Predictors of change in anxiety symptoms of older persons: results from the Longitudinal Aging Study Amsterdam
Predictors of change in anxiety symptoms of older persons: results from the Longitudinal Aging Study Amsterdam
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DOI：
10.1017/s0033291799001956
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发表时间：
2000-05-01
影响因子：
6.9
通讯作者：
Van Tilburg, W
中科院分区：
文献类型：
--
作者：
De Beurs, E;Beekman, ATF;Van Tilburg, W
背景关于晚年焦虑的数据很少。本研究旨在调查焦虑的过程，如HADS-A（Zigmond & Snaith，1983）在社区居住的老年人，并评估预测因素的变化超过3年的焦虑症状的脆弱性/压力模型。基于第一次焦虑评估，形成两个队列：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（N = 1602）中，我们研究了焦虑症状发展的风险因素;在焦虑队列（N = 563）中，评估了相同因素对症状恢复的预测价值。风险因素包括脆弱性因素（人口统计学，健康状况，个性特征和社会资源）和压力源（两次焦虑评估之间发生的生活事件）。逻辑回归模型估计了易感因素、压力及其相互作用对焦虑可能性和焦虑症状慢性化的影响。结果。结果表明，女性、高神经质、听力/视力问题和生活事件是焦虑的最佳预测因素。女性和神经质也增加了老年人焦虑症状慢性化的可能性，但生活事件与慢性化无关。晚年与焦虑相关的主要压力事件是伴侣的死亡。脆弱性因素和压力是相互作用的，而不是相互作用的，它们与焦虑的发展或慢性化有关。脆弱性/压力模式提供了一个有用的框架，组织风险因素的发展和慢性焦虑症状的老年人，但没有得到支持的假设，脆弱性和压力放大对方的影响。最后，研究结果表明，预防工作应该针对的人：神经质高的人，妇女和那些经历痛苦的生活事件。
Background. Data on the course of anxiety in late life are scarce. The present study sets out to investigate the course of anxiety, as measured by the HADS-A (Zigmond & Snaith, 1983) in community dwelling older persons, and to evaluate predictive factors for change over 3 years in anxiety symptoms following the vulnerability/stress model.Method. Based on the first anxiety assessment, two cohorts were formed: subjects with and subjects without anxiety symptoms. In the non-anxious cohort (N = 1602) we studied risk factors for the development of anxiety symptoms ; in the anxious cohort (N = 563) the same factors were evaluated on their predictive value for restitution of symptoms. Risk factors included vulnerability factors (demographics, health status, personality characteristics and social resources) and stressors (life events occurring in between both anxiety assessments). Logistic regression models estimated the effects of vulnerability factors, stress and their interaction on the likelihood of becoming anxious and chronicity of anxiety symptoms.Results. It was indicated that the best predictors for becoming anxious were being female, high neuroticism, hearing/eyesight problems and Life-events. Female sex and neuroticism also increased the likelihood of chronicity of anxiety symptoms in older adults, but life events were not related to chronicity. The main stressful event in late life associated with anxiety was death of one's partner. Vulnerability factors and stress added on to each other rather than their interaction being associated with development or chronicity of anxiety.Conclusion. The vulnerability/stress model offers a useful framework for organizing risk factors for development and chronicity of anxiety symptoms in older persons, but no support was attained for the hypothesis that vulnerability and stress amplify each others effects. Finally, the results indicate to whom preventive efforts should be directed: persons high in neuroticism, women, and those who experience distressing life events.