de Beurs E, Beekman A T, van Balkom A J, Deeg D J, van Dyck R, van Tilburg W
Department of Psychiatry and Institute for Research in Extramural Medicine, Vrije Universiteit, Amsterdam, The Netherlands.
Psychol Med. 1999 May;29(3):583-93. doi: 10.1017/s0033291799008351.
Although anxiety is quite prevalent in late life, its impact on disability, well-being, and health care utilization of older persons has not been studied. Older persons are a highly relevant age group for studying the consequences of anxiety, since their increasing numbers put an extra strain on already limited health care resources.
Data of a large community-based random probability sample (N = 659) of older subjects (55-85 year) in the Netherlands were used to select three groups: subjects with a diagnosed anxiety disorder, subjects with merely anxiety symptoms and a reference group without anxiety. These groups were compared with regard to their functioning, subjective well-being, and use of health care services, while controlling for potentially confounding variables.
Anxiety was associated with increased disability and diminished well-being. Older persons with a diagnosed anxiety disorder were equally affected in their functioning as those with merely anxiety symptoms. Although use of health services was increased in anxiety sufferers, their use of appropriate care was generally low.
Anxiety has a clear negative impact on the functioning and well-being of older subjects. The similarity of participants with an anxiety disorder and those having merely anxiety symptoms regarding quality of life variables and health care use was quite striking. Finally, in spite of its grave consequences for the quality of life, appropriate care for anxiety is seldom received. Efforts to improve recognition, disseminate effective treatments in primary care, and referring to specialized care may have positive effects on the management of anxiety in late life.
尽管焦虑在老年人群中相当普遍，但尚未对其对老年人残疾、幸福感及医疗保健利用情况的影响进行研究。老年人是研究焦虑后果的一个高度相关的年龄组，因为他们数量的不断增加给本就有限的医疗保健资源带来了额外压力。
使用荷兰一个基于社区的大型随机概率样本（N = 659）中55至85岁老年受试者的数据，选取三组：诊断为焦虑症的受试者、仅有焦虑症状的受试者以及无焦虑的参照组。在控制潜在混杂变量的同时，对这些组在功能、主观幸福感及医疗保健服务使用方面进行比较。
焦虑与残疾增加和幸福感降低相关。诊断为焦虑症的老年人在功能方面受到的影响与仅有焦虑症状的老年人相同。尽管焦虑患者的医疗服务使用增加，但其对适当护理的使用普遍较低。
焦虑对老年受试者的功能和幸福感有明显的负面影响。患有焦虑症的参与者与仅有焦虑症状的参与者在生活质量变量和医疗保健使用方面的相似性相当显著。最后，尽管焦虑对生活质量有严重后果，但很少能得到适当的焦虑护理。提高认知度、在初级保健中推广有效治疗方法以及转诊至专科护理的努力可能会对老年焦虑的管理产生积极影响。
