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Age at Onset of Generalized Anxiety Disorder in Older Adults

Received December 16, 2002; revised March 18, September 17, 2003; accepted December 8, 2003. From the Dept. of Psychology, University of Nevada, Reno (HL); the Dept. of Psychology, University of Southern California, Los Angeles, CA (MG); and the Dept. of Psychiatry, Univ. of California, San Diego and VA San Diego Healthcare System, San Diego, CA (JLW). Send correspondence and reprint requests to Julie Wetherell, Ph.D., Dept. of Psychiatry, Univ. of California, San Diego, 9500 Gilman Drive, Dept. 0603V, La Jolla, CA 92093-0603. e-mail: jwetherell{at}ucsd.edu
© 2005 American Association for Geriatric Psychiatry

Objective: The authors explored the distribution and correlates of age-at-onset of late-life generalized anxiety disorder (GAD). Methods: Authors examined the distribution of age at onset in a sample of 67 older adults with GAD recruited for a psychotherapy study. They compared those with an early onset of symptoms (before age 50) to those with a late onset (after 50) on demographic variables and measures of psychopathology and health-related quality of life. Results: There was a bimodal distribution of age at onset, with 57% reporting early onset and 43% reporting a late onset. Patients with an early onset of symptoms had a higher rate of psychiatric comorbidity and psychotropic medication use and more severe worry. Patients with a late onset of symptoms reported more functional limitations due to physical problems. Conclusions: Although most older GAD patients report an onset in childhood or adolescence, almost half develop the disorder in late life. Older adults with an early onset of GAD appear to have a more severe course, characterized by pathological worry, than those with a later onset. Role disability may be a risk factor for onset of GAD in late life.

Key Words: Anxiety Disorders • Depression • Comorbidity

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