Twenty three percent of the studied older adults, that were available for follow up, with an anxiety disorder met the criteria for persistent anxiety.
Nearly half of the participants demonstrated subsyndromal anxiety, making up the partial remission group, while 31% were in full remission. Drawing on previous literature regarding the fluctuating nature of anxiety disorder in younger patients, the researchers surmise that too much emphasis should not be placed on the difference between persistent anxiety and those in partial remission. At the 6-year-old follow up, more than two-thirds of the subjects suffered from either partial or persistent anxiety, which the researchers note is an unfavorable outcome.
However, when compared to similar studies performed on younger adults, the results are more encouraging, as full remission rates typically only range from 12 to 38%. The results of the study suggest that the outcome of anxiety disorders are different from those of depression, with rates being significantly higher for those suffering from anxiety. Lastly, the researchers found that efforts to enhance appropriate referrals for mental health care for older adults suffering from anxiety were not effective (Schuurman et al., 2005). Limitations of the study were underscored, especially the small sample size and the singular point in time for the follow-up study.
However, alternative answers were not given, other than the possibility that the partial remission results may still be persistently anxious. The researchers recommend future studies to create a larger sample size to identify potential other prognostic factors.
Brief Description of Conclusion:
Schuurman et al. (2005) concluded with the notation that the findings of their research supported an unfavorable long-term outcome for older adults and anxiety, due to the significant percentage that demonstrated a persistent outcome at the 6-year follow up. Yet, they note that no conclusive inferences can be made, since follow-up data was restricted to only one point in time.
Although neuroticism was found to be strongly associated with persistent anxiety, as noted, the researchers recommend future studies to create a larger sample size to identify potential other prognostic factors. They also note that appropriate treatment for those suffering from anxiety is severely lacking, and then with better treatment, health care costs may be significantly reduced in older adults.
Personal Reactions to the Study:
The main points of the study were fairly straight forward. First, there was a deficit in the current literature regarding older adults and anxiety disorder persistence. Utilizing the Longitudinal Aging Study Amsterdam and a 6-year follow up study, the researchers were able to determine that the prognostic factor related to the persistence in anxiety disorder was neuroticism. Furthermore, they discovered that current referral efforts for mental health services was not effective in countering anxiety.
This was a very interesting study, that was worthwhile as I'll be able to apply the findings to my work, as it will help me understand that anxiety disorder is just as prevalent as depression disorders, and ensure that treatment referral is effective, as this is applicable to every patient over the age of 55. It was valid as it begins to fill a gap in current literature. The research was described thoroughly enough that it could easily be replicated and would be an excellent tool in designing a similar study, here in the United States. and, it made me think about the lack of acknowledgment of anxiety disorders in geriatric patients. This is especially disturbing when one considers that the co-occurrence of anxiety and depression has been show to represent more severe and chronic psychopathology (Holwerda et al., 2007). Using this knowledge of the importance of diagnosing and treating anxiety, I can apply the 4 effective types of EBTs suggested by Ayers, Sorrell, Thorp, and Wetherell (2007): cognitive behavioral therapy, relaxation training, supportive therapy, and cognitive therapy.
Ayres, C., Sorrell, J., Thorp, S., & Wetherell, J. (Mar 2007). Evidence-based psychological treatments for late-life anxiety. Psychology & Aging, 22(1). Retrieved October 30, 2007, from Academic Search Premier database.
Holwerda, T., Schoevers, R., Dekker, J., Deeg, D., Jonker, C., Beekman, a. (Mar 2007). The relationship between generalized anxiety disorder, depression and mortality in old age. International Journal of Geriatric Psychiatry, 22(3). Retrieved October 30, 2007, from Academic Search Premier database.
Schuurman, J., Comija, H., Beekman, a., de Beurs, E., Deeg, D., Emmelkamp, P., and van Dyak, R. (2005). The…