de Beurs E, Deeg D J, Beekman A T
Vrije Universiteit, Amsterdam.
Tijdschr Gerontol Geriatr. 2000 Oct;31(5):203-10.
The prognostic value of physical health for changes in anxiety symptoms in older people was investigated in a prospective longitudinal study design with data from the Longitudinal Aging Study Amsterdam (LASA). In a sample of 2165 older (> 55 yrs.) respondents anxiety symptoms were measured twice over a three year interval with the anxiety subscale of the Hospital Anxiety and Depression Scale (HADS-A). Utilizing a cut-off value of 4 on the HADS-A, subjects were considered as anxious or as non-anxious. Based on the first assessment two groups were formed: subjects with and subjects without anxiety symptoms. In the non-anxious cohort the effect of physical health on the development of anxiety symptoms was studied; in the anxious cohort the same factors were evaluated on their predictive value for chronicity of anxiety. Indices of physical health included the presence of chronic diseases, functional limitations, and self-perceived health at the first assessment and changes on these variables over time. Results revealed that poor self-perceived health was predictive of incidence (OR = 1.5; 95% CI = 1.3-1.8) and chronicity of anxiety (OR = 1.2; CI = 1.0-1.5). Regarding chronic diseases, the results showed that suffering from more than one chronic disease predicted becoming anxious and chronicity of anxiety (OR = 1.7; CI = 1.2-2.5 and OR = 2.2; CI = 1.3-3.6, respectively). Specific chronic diseases were not strongly related to a change in anxiety levels. Thus, somatic diseases not only lead to depression, a finding reported in numerous studies, but also increase the likelihood of anxiety symptoms at a later point in time.
在一项前瞻性纵向研究设计中，利用来自阿姆斯特丹纵向老龄化研究（LASA）的数据，对老年人身体健康状况对焦虑症状变化的预后价值进行了调查。在2165名年龄大于55岁的受访者样本中，使用医院焦虑抑郁量表（HADS-A）的焦虑分量表，在三年时间间隔内对焦虑症状进行了两次测量。根据HADS-A上4分的临界值，将受试者分为焦虑组或非焦虑组。基于首次评估，形成了两组：有焦虑症状的受试者和无焦虑症状的受试者。在非焦虑队列中，研究了身体健康对焦虑症状发展的影响；在焦虑队列中，评估了相同因素对焦虑慢性化的预测价值。身体健康指标包括首次评估时慢性病的存在情况、功能受限情况和自我感知健康状况，以及这些变量随时间的变化。结果显示，自我感知健康状况差可预测焦虑的发生率（OR = 1.5；95%CI = 1.3 - 1.8）和慢性化（OR = 1.2；CI = 1.0 - 1.5）。关于慢性病，结果表明，患有不止一种慢性病可预测焦虑的发生和慢性化（分别为OR = 1.7；CI = 1.2 - 2.5和OR = 2.2；CI = 1.3 - 3.6）。特定慢性病与焦虑水平的变化没有强烈关联。因此躯体疾病不仅会导致抑郁（众多研究已报道这一发现），还会增加后期出现焦虑症状的可能性。
