The burden of late-life generalized anxiety disorder: Effects on disability, health-related quality of life, and healthcare utilization

OBJECTIVE:: To describe the burden of Generalized Anxiety Disorder (GAD), a common anxiety disorder in older adults. DESIGN:: Cross-sectional. SETTING:: Late-life depression and anxiety research clinic in Pittsburgh, PA. PARTICIPANTS:: One hundred sixty-four older adults with GAD and 42 healthy comparison participants with no lifetime history of psychiatric disorder were recruited from primary care and mental health settings as well as advertisements. MEASUREMENTS:: Participants were evaluated with the Late Life Function and Disability Index to assess disability, the MOS 36-Item Short Form Survey Instrument to assess health-related quality of life (HRQOL), and the Cornell Service Index to assess healthcare utilization. RESULTS:: Older adults with GAD were more disabled, had worse HRQOL, and had greater healthcare utilization, than nonanxious comparison participants, even in the absence of psychiatric comorbidity. After controlling for medical burden and depressive symptoms, higher severity of anxiety symptoms was associated with greater disability and poorer HRQOL in several domains. The greatest decrements in HRQOL and function were observed in measures assessing role functioning, including social function. CONCLUSION:: This study, the largest ever of GAD in older adults, provides evidence of the significant burden of this disorder in late life. Given the high prevalence and chronicity of GAD in the elderly, these data provide a public health imperative for finding and implementing effective management strategies for this typically undiagnosed and untreated disorder.