Whereas depression as a risk factor for the incidence of activity limitations in the elderly has been confirmed, little attention has been paid to anxiety, despite its high prevalence, with or without comorbid depression.

In a community-dwelling cohort of 1581 participants aged 65 years and over, the association between trait anxiety symptoms (Spielberger State-Trait Anxiety Inventory, third highest tercile) and current DSM-IV anxiety disorder (GAD, PTSD, OCD, panic disorder, agoraphobia or social phobia) at baseline and 7-year incident activity limitations was determined using mixed logistic regression models. Repeated measures of activity limitations included by increased severity level: social restriction (neighbourhood and house confined), mobility (Rosow and Breslau scale) and limitations in instrumental activities of daily living (IADL).

Of the sample, 42% were male and 14.2% had an anxiety disorder at baseline. Adjusting for socio-demographic and health variables, past and present depression and anxiolytic drugs, trait anxiety symptomatology was associated with increased incidence of social restriction (OR (95% CI): 2.46 (1.45–4.16), p = 0.0008) and current anxiety disorder with an increased risk of incident IADL limitation (OR (95% CI): 1.86 (1.01–3.41), p = 0.046). Associations remained significant in participants free of depressive symptoms at baseline (OR (95% CI): 2.92 (1.41–6.05), p = 0.004; OR (95% CI): 3.21 (1.31–7.89), p = 0.011, respectively).

Despite high comorbidity between depressive and anxiety symptoms, both trait symptomatology and anxiety disorder are independently associated with increased incident dependency with a gradient of severity: trait anxiety symptoms associated with incident social restriction and anxiety disorder with incidence of IADL limitations.