de Beurs E, et al. Anxiety disorders in later life: a report from the Longitudinal Aging Study Amsterdam. Int J Geriatr Psychiatry (1998) 13(10):717–26.10.1002/(SICI)1099-1166(1998100)13:10<717::AID-GPS857>;2-M
    1. Himmelfarb S, Murrell SA. The prevalence and correlates of anxiety symptoms in older adults. J Psychol (1984) 116(2d Half):159–67.10.1080/00223980.1984.9923632
    1. Teixeira CM, Vasconcelos-Raposo J, Fernandes HM, Brustad RJ. Physical activity, depression and anxiety among the elderly. Soc Indic Res (2013) 113(1):307–18.10.1007/s11205-012-0094-9
    1. Forsell Y. Predictors for depression, anxiety and psychotic symptoms in a very elderly population: data from a 3-year follow-up study. Soc Psychiatry Psychiatr Epidemiol (2000) 35(6):259–63.10.1007/s001270050237
    1. Oh DH, Kim SA, Lee HY, Seo JY, Choi BY, Nam JH. Prevalence and correlates of depressive symptoms in Korean adults: results of a 2009 Korean Community Health Survey. J Korean Med Sci (2013) 28(1):128–35.10.3346/jkms.2013.28.1.128
    1. Cole M, Dendukuri N. Risk factors for depression among elderly community subjects: a systematic review and meta-analysis. Am J Psychiatry (2003) 160(6):1147–56.10.1176/appi.ajp.160.6.1147
    1. Boden JM, Fergusson DM. Alcohol and depression. Addiction (2011) 106(5):906–14.10.1111/j.1360-0443.2010.03351.x
    1. JS M. Alcohol and depression. Br J Hosp Med (1993) 50(5):261–4.
    1. Barnard KD, Skinner TC, Peveler R. The prevalence of co-morbid depression in adults with Type 1 diabetes: systematic literature review. Diabet Med (2006) 23(4):445–8.10.1111/j.1464-5491.2006.01814.x
    1. Gudmundsson G, Gislason T, Janson C, Lindberg E, Suppli Ulrik C, Brondum E, et al. Depression, anxiety and health status after hospitalisation for COPD: a multicentre study in the Nordic countries. Respir Med (2006) 100(1):87–93.10.1016/j.rmed.2005.04.003
    1. Rodin G, Katz M, Lloyd N, Green E, Mackay JA, Wong RKS. Treatment of depression in cancer patients. Curr Oncol (2007) 14(5):180–8.10.3747/co.2007.146
    1. Margaretten M, Julian L, Katz P, Yelin E. Depression in patients with rheumatoid arthritis: description, causes and mechanisms. Int J Clin Rheumtol (2011) 6(6):617–23.10.2217/ijr.11.62
    1. Djernes JK. Prevalence and predictors of depression in populations of elderly: a review. Acta Psychiatr Scand (2006) 113(5):372–87.10.1111/j.1600-0447.2006.00770.x
    1. Tomoum MO, Klattcromwell C, DelSignore A, Ebert C, Senior BA. Depression and anxiety in chronic rhinosinusitis. Allergy Rhinol (2015) 5(8):674–81.10.1002/alr.21528
    1. Barefoot JC, Mortensen EL, Helms MJ, Avlund K, Schroll M. A longitudinal study of gender differences in depressive symptoms from age 50 to 80. Psychol Aging (2001) 16(2):342–5.10.1037/0882-7974.16.2.342
    1. Roberts RE, Kaplan GA, Shema SJ, Strawbridge WJ. Prevalence and correlates of depression in an aging cohort: the Alameda County Study. J Gerontol B Psychol Sci Soc Sci (1997) 52(5):S252–8.10.1093/geronb/52B.5.S252
    1. Steffens DC, Skoog I, Norton MC, Hart AD, Tschanz JT, Plassman BL, et al. Prevalence of depression and its treatment in an elderly population: the Cache County study. Arch Gen Psychiatry (2000) 57(6):601–7.10.1001/archpsyc.57.6.601
    1. van’t Veer-Tazelaar PJ, van Marwijk HW, Jansen AP, Rijmen F, Kostense PJ, van Oppen P, et al. Depression in old age (75+), the PIKO study. J Affect Disord (2008) 106(3):295–9.10.1016/j.jad.2007.07.004
    1. Breeman S, Cotton S, Fielding S, Jones GT. Normative data for the Hospital Anxiety and Depression Scale. Qual Life Res (2015) 24(2):391–8.10.1007/s11136-014-0763-z

Source: PubMed

Sponsorer og samarbeidspartnere

Medisinsk tilstand

Legemiddelintervensjoner

3
Abonnere