The prevalence of mental disorders in older people in Western countries – a meta-analysis

A systematic review of reviews on the prevalence of anxiety disorders in adult populations

“…student enrolment lists, health‐screening programs) High‐income western countries; ¾ participants from southeast Asia Community settings Clinical interview, trained interviewers using validated diagnostic methods4% (3–6) of refugees diagnosed with GAD Vulnerable population subgroups Older people and their caregivers Bryant 2008 Search: 2007 # incl. studies 49 Meta‐analysis: no People 60 +  years in community or clinical settings Range: 286–10,641 Community surveys, GP lists, geriatric hospital, general hospital, case register, clinic referrals, consecutive series; participants included institutionalized older adults, nursing home residentsChecklists, self‐report, clinical record review, clinical diagnoses Anxiety in community: 1.2–14%; anxiety in clinical samples: 1–28% Anxiety symptoms: 15–52.3% in community and 15–56% in clinical samples PD: 1.4–25.6%; Agoraphobia: 0.4–20% SP: 5.9–13.1%; SAD: 0.0–18.7% OCD: 0.6–1.8%; PD: 0.0–10.5% GAD commonest & more women with anxiety Volkert 2013 Search date: Dec. 2011 # incl. studies 25 Meta‐analysis: yes Older people 50 +  years mainly from Germany, US, Sweden Range: 242–22,777 Mostly random samples, representative samples, 1 study contacted all elderly of one town, sample stratification according to various criteria Community settings Diagnostic interviews, dimensional instruments Current and lifetime PD: 0.88% (0.76, 0.99), 2.63% (2.43, 2.84) Agoraphobia: 0.53% (0.39, 0.66), 1.00% (0.54, 1.45); SP: 4.52% (4.15, 4.89), 6.66% (6.17, 7.15) SAD: 1.31% (1.18, 1.44), 5.07% (4.82, 5.32) GAD: 2.30% (2.03, 2.57), 6.36% (5.57, 7.14) OCD: 0.90% (0.63, 1.17), 0.97 (0.55, 1.38) Lower SP prev in old Monastero 2009 Search: Aug. 2008 # incl.…”

“…studies 49 Meta‐analysis: no Hypothesis‐driven research with late‐life anxiety as primary focus Longitudinal designs Studies on anxiety in old age Prevention and early treatment should target old people in poor health and who are at risk for anxiety Original studies Differences in definition and measurement of anxiety Measurement equivalence issues in elderly – is anxiety experienced differently in elderly? (case definition) Difficult to disentangle physical symptoms & anxiety in elderly Possible selection bias Older people may underreport anxiety Mostly cross‐sectional studies Review 5 Volkert 2013 Search date: Dec. 2011 # incl. studies 25 Meta‐analysis: yes Studies on anxiety in elderly using improved methodology and accounting for changes in old age (adapted instruments)  Differences in instruments and diagnostic criteria Difficult to disentangle anxiety from physical diseases, somatoform disorders, and depression in elderly Instruments not designed for elderly – what constitutes anxiety in elderly? Heterogeneity: studies of different geographic and cultural regions and using different case definitions and case identification methods Difficult to recruit elderly for studies Review Studies in English and German – limited generalizability No missing data analysis 8 Monastero 2009 Search: Aug. 2008 # incl.…”

Late-Life Mental Health Disorders. Data from a Population-Based Study

“…In the former meta-analysis [40] rates for current and lifetime GAD were 2.30% and 6.36% respectively, and differed from previous findings that reported a much higher rate for current GAD (10.8%) and a lower rate for lifetime GAD (4.6%) [41]. Although GAD has been posed as the most common anxiety disorder in old age [42], there is much controversy about whether GAD is a diagnosis in its own right [43] or lies on a continuum of depression [44].…”

“…According to a recent meta-analysis assessing the prevalence of mental disorders in older people in Europe and North America [40] the overall random-effects estimate for the 13 included studies was 3.29% for current major depression (MD) and 16.52% for lifetime MD, with high variability within study entered the meta-analysis. Large heterogeneity has been reported in a previous review [41], between 3.1% and 26.9%.…”

Protective Psychosocial Factors of Geriatric Depression in Community Dwelling Older Adults: A Review Article

“…However, symptoms of depression often fail to meet the diagnostic criteria, so they usually are not considered as clinical (5). The reported prevalence of geriatric depression was variable; from 19.5% in western countries (6), 27.8% in Sri Lanka (7) to 23% in Pakistan (8), 58% in Iran (9) and 20% -34% in South Korea (10).…”