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Generalized Anxiety Disorder in Late Life

Lifetime Course and Comorbidity With Major Depressive Disorder

Received August 25, 2003; revised March 26, 2004, June 7, 2004; accepted June 9, 2004. From the Intervention Research Center in Late-Life Mood Disorders, Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA (EJL,BHM,MKS,MAD,RS,MDM,BT,CFR), the VA Pittsburgh (BHM), and the Department of Psychology, Syracuse University, Syracuse, NY (JM). Send correspondence and reprint requests to Dr. Lenze, Western Psychiatric Institute and Clinic, Room E835, 3811 O’Hara Street, Pittsburgh, PA 15213. e-mail: lenzeej{at}upmc.edu
© 2005 American Association for Geriatric Psychiatry

Objective: Generalized anxiety disorder (GAD) in elderly persons is highly prevalent, but little is known about its course, age at onset, and relationship to comorbid major depressive disorder (MDD). The authors assessed the course and comorbidity of late-life GAD and MDD. Methods: Authors assessed elderly subjects in anxiety or depression intervention studies who had a lifetime history of GAD, with current MDD (N=57) or without (N=46). Subjects' lifetime course of illness was charted retrospectively. Results: The 103 subjects had a mean age of 74.1 years, and a mean age at onset of GAD of 48.8 years; 46% were late-onset. GAD episodes were chronic, and 36% were longer than 10 years. Of the comorbid GAD–MDD patients, most had different times of onset and/or offset of the disorders; typically, GAD preceded MDD. Conclusions: Elderly subjects with GAD tended to have chronic symptoms lasting years-to-decades, without interruption, and many have late onset. Elderly persons with lifetime GAD and MDD tend to have different onset and offset of the two disorders. Findings characterize late-life GAD as a chronic disorder distinct from MDD.

Key Words: Anxiety Disorders • Depression • Comorbidity

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