Anxiety and physical health conditions in older adults: an examination of co-occurrence, predictors of co-occurrence, and mental health service use
Authors: Renée El-Gabalawy
The dramatic growth of the older adult population corresponds with several challenges relating to complex comorbidities of commonly occurring physical health conditions and mental disorders. The ‘Strength and Vulnerability Integration (SAVI)’ theoretical model (Charles, 2010) posits that aging is associated with enhancements in emotional well-being. Unfortunately these emotional enhancements are compromised in the context of a chronic, unrelenting stressor such as a physical health condition and vulnerabilities in emotional well-being are associated with maladaptive physiological changes. Understanding age-related vulnerabilities within this framework, the present research explored the comorbidity of anxiety disorders and physical health conditions longitudinally and mental health service use implications of comorbidities in adults aged 55 years and older. This research specifically focused on arthritis, gastrointestinal disease, and cardiovascular disease. Study 1 examined the bi-directional relationship between individual anxiety disorders and the specified physical health conditions, and further examined sociodemographic and health predictors of incident comorbidities in a longitudinal population-based sample of American older adults. Results provided support for a bi-directional relationship across a 3 year period. Any anxiety disorder and post-traumatic stress disorder were significant independent predictors of incident gastrointestinal disease and arthritis was a significant independent predictor of incident generalized anxiety disorder. Being female and poor mental health related quality of life at baseline were independent predictors of incident comorbid any anxiety disorder and the specified physical health conditions. Study 2 examined the effect of comorbid any anxiety disorder and the specified physical health conditions on past-year mental health service use in a cross-sectional Canadian population-based sample of older adults. Differential relationships emerged across specified physical health conditions on mental health service use with gastrointestinal disease and comorbid any anxiety disorder being associated with lower rates of use. Results have important clinical implications for identification and possible prevention initiatives. The findings are discussed within the context of SAVI and current healthcare practices for older adults.
Please note that abstracts only appear in the language of the publication and might not have a translation.
Jordanna L. Sommer, Edward Noh, Eric Jacobsohn, Chris Christodoulou, and Renee El-Gabalawy (2020).
An examination of difficulties accessing surgical care in Canada from 2005-2014: Results from the Canadian Community Health Survey
PLoS ONE , 12-Jan
Jitender Sareen, Shay-Lee Bolton, Natalie Mota, Tracie O. Afifi, Murray W. Enns, Tamara Taillieu, Ashley Stewart-Tufescu, Renée El-Gabalawy, Ruth Ann Marrie, J. Don Richardson, Murray B. Stein, Charles N. Bernstein, James M. Bolton, Jianli Wang, Gordon J. G. Asmundson, James M. Thompson, Linda VanTil, Mary Beth MacLean, and Sarvesh Logsetty (2021).
Lifetime prevalence and comorbidity of mental disorders in the two-wave 2002–2018 Canadian Armed Forces Members and Veterans Mental Health Follow-up Survey (CAFVMHS) / Prévalence et comorbidité de durée de vie des Troubles Mentaux Dans l’Enquête de Suivi Sur la Santé Mentale Auprès des Membres des Forces Armées Canadiennes et Des ex-Militaires (ESSMFACM) en deux cycles de 2002 à 2018
Canadian Journal of Psychiatry , 10-Jan
Tracie O. Afifi, Shay-Lee Bolton, Natalie Mota, Ruth Ann Marrie, Murray B. Stein, Murray W. Enns, Renée El-Gabalawy, Charles N. Bernstein, Corey Mackenzie, Linda VanTil, Mary Beth MacLean, Jian Li Wang, Scott Patten, Gordon J. G. Asmundson, and Jitender Sareen (2020).
Rationale and methodology of the 2018 Canadian Armed Forces Members and Veterans Mental Health Follow-up Survey (CAFVMHS): A 16-year follow-up survey / Raison d’être et méthodologie de l’enquête de suivi sur la santé mentale auprès des membres des Forces armées canadiennes et des ex-militaires, 2018 (ESSMFACM)
Canadian Journal of Psychiatry , 9-Jan
Renée El-Gabalawy, Corey S. Mackenzie, and Jitender Sareen (2016).
Mental health service use among older Canadians with anxiety and comorbid physical conditions
Aging and Mental Health , 627-636
Rachel Roy, Jordana L Sommer, James M Bolton, and Renée El-Gabalawy (2021).
Understanding correlates of suicidality among those with usual pain and discomfort: A Canadian nationally representative study
Journal of Psychosomatic Research , 1106511
Everett Vun, Sarah Turner, Natalie Mota, Tracie O. Afifi, Jitender Sareen, and Renée El-Gabalawy (2018).
Prevalence of comorbid chronic pain and mental health conditions in Canadian Armed Forces active personnel: Analysis of a cross-sectional survey
CMAJ Open , E528-E536
Jordana L. Sommer, Caitlin Blaney, and Renée El-Gabalawy (2019).
A population-based examination of suicidality in comorbid generalized anxiety disorder and chronic pain
Journal of Affective Disorders , 562-567