Hostname: page-component-76fb5796d-9pm4c Total loading time: 0 Render date: 2024-04-28T09:54:03.630Z Has data issue: false hasContentIssue false
  • English
  • Français

Quality of Life in Geriatric Patients with Mood and Anxiety Disorders

Published online by Cambridge University Press:  07 November 2014

Rachel E. Maddux ,
Katia K. Delrahim  and
Mark H. Rapaport
Get access Rights & Permissions [Opens in a new window]

Abstract

This article reviews the impact of depressive and anxiety disorders on quality of life (QOL), disability, and economic burden in the lives of older individuals. Distinctions between the terms QOL, disability, and burden are important in understanding the extent of improvement needed in treatment for elderly patients with depression or anxiety. Treatment efforts should be extended to remediate not only signs and symptoms of psychiatric syndromes but QOL and disability as well; increased understanding toward this end is evolving, yet it is clear that these issues need to be the focus of more investigation.

Type
Academic Supplement
Information
CNS Spectrums , Volume 8 , Issue S3: Anxiety and Depression in the Elderly: Implications for Diagnosis and Treatment , December 2003 , pp. 35 - 47
Copyright
Copyright © Cambridge University Press 2003

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1.The WHOQOL Group. Development of the World Health Organization WHOQOL-BREF quality of life assessment. Psychol Med. 1998;3:551–558.Google Scholar
2.Schipper, H. Guidelines and caveats for quality of life measurement in clinical practice and research. Oncology (Huntingt). 1990;5:51–57.Google Scholar
3.Blazer, DG. Psychiatry and the oldest old. Am J Psychiatry. 2000;12:1915–1924.CrossRefGoogle Scholar
4.Patrick, D, Erickson, P. Health Status and Health Policy: Quality of Life in Health Care Evaluation and Resource Allocation. New York, NY: Oxford Press; 1993.Google Scholar
5.Beekman, AT, Deeg, DJ, van Tilburg, T, et al.Major and minor depression in later life: a study of prevalence and risk factors. J Affect Disord. 1995;36:65–75.CrossRefGoogle ScholarPubMed
6.Borson, S. Psychiatric problems in the medically ill elderly. In: Kaplan, HI, Sadock, BJ, eds. Comprehensive Textbook of Psychiatry. 6th ed. Baltimore, MD: Williams & Wilkins; 1995:2568.Google Scholar
7.Borson, S, Barnes, RA, Kukull, WA, et al.Symptomatic depression in elderly medical outpatients: I. Prevalence, demography, and health service utilization. J Am Geriatr Soc. 1986;34:341–347.CrossRefGoogle ScholarPubMed
8.Oxman, TE, Barrett, JE, Barrett, J, et al.Symptomatology of late-life minor depression among primary care patients. Psychosomatics. 1990;31:174–180.CrossRefGoogle ScholarPubMed
9.Callahan, CM, Hui, SL, Nienaber, NA, et al.Longitudinal study of depression and health services use among elderly primary care patients. J Am Geriatr Soc. 1994;42:833–838.CrossRefGoogle ScholarPubMed
10.Blazer, D. Depression in the elderly. N Eng J Med. 1989;320:164–166.CrossRefGoogle ScholarPubMed
11.Jones, BE, Yang, TZ. The efferent projections from the reticular formation and the locus coeruleus studied by anterograde and retrograde axonal transport in the rat. J Camp Neurol. 1985;242:56–92.CrossRefGoogle ScholarPubMed
12.Alexopoulos, GS. Depression and other mood disorders. Clin Geriatr. 2000;11:69–82.Google Scholar
13.Beekman, AT, Deeg, DJ, van Tilburg, T, et al.Major and minor depression in later life: a study of prevalence and risk factors. J Affect Disord. 1995;36:65–75.CrossRefGoogle ScholarPubMed
14.Paivarinta, A, Verkakoniemi, A, Niinisto, L, et al.The prevalence and associates of depressive disorders in the oldest-old Finns. Soc Psychiatry Psychiatr Epidemiol. 1999;34:352–359.Google ScholarPubMed
15.Rovner, BW, German, PS, Brant, LJ, et al.Depression and mortality in nursing homes. JAMA. 1991;8:993–996.CrossRefGoogle Scholar
16.Parmelee, PA, Katz, IR, Lawton, MP. Depression among institutionalized aged: assessment and prevalence estimation. J Gerontol. 1989;44:22–29.CrossRefGoogle ScholarPubMed
17.Lavretsky, H, Kumar, A. Clinically significant nonmajor geriatric depression. Psychiatr Serv. 2003;3:297–299.CrossRefGoogle Scholar
18.Wells, KB, Stewart, A, Hays, RD. The functioning and well-being of depressed patients: results from the Medical Outcomes Study. JAMA. 1989;262:914–919.CrossRefGoogle ScholarPubMed
19.Beekman, AT, Deeg, DJ, Braam, AW, et al.Consequences of major and minor depression in later life: a study of disability, well-being and service utilization. Psychol Med. 1997;27:1397–1409.CrossRefGoogle ScholarPubMed
20.Serby, M, Yu, M. Overview: depression in the elderly. Mt Sinai J Med. 2003;1:38–44.Google Scholar
21.Steffens, DC, Skoog, I, Norton, MC, et al.Prevalence of depression and its treatment in an elderly population: the Cache County study. Arch Gen Psychiatry. 2000;6:601–607.CrossRefGoogle Scholar
22.Lebowitz, BD, Person, JL, Schneider, LS, et al.Diagnosis and treatment of depression in late life. Consensus statement update. JAMA. 1997;14:1186–1190.CrossRefGoogle Scholar
23.NIH Consensus Conference. NIH Consensus Development Panel on Depression in Late Life: diagnosis and treatment of depression in late life. JAMA. 1992;8:1018–1024.Google Scholar
24.Wood, KA, Nissenbaum, H, Livingston, M. Affective flattening in elderly patients. Age Aging. 1990;19:253–256.CrossRefGoogle ScholarPubMed
25.Cole, MG, Dendukuri, N. Risk factors for depression among elderly community subjects: a systematic review and meta-analysis. Am J Psychiatry. 2003;6:1147–1156.CrossRefGoogle Scholar
26.Yesavage, JA, Brink, TL, Rose, TL, et al.Developmental and validation of a geriatric depression screening scale: a preliminary report. J Psychiatry Res. 1982;1:37–49.CrossRefGoogle Scholar
27.Rose, WG, Mohs, RC, Davis, KL. A new rating scale for Alzheimer's disease. Am J Psychiatry. 1984;11:1356–1364.Google Scholar
28.Reisberg, B, Borenstein, J, Salob, SP, et al.Behavioral symptoms in Alzheimer's disease: phenomenology and treatment. J Clin Psychiatry. 1987;48(suppl)9–15.Google ScholarPubMed
29.Koenig, HG. Differences in psychosocial and health correlates of major and minor depression in medically ill older adults. J Am Geriatr Soc. 1997;45:1487–1495.CrossRefGoogle ScholarPubMed
30.Gruenberg, AM, Goldstein, RD. Mood disorders: depression. In: Tasman, A, Kay, J, Lieberman, J eds. Psychiatry. 2nd ed. London, England. John Wiley & Sons; 2003:1207–1236.Google Scholar
31.Depression Guideline Panel. Depression in Primary Care: Vol. 1. Detection and Diagnosis, Clinical Practice Guideline, No. 5. US Department of Health and Human Services, Agency for Health Care and Policy Research; April, 1993. AHCPR Publication No.93-0551.Google Scholar
32.Musselman, DL, Evans, DL, Nemeroff, CB. The relationship of depression to cardiovascular disease. Arch Gen Psychiatry. 1998;55:580–592.CrossRefGoogle ScholarPubMed
33.Reynolds, CF, Kupfer, DJ. Depression and aging: a look to the future. Psychiatr Serv. 1999;9:1167–1172.CrossRefGoogle Scholar
34.Zisook, S, Shuchter, SR. Major depression associated with widowhood. Am J Geriatr Psychiatry. 1993;1:316–326.CrossRefGoogle ScholarPubMed
35.Zisook, S, Paulus, M, Schuchter, SR, et al.The many faces of depression following spousal bereavement. J Affect Disord. 1997;45:85–94.CrossRefGoogle ScholarPubMed
36.Unützer, J, Katon, W, Callahan, CM, et al.Collaborative care management of late-life depression in the primary care setting: a randomized controlled trial. JAMA. 2002;22:2836–2845.CrossRefGoogle Scholar
37.Endicott, J, Nee, J, Harrison, W, et al.Quality of Life Enjoyment and Satisfaction Questionnaire: a new measure. Psychopharmacol Bull. 1993;29:321–326.Google ScholarPubMed
38.Ware, JE, Snow, KK, Kosinski, M, et al.SF-36 Health Survey: Manual & Interpretation Guide. Boston, Mass: The Health Institute, New England Medical Center; 1993.Google Scholar
39.Doraiswamy, PM, Khan, ZM, Donahue, RM, et al.The spectrum of quality-of-life impairments in recurrent geriatric depression. J Gerontol A Biol Sci Med Sci. 2002;2:134–137.CrossRefGoogle Scholar
40.Finkel, SI, Richter, EM, Clary, CM, et al.Comparative efficacy of sertraline vs. fluoxetine in patients age 70 or over with major depression. Am J Geriatr Psychiatry. 1999;3:221–227.CrossRefGoogle Scholar
41.Hamilton, M. A rating scale for depression. J Neurol Neurosurg Psychiatry. 1960;23:56–62.CrossRefGoogle ScholarPubMed
42.Hamilton, M. The assessment of anxiety states by rating. Br J Med Psychol. 1959;32:50–55.CrossRefGoogle ScholarPubMed
43.Guy, W, ed. ECDEU Assessment Manual for Psychopharmacology. In: Publication ADM 76-388. Washington DC: US Department of Health, Education, and Welfare; 1976:218–222.Google Scholar
44.Norcross, JC, Guadagnoli, E, Prochaska, JO. Factor structure of the profile of mood states. J Clin Psychol. 1984;40:1270–1277.3.0.CO;2-7>CrossRefGoogle ScholarPubMed
45.Bondareff, W, Alpert, M, Friedhoff, AJ, et al.Comparison of sertraline and nortriptyline in the treatment of major depressive disorder in late life. Am J Psychiatry. 2000;5:729–736.CrossRefGoogle Scholar
46.Doraiswamy, PM, Khan, ZM, Donahue, RMJ, et al.Quality of life in geriatric depression: a comparison of remitters, partial responders, and nonresponders. Am J Geriatr Psychiatry. 2001;4:423–428.CrossRefGoogle Scholar
47.Williams, JW, Barrett, J, Oxman, T, et al.Treatment of dysthymia and minor depression in primary care: a randomized controlled trial in older adults. JAMA. 2000;12:1519–1526.CrossRefGoogle Scholar
48.Fortner, MR, Brown, K, Varia, IM, et al.Effect of bupropion SR on the quality of life of elderly depressed patients with comorbid medical disorders. Primary Care Companion J Clin Psychiatry. 1999;6:174–179.Google Scholar
49.Small, GW, Birkett, M, Meyters, BS, et al.Impact of physical illness on quality of life and antidepressant response in geriatric major depression. Fluoxetine Collaborative Study Group. J Am Geriatr Soc. 1996;10:1220–1225.CrossRefGoogle Scholar
50.Finkel, SI, Richter, EM, Clary, CM, et al.Comparative efficacy of sertraline vs. fluoxetine in patients age 70 or over with major depression. Am J Geriatr Psychiatry. 1999;3:221–227.CrossRefGoogle Scholar
51.Bruce, ML, Seeman, TE, Merrill, SS, et al.The impact of depressive symptomology on physical disability: MacArthur Studies of Successful Aging. Am J Public Health. 1994;84:1796–1799.CrossRefGoogle Scholar
52.Koenig, HG, George, LK. Depression and physical disability outcomes in depressed medically ill hospitalized older adults. Am J Geriatr Psychiatry. 1998;6:230–247.CrossRefGoogle ScholarPubMed
53.Penninx, BW, Guralnik, JM, Ferrucci, L, et al.Depressive symptoms and physical decline in community-dwelling older persons. JAMA. 1998;279:1720–1726.CrossRefGoogle ScholarPubMed
54.Berardi, D, Menchetti, M, De Ronchi, D, et al.Late-life depression in primary care: a nationwide Italian epidemiological survey. J Am Geriatr Soc. 2002;1:77–83.CrossRefGoogle Scholar
55.Sinclair, PA, Lyness, JM, King, DA, et al.Depression and self-reported functional status in older primary care patients. Am J Psychiatry. 2001;3:416–419.CrossRefGoogle Scholar
56.Mehta, KM, Yaffe, K, Covinsky, KE. Cognitive impairment, depressive symptoms, and functional decline in older people. J Am Geriatr Soc. 2002;6:1045–1050.CrossRefGoogle Scholar
57.Han, B. Depressive symptoms and self-rated health in community-dwelling older adults: a longitudinal study. J Am Geriatr Soc. 2002;9:1549–1556.CrossRefGoogle Scholar
58.Luber, MP, Meyers, BS, Williams-Russo, PG, et al.Depression and service utilization in elderly primary care patients. Am J Geriatr Psychiatry. 2001;2:169–176.CrossRefGoogle Scholar
59.Bula, CJ, Wietlisbach, V, Burnand, B, et al.Depressive symptoms as a predictor of 6-month outcomes and services utilization in elderly medical inpatients. Arch Intern Med. 2001;161:2609–2615.CrossRefGoogle ScholarPubMed
60.Luber, MP, Alexopoulos, GS, Charlson, M. Recognition, treatment, comorbidity, and resource utilization of depressed patients in a general medical practice. Presented at: Annual Meeting of the Society of General Internal Medicine; May 2-4, 1996; Washington, DC.Google Scholar
61.Unützer, J, Patrick, DL, Simon, G, et al.Depressive symptoms and the cost of health services in HMO patients aged 65 years and older: a four-year prospective study. JAMA. 1997;277:1618–1623.CrossRefGoogle Scholar
62.Murphy, JM, Monson, RR, Olivier, DC, et al.Affective disorders and mortality. Arch Gen Psychiatry. 1987;44:473–480.CrossRefGoogle ScholarPubMed
63.Simonsick, EM, Wallace, RB, Blazer, DG, et al.Depressive symptomatology and hypertension-associated morbidity and mortality in older adults. Psychosom Med. 1995;57:427–435.CrossRefGoogle ScholarPubMed
64.Everson, SA, Goldberg, DE, Kaplan, GA, et al.Hopelessness and risk of mortality and incidence of myocardial infarction and cancer. Psychosom Med. 1996;58:113–121.CrossRefGoogle ScholarPubMed
65.Frasure-Smith, N, Lesperance, F, Talajic, M. Depression following myocardial infarction: impact on 6-month survival. JAMA. 1993;270:1819–1861.CrossRefGoogle ScholarPubMed
66.Frasure-Smith, N, Lesperance, F, Talajic, M. Depression and 18-month prognosis after myocardial infarction. Circulation. 1995;91:999–1005.CrossRefGoogle ScholarPubMed
67.Zebenko, GS, Zubenko, WN, McPherson, S. A collaborative study of the emergence and clinical features of the major depressive syndrome of alzheimer's disease. Am J Psychiatry. 2003;5:857–866.CrossRefGoogle Scholar
68.Schulz, R, Beach, SR, Ives, DG, et al.Association between depression and mortality in older adults: the Cardiovascular Health Study. Arch Intern Med. 2000;12:1761–1768.CrossRefGoogle Scholar
69.Hirschfeld, RM, Russell, JM. Assessment and treatment of suicidal patients. N Engl J Med. 1997;13:910–915.CrossRefGoogle Scholar
70.Conwell, Y. In: Schneider, LS, Reynolds, CF, Lebowitz, BD, eds. Diagnosis and Treatment of Depression in Late Life: Results of the NIH Consensus Development Conference. Washington, DC: American Psychiatric Press, Inc.; 1994:397–418.Google Scholar
71.Manela, M, Katona, C, Livingston, G. How common are the anxiety disorders in old age? Int J Geriatr Psychiatry. 1996;11:65–70.3.0.CO;2-M>CrossRefGoogle Scholar
72.Carmin, CN, Wiegartz, PS, Scher, C. Anxiety disorders in the elderly. Curr Psychiatry Reps. 2000;2:13–19.CrossRefGoogle ScholarPubMed
73.Palmer, BW, Jeste, DV, Sheikh, JI. Anxiety disorders in the elderly: DSM-IV and other barriers to diagnosis and treatment. J Affect Disord. 1997;46:183–190.CrossRefGoogle ScholarPubMed
74.Fuentes, K, Cox, BJ. Prevalence of anxiety disorders in elderly adults: a critical analysis. J Behav Ther Exp Psychiat. 1997;28:269–279.CrossRefGoogle ScholarPubMed
75.Krasucki, C, Howard, R, Mann, A. The relationship between anxiety disorders and age. Int J Geriatr Psychiatry. 1998;13:79–99.8.3.0.CO;2-G>CrossRefGoogle ScholarPubMed
76.Gallo, JJ, Rabins, PV, Illiffe, S. The “research magnificent” in late life: psychiatric epidemiology and the primary health care of older adults. Int J Psychiatry Med. 1997;27:185–204.CrossRefGoogle Scholar
77.Shapiro, AM, Roberts, JE, Beck, JG. Differentiating symptoms of anxiety and depression in older adults: distinct cognitive and affective profiles? Cog Ther Res. 1999;33:53–74.CrossRefGoogle Scholar
78.Lawton, MP, Kleban, MH, Dean, J. Affect and age: cross-sectional comparisons of structure and prevalence. Psychol Aging. 1993;8:165–175.CrossRefGoogle ScholarPubMed
79.Spar, JE, La Rue, A. Geriatric Psychiatry. Washington, DC: American Psychiatric Press; 1990.Google Scholar
80.Person, DC, Borkovec, TC. Anxiety disorders among the elderly: patterns and issues. Paper presented at: Annual Meeting of the American Psychological Association; August, 1995; New York, NY.Google Scholar
81.Kogan, JN, Edelstein, BA, McKee, DR. Assessment of anxiety in older adults: current status. J Anxiety Disord. 2000;2:109–132.CrossRefGoogle Scholar
82.Stanley, MA, Novy, DM, Bourland, SL, et al.Assessing older adults with generalized anxiety: a replication and extension. Behav Res Ther. 2001;39:221–235.CrossRefGoogle ScholarPubMed
83.Kogan, JN, Edelstein, BA. Fears in middle-aged and older adults: Relations to daily functioning and satisfaction with life. In press.Google Scholar
84.Hersen, M, Van Hasselt, VB. Behavioral assessment and treatment of anxiety in the elderly. Clin Psychol Rev. 1992;12:619–640.CrossRefGoogle Scholar
85.Salzman, C, Lebowitz, BD. Anxiety in the Elderly: Treatment and Research. New York, NY: Springer; 1991.Google Scholar
86.Stanley, MA, Beck, JG. Anxiety disorders. In: Herson, M, Van Hasselt, VB, eds. Handbook of Clinical Geropsychology. New York, NY: Plenium Press. 1998:217–238.CrossRefGoogle Scholar
87.Wragg, R, Jeste, DV. Overview of depression and psychosis in Alzheimer's disease. Am J Psychiatry. 1989;146:577–587.Google ScholarPubMed
88.Swearer, JM, Drachman, DA, O'Donnell, BF, Mitchell, AL. Troublesome and disruptive behaviors in dementia. J Am Geriatr Soc. 1988;36:784–790.CrossRefGoogle ScholarPubMed
89.Fisher, JE, Noll, JP. Anxiety disorder. In: Carstensen, LL, Edelstein, BA, Dornbrand, L, eds. The Practical Handbook of Clinical Gerontology. Thousand Oaks, CA: Sage Publications; 1996:304–323.Google Scholar
90.Kathol, RG, Turner, R, Delahunt, J. Depression and anxiety associated with hyperthyroidism: response to anthyroid therapy. Psychosomatics. 1986;27:501–505.CrossRefGoogle Scholar
91.Lustman, PJ, Griffith, LS, Clouse, RE, Cryer, PE. Psychiatric illness in diabetes mellitus: relationship to symptoms and glucose control. J Nerv Ment. 1986;174:736–742.CrossRefGoogle ScholarPubMed
92.Popkin, MK, Callies, AL, Lentz, RD, Colon, EA, Sutherland, DE. Prevalence of major depression, simple phobia, and other psychiatric disorders in patients with long-standing type I diabetes mellitus. Arch Gen Psychiatry. 1988;45:64–68.CrossRefGoogle ScholarPubMed
93.Beitman, BD, Kushner, M, Lamberti, JW, Mukerji, V. Panic disorder without fear in patients with angiographically normal coronary arteries. J Nerv. Ment Dis. 1990;178:307–312.CrossRefGoogle ScholarPubMed
94.Karajgi, B, Rifkin, A, Doddi, S, Kolli, R. The prevalence of anxiety disorders in patients with chronic obstructive pulmonary disease. Am J Psychiatry. 1990;147:200–201.Google ScholarPubMed
95.Yellowless, PM, Alpers, JH, Bowden, JJ, Bryant, GD, Ruffin, RE. Psychiatric morbidity in subjects with chronic airflow obstruction. Med J Aust. 1987;146:305–307.CrossRefGoogle Scholar
96.Grigsby, AB, Anderson, RJ, Freedland, KE, Clouse, RE, Lustman, PJ. Prevalence of anxiety in adults with diabetes: A systematic review. J Psychosom Res. 2002;53:1053–1060.CrossRefGoogle ScholarPubMed
97.Boyd, JH, Rae, DS, Thompson, JW, et al.Phobia: prevalence and risk factors. Soc Psychiatry Psychiatri Epidemiol. 1990;25:314–325.CrossRefGoogle ScholarPubMed
98.Schneier, FR, Johnson, J, Hornig, CD, Liebowitz, MR, Weissman, MM. Social phobia: comorbidity and morbidity in an epidemiologic sample. Arch Gen Psychiatry. 1992;49:282–288.CrossRefGoogle Scholar
99.Kushner, MG, Sher, KJ, Beitman, BD. The relationship between alcohol problems and the anxiety disorders. Am J Psychiatry. 1990;147:685–695.Google ScholarPubMed
100.Blazer, D, Hughes, DC, George, LK. The epidemiology of depression in an elderly community population. Gerontologist. 1987;27:281–287.CrossRefGoogle Scholar
101.Regier, DA, Burke, JD, Burke, KC. Comorbidity of affective and anxiety disorders in the NIMH epidemiologic catchment area program. In: Maser, JD, Cloninger, CR, eds. Comorbidity of Mood and Anxiety Disorders. Washington, DC: American Psyciatric Press; 1990:113–122.Google Scholar
102.Alexopolous, G. Anxiety and depression in the elderly. In: Salzman, C, Lebowitz, BD, eds. Anxiety in the Elderly: Treatment and Research. New York, NY: Springer; 1991:63–77.Google Scholar
103.Colenda, C. Smith, S. Multivariate modeling of anxiety and depression in community-dwelling elderly persons. Am J Geriatr Psychiatry. 1993;1:327–338.CrossRefGoogle ScholarPubMed
104.Mehta, KM, Simonsick, EM, Penninx, BWJH, et al.Prevalence and correlates of anxiety symptoms in well-functioning older adults: findings from the Health Aging and Body Composition study. J Am Geriatr Soc. 2003;51:499–504.CrossRefGoogle ScholarPubMed
105.Beekman, AT, de Beurs, E, van Balkom, AJ, et al.Anxiety and depression in later life: co-occurrence and communality of risk factors. Am J Psychiatry. 2000;157:89–95.CrossRefGoogle ScholarPubMed
106.Feldman, LA. Distinguishing depression and anxiety in self-report: evidence from confirmatory factor analysis on nonclinical and clinical samples. J Consult Clin Psychol. 1993;61:631–638.CrossRefGoogle ScholarPubMed
107.De Beurs, E, Beekman, AT, van Balkom, AJ, Deeg, DJ, van Dyck, R, van Tilburg, W. Consequences of anxiety in older persons: its effect on disability, well-being and use of health services. Psychol Med. 1999;29:583–593.CrossRefGoogle ScholarPubMed
108.Lenze, EJ, Rogers, JC, Martire, LM, et al.The association of late-life depression and anxiety with physical disability. Am J Geriatr Psychiatry. 2001;9:113–135.CrossRefGoogle ScholarPubMed
109.Massion, AO, Warshaw, MG, Keller, MB. Quality of life in psychiatric morbidity in panic disorder and generalized anxiety disorder. Am J Psychiatry. 1993;150:600–607.Google ScholarPubMed
110.Warshaw, MG, Fierman, E, Pratt, L, et al.Quality of life and disassociation in anxiety disorder patients with histories of trauma or PTSD. Am J Psychiatry. 1993;150:1512–1516.Google ScholarPubMed
111.Simon, G, Ormel, J, Vonkorff, M, Barlow, W. Health care costs associated with depressive and anxiety disorders in primary care. Am J Psychiatry. 1995;152:352–357.Google ScholarPubMed
112.Blazer, D, George, LK, Hughes, D. The epidemiology of anxiety disorders: an age comparison. In: Salzman, C, Lebowitz, BD, eds. Anxiety in the Elderly: Treatment and Research. New York, NY: Springer; 1991:17–30.Google Scholar
113.Kawachi, I, Sparrow, D, Vokonas, PS, Weiss, ST. Symptoms of anxiety and risk of coronary heart disease: The normative aging study. Circulation. 1994;90:2225–2229.CrossRefGoogle ScholarPubMed
114.Stein, MB, Barrett-Connor, E. Quality of life in older adults receiving medications for anxiety, depression, or insomnia: findings from a community-based study. Am J Geriatr Psychiatry. 2002;10:568–574.CrossRefGoogle ScholarPubMed
115.Shapiro, S, Skinner, EA, Kessler, LG, et al.Utilization of health and mental health services. Three Epidemiologic Catchment Area sites. Arch Gen Psychiatry. 1984;41:971–978.CrossRefGoogle ScholarPubMed
116.Allsup, SJ, Gosney, MA. Anxiety and depression in an older research populaton and their impact on clinical outcomes in a randomized controlled trial. Postgrad Med J. 2002;78:674–677.CrossRefGoogle Scholar
117.Stanley, MA, Hopko, DR, Diefenbach, GJ, Bourland, SL, Rodriguez, H, Wagener, P. Cognitive-behavior therapy for late-life generalized anxiety disorder in primary care: preliminary findings. Am J Geriatr Psychiatry. 2003;11:92–96.Google ScholarPubMed
118.Mohlman, J, Gorenstein, EE, Kleber, M, de Jesus, M, Gorman, JM, Papp, LA. Standard and enhanced cognitive-behavior therapy for late-life generalized anxiety disorder: two pilot investigations. Am J Geriatr Psychiatry. 2003;11:24–32.Google ScholarPubMed
119.Katz, IR, Reynolds, CF, Alexopoulos, GS, Hackett, D. Venlafaxine ER as a treatment for generalized anxiety disorder in older adults: pooled analysis of five randomized placebo-controlled clinical trials. J Am Geriatr Soc. 2002;50:18–25.CrossRefGoogle Scholar