Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Int J Geriatr Psychiatry. 2019 Feb;34(2):249-257. doi: 10.1002/gps.5012. Epub 2018 Nov 19.
The prevalence of generalized anxiety disorder (GAD) is supposed to decrease with age. Reasons suggested include that emotional control increases and that anxiety and worry are expressed differently in older adults. The aim of this study was to examine how the expression of anxiety and worry changes with age and how this influences diagnoses in current classification systems.
Semistructured psychiatric examinations were performed in population-based samples of 70- (n = 562), 75- (n = 770), 79/80- (n = 603), and 85-year-olds (n = 433). Individuals with dementia were excluded. GAD was diagnosed according to DSM-5 (DSM5 GAD) and ICD-10 (ICD10 GAD) criteria. Individual symptoms were assessed according to severity and frequency. Functioning was measured with Global Assessment of Functioning (GAF).
The prevalence of clinical anxiety, autonomic arousal, muscle tension, and irritability decreased with age, while that of worry and fatigue increased. Concentration difficulties and sleep disturbances remained stable. The prevalence of ICD10 GAD tended to decrease, while that of DSM5 GAD did not change with age. Core symptoms and diagnoses of GAD were related to lower GAF scores. However, in those with autonomic arousal and ICD10 GAD, GAF scores increased with age.
The prevalence of ICD10 GAD tended to decrease with increasing age while the prevalence of DSM5 GAD remained stable. This difference was partly due to a decreased frequency of severe anxiety and autonomic arousal symptoms, and that worries increased, suggesting changes in the expression of GAD with increasing age.
广泛性焦虑障碍（GAD）的患病率随着年龄的增长而降低。其原因可能包括情绪控制能力增强，以及老年人焦虑和担忧的表达方式不同。本研究旨在探讨焦虑和担忧的表达方式如何随年龄变化，以及这如何影响当前分类系统中的诊断。
对来自基于人群的 70 岁（n=562）、75 岁（n=770）、79/80 岁（n=603）和 85 岁（n=433）人群样本进行半结构式精神科检查。排除痴呆患者。根据 DSM-5（DSM5 GAD）和 ICD-10（ICD10 GAD）标准诊断 GAD。根据严重程度和频率评估个体症状。使用总体功能评估（GAF）测量功能。
临床焦虑、自主唤醒、肌肉紧张和易怒的患病率随着年龄的增长而降低，而担忧和疲劳的患病率增加。注意力困难和睡眠障碍保持稳定。ICD10 GAD 的患病率趋于降低，而 DSM5 GAD 的患病率与年龄无关。GAD 的核心症状和诊断与较低的 GAF 评分相关。然而，在有自主唤醒和 ICD10 GAD 的患者中，GAF 评分随年龄增加而增加。
ICD10 GAD 的患病率随着年龄的增长而趋于降低，而 DSM5 GAD 的患病率保持稳定。这种差异部分归因于严重焦虑和自主唤醒症状的频率降低，以及担忧增加，这表明随着年龄的增长，GAD 的表达方式发生变化。
