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Objective: To examine long-term outcome of late-life anxiety disorders and utilization of mental health care services. Method: A cohort of subjects (aged ≥55 years) with an anxiety disorder (n = 112) was identified in the Longitudinal Aging Study Amsterdam (n = 3107). At 6 year follow-up, the rate of persistence and prognostic factors for persistence of anxiety were established. Results: Six years after baseline 23% of our sample met the criteria for an anxiety disorder. Another 47% suffered from subclinical anxiety symptoms. Persistence of anxiety was associated with a high score on neuroticism at baseline. Use of benzodiazepines was high (43%), while use of mental health care facilities (14%) and anti-depressants (7%) remained low in those with persistent anxiety. Conclusion: Results indicate that those high in neuroticism are at greater risk for persistence of anxiety. Efforts to enhance appropriate referral of anxious older adults do not seem to have had the desired effect. © Blackwell Munksgaard 2005.

Objective: To study the impact of depression on the wellbeing, disability and use of health services of older adults. Method: Prospective community-based study, using a large (ne2200) sample of the elderly (55–85) in the Netherlands. Using a 3-year follow-up, the effect of depressive symptoms (CES-D) on disability, wellbeing and service utilization was assessed, controlling for competing need-for-care (chronic physical illness, functional limitation and cognitive decline), enabling (partner status, size of the social network, social support and locus of control), and predisposing factors (age, sex and level of education). Results: Depressive symptoms have considerable impact on the wellbeing and disability of older people and clear economic consequences caused by inappropriate service utilization. Compared with other need-for-care variables the impact of depression is weaker (service utilization), similar (disability) or stronger (wellbeing). Conclusion: The steeply rising prevalence of competing health risks in later life does not influence the significance of depression.

Sonnenberg CM, Beekman ATF, Deeg DJH, van Tilburg W. Sex differences in late-life depression. Acta Psychiatr Scand 2000: 101: 286–292. © Munksgaard 2000. Objective: The primary aim of this study was to assess sex differences in depression in later life. Method: In a random, age and sex-stratified community sample of 3056 older Dutch people (55–85 years) the prevalence, symptom-reporting and risk factors associated with depression in later life were studied. Depression was measured with the Center for Epidemiologic Studies Depression scale (CES-D). Bivariate, multivariate and factor analyses were used. Results: Prevalence of depression in women was almost twice as high as in men. Controlling for age and competing risk factors reduced the relative risk for females with more than half. Symptom-patterns in men and women were very much alike. Sex differences in associations with risk factors were small, but exposure to these risk factors was considerably higher in females. Conclusion: Very little evidence for a typical ‘female depression’ was found. Female preponderance in depression was related to a greater exposure to risk factors.

Objective: The aim of the study was to investigate patterns of comorbidity among the anxiety disorders in a community-based older population, and the relationship of these disorders with major depression, use of alcohol and benzodiazepines, cognitive impairment and chronic somatic illnesses. Method: The data were derived from the Longitudinal Aging Study Amsterdam (LASA) study. A two-stage screening design was adopted to identify respondents with anxiety disorders. Results: In total, 10% of the elderly with an anxiety diagnosis suffered from two or more anxiety disorders. Major depression (13% vs. 3%), benzodiazepine use (24% vs. 11%) and chronic somatic diseases (12% vs. 7%) were significantly more prevalent in respondents with an anxiety disorder than in respondents without anxiety disorders. Heavy or excessive alcohol intake (5% vs. 4%) and cognitive impairment (11% vs. 13%) were not significantly associated with any anxiety disorder. Conclusion: When anxiety disorders are diagnosed, in older people there is a relatively high probability of comorbid conditions being present.

This study examines the impact of religiosity on the incidence and course of depressive syndromes in a community-based sample of elderly people in The Netherlands (n=177). The course of depression was assessed in five waves of measurements, covering a period of 1 year. Religiosity was defined as salience of religion compared to the salience of other aspects of life. Religious salience was not associated with incidence of depression, but showed a relatively strong association with improvement of depression among the respondents who were depressed at the first measurement. This association was most prominent among subjects with poor physical health.

To study the impact of depression on the wellbeing, disability and use of health services of older adults.Prospective community-based study, using a large (n = 2,200) sample of the elderly (55-85) in the Netherlands. Using a 3-year follow-up, the effect of depressive symptoms (CES-D) on disability, wellbeing and service utilization was assessed, controlling for competing need-for-care (chronic physical illness, functional limitation and cognitive decline), enabling (partner status, size of the social network, social support and locus of control), and predisposing factors (age, sex and level of education).Depressive symptoms have considerable impact on the wellbeing and disability of older people and clear economic consequences caused by inappropriate service utilization. Compared with other need-for-care variables the impact of depression is weaker (service utilization), similar (disability) or stronger (wellbeing).The steeply rising prevalence of competing health risks in later life does not influence the significance of depression.