Department of General Internal Medicine and Psychosomatics, Medical University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany.
Department of General Internal Medicine and Psychosomatics, Medical University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany.
J Affect Disord. 2020 Feb 1;262:174-181. doi: 10.1016/j.jad.2019.10.025. Epub 2019 Oct 19.
Anxiety in older age is common. In comparison with men, older women experience higher levels of anxiety and show different patterns of co-occurring mental disorders. The aim of this study is to investigate gender-specific biopsychosocial predictors associated with GAD (Generalized Anxiety Disorder) symptoms after a period of three years in the elderly population.
Data were derived from the third (2008-2010) and the fourth follow-up (2011-2014) of the large population-based German ESTHER study. 2254 participants ages 55-85 were included in the study (52.3% female; 47.7% male). Generalized Anxiety Disorder Symptoms were measured using the GAD-7 questionnaire at both follow-ups. Linear regression analyses were performed to predict GAD severity after three years; the analyses were separated by gender and adjusted for demographic variables, biopsychosocial health, cognitive impairment, loneliness, and psychosocial resources.
In women, GAD severity after three years (t1) was positively associated with younger age, depression symptoms, loneliness, and GAD severity at t0. In men, GAD severity was positively associated with somatic symptoms as well as with GAD severity at t0. In both genders GAD severity at baseline was the strongest predictor of elevated future anxiety symptoms.
GAD was examined by the use of questionnaires rather than by personal assessment; underreporting of GAD symptoms is therefore possible.
Our study shows that an increase as well as a decrease of GAD severity in older women and men can be predicted by several biopsychosocial variables.
老年人中焦虑很常见。与男性相比，老年女性的焦虑水平更高，并且同时患有精神障碍的模式也不同。本研究旨在调查与老年人中广泛性焦虑障碍（GAD）症状相关的特定于性别的生物心理社会预测因子，随访时间为三年。
数据来自德国大型基于人群的 ESTHER 研究的第三次（2008-2010 年）和第四次随访（2011-2014 年）。该研究纳入了 2254 名年龄在 55-85 岁的参与者（52.3%为女性；47.7%为男性）。在两次随访中，均使用 GAD-7 问卷测量 GAD 症状。进行线性回归分析，以预测三年后的 GAD 严重程度；分析结果按照性别进行了区分，并根据人口统计学变量、生物心理社会健康、认知障碍、孤独感和心理社会资源进行了调整。
在女性中，三年后（t1）的 GAD 严重程度与年龄较小、抑郁症状、孤独感和 t0 时的 GAD 严重程度呈正相关。在男性中，GAD 严重程度与躯体症状以及 t0 时的 GAD 严重程度呈正相关。在两性中，基线时的 GAD 严重程度都是未来焦虑症状加重的最强预测因子。
GAD 通过使用问卷进行检查，而不是通过个人评估；因此，可能存在 GAD 症状的漏报。
我们的研究表明，老年女性和男性的 GAD 严重程度的增加和降低都可以由几个生物心理社会变量来预测。
