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Anxiety, depression, and comorbid anxiety and depression: risk factors and outcome over two years

  • Osvaldo P. Almeida (a1) (a2) (a3), Brian Draper (a4), Jane Pirkis (a5), John Snowdon (a6), Nicola T. Lautenschlager (a1) (a2) (a7), Gerard Byrne (a8), Moira Sim (a9), Nigel Stocks (a10), Ngaire Kerse (a11), Leon Flicker (a2) (a12) (a13) and Jon J. Pfaff (a1) (a2)
  • DOI:
  • Published online: 12 June 2012

Background: This study aimed to determine: (1) the prevalence of depression, anxiety, and depression associated with anxiety (DA); (2) the risk factor profile of depression, anxiety, and DA; (3) the course of depression, anxiety, and DA over 24 months.

Methods: Two-year longitudinal study of 20,036 adults aged 60+ years. We used the Patient Health Questionnaire and the Hospital Anxiety and Depression Scale anxiety subscale to establish the presence of depression and anxiety, and standard procedures to collect demographic, lifestyle, psychosocial, and clinical data.

Results: The prevalence of anxiety, depression, and DA was 4.7%, 1.4%, and 1.8%. About 57% of depression cases showed evidence of comorbid anxiety, while only 28% of those with clinically significant anxiety had concurrent depression. There was not only an overlap in the distribution of risk factors in these diagnostic groups but also differences. We found that 31%, 23%, and 35% of older adults with anxiety, depression, and DA showed persistence of symptoms after two years. Repeated anxiety was more common in women and repeated depression in men. Socioeconomic stressors were common in repeated DA.

Conclusions: Clinically significant anxiety and depression are distinct conditions that frequently coexist in later life; when they appear together, older adults endure a more chronic course of illness.

Corresponding author
Correspondence should be addressed to: Professor Osvaldo P. Almeida, Western Australian Centre for Health & Ageing (M573), Centre for Medical Research, University of Western Australia, 35 Stirling Highway, Crawley, Perth, WA 6009, Australia. Phone: +61 8 9224 2855; Fax: +61 8 9224 8009. Email:
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International Psychogeriatrics
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