Anxiety Symptoms and Decline in Physical Function over 5 Years in the Health, Aging and Body Composition Study

Authors

  • Kala M. Mehta DSc,

    1. From the *Division of Geriatrics, Departments of Psychiatry, Neurology, §Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, CaliforniaDepartment of Psychiatry and Behavioral Medicine, Wake Forest University School of Medicine, Winston-Salem, North CarolinaUniversity of Pittsburgh School of Medicine, Division of Geriatric Medicine, Pittsburgh, Pennsylvania#Department of Preventive Medicine, University of Tennessee College of Medicine, Memphis, Tennessee**Clinical Research Branch, National Institute on Aging, Baltimore, Maryland.
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  • Kristine Yaffe MD,

    1. From the *Division of Geriatrics, Departments of Psychiatry, Neurology, §Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, CaliforniaDepartment of Psychiatry and Behavioral Medicine, Wake Forest University School of Medicine, Winston-Salem, North CarolinaUniversity of Pittsburgh School of Medicine, Division of Geriatric Medicine, Pittsburgh, Pennsylvania#Department of Preventive Medicine, University of Tennessee College of Medicine, Memphis, Tennessee**Clinical Research Branch, National Institute on Aging, Baltimore, Maryland.
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  • Gretchen A. Brenes PhD,

    1. From the *Division of Geriatrics, Departments of Psychiatry, Neurology, §Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, CaliforniaDepartment of Psychiatry and Behavioral Medicine, Wake Forest University School of Medicine, Winston-Salem, North CarolinaUniversity of Pittsburgh School of Medicine, Division of Geriatric Medicine, Pittsburgh, Pennsylvania#Department of Preventive Medicine, University of Tennessee College of Medicine, Memphis, Tennessee**Clinical Research Branch, National Institute on Aging, Baltimore, Maryland.
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  • Anne B. Newman MD, MPH,

    1. From the *Division of Geriatrics, Departments of Psychiatry, Neurology, §Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, CaliforniaDepartment of Psychiatry and Behavioral Medicine, Wake Forest University School of Medicine, Winston-Salem, North CarolinaUniversity of Pittsburgh School of Medicine, Division of Geriatric Medicine, Pittsburgh, Pennsylvania#Department of Preventive Medicine, University of Tennessee College of Medicine, Memphis, Tennessee**Clinical Research Branch, National Institute on Aging, Baltimore, Maryland.
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  • Ronald I. Shorr MD, MS,

    1. From the *Division of Geriatrics, Departments of Psychiatry, Neurology, §Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, CaliforniaDepartment of Psychiatry and Behavioral Medicine, Wake Forest University School of Medicine, Winston-Salem, North CarolinaUniversity of Pittsburgh School of Medicine, Division of Geriatric Medicine, Pittsburgh, Pennsylvania#Department of Preventive Medicine, University of Tennessee College of Medicine, Memphis, Tennessee**Clinical Research Branch, National Institute on Aging, Baltimore, Maryland.
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  • Eleanor M. Simonsick PhD,

    1. From the *Division of Geriatrics, Departments of Psychiatry, Neurology, §Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, CaliforniaDepartment of Psychiatry and Behavioral Medicine, Wake Forest University School of Medicine, Winston-Salem, North CarolinaUniversity of Pittsburgh School of Medicine, Division of Geriatric Medicine, Pittsburgh, Pennsylvania#Department of Preventive Medicine, University of Tennessee College of Medicine, Memphis, Tennessee**Clinical Research Branch, National Institute on Aging, Baltimore, Maryland.
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  • Hilsa N. Ayonayon PhD,

    1. From the *Division of Geriatrics, Departments of Psychiatry, Neurology, §Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, CaliforniaDepartment of Psychiatry and Behavioral Medicine, Wake Forest University School of Medicine, Winston-Salem, North CarolinaUniversity of Pittsburgh School of Medicine, Division of Geriatric Medicine, Pittsburgh, Pennsylvania#Department of Preventive Medicine, University of Tennessee College of Medicine, Memphis, Tennessee**Clinical Research Branch, National Institute on Aging, Baltimore, Maryland.
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  • Susan M. Rubin MPH,

    1. From the *Division of Geriatrics, Departments of Psychiatry, Neurology, §Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, CaliforniaDepartment of Psychiatry and Behavioral Medicine, Wake Forest University School of Medicine, Winston-Salem, North CarolinaUniversity of Pittsburgh School of Medicine, Division of Geriatric Medicine, Pittsburgh, Pennsylvania#Department of Preventive Medicine, University of Tennessee College of Medicine, Memphis, Tennessee**Clinical Research Branch, National Institute on Aging, Baltimore, Maryland.
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  • Kenneth E. Covinsky MD, MPH

    1. From the *Division of Geriatrics, Departments of Psychiatry, Neurology, §Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, CaliforniaDepartment of Psychiatry and Behavioral Medicine, Wake Forest University School of Medicine, Winston-Salem, North CarolinaUniversity of Pittsburgh School of Medicine, Division of Geriatric Medicine, Pittsburgh, Pennsylvania#Department of Preventive Medicine, University of Tennessee College of Medicine, Memphis, Tennessee**Clinical Research Branch, National Institute on Aging, Baltimore, Maryland.
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  • Presented at the Gerontological Society of America Meeting, November 21, 2005, Orlando, Florida, and the American Geriatrics Society Meeting, May 5, 2006, Chicago, Illinois.

Address correspondence to Kala M. Mehta, DSc, 4150 Clement Street, Box 181G, San Francisco, CA 94121. E-mail: kala.mehta@ucsf.edu

Abstract

OBJECTIVES: To examine the relationship between anxiety and functional decline.

DESIGN: A 5-year longitudinal cohort study of well-functioning adults.

SETTING: The Health, Aging and Body Composition (Health ABC) Study.

PARTICIPANTS: Two thousand nine hundred forty adults aged 70 to 79 (48% male, 41% black), initially free of self-reported mobility difficulty.

MEASUREMENTS: In 1997/98, presence of three anxiety symptoms (feeling fearful, tense or keyed up, or shaky or nervous) from the Hopkins Symptom Checklist were ascertained. Physical function was examined over 5 years using the Health ABC performance battery (continuous range 0–4) consisting of chair stands, usual and narrow course gait speed, and difficulty with standing balance and self-reported mobility, defined as difficulty walking one-quarter of a mile or difficulty climbing 10 steps.

RESULTS: Participants with anxiety symptoms had similar baseline physical performance scores. After adjustment for potential confounders, subjects with anxiety symptoms had similar declines in physical performance over 5 years as participants without anxiety symptoms. Adults with anxiety symptoms were more likely to report incident mobility difficulty, with a hazard ratio of 1.4 (95% confidence interval=1.3–1.6), compared with adults without anxiety symptoms. These results persisted after adjustment for depressive symptoms, demographics, comorbidity, and use of antianxiety, depressant, and sedative hypnotic medications.

CONCLUSION: Anxiety symptoms are not associated with declines in objectively measured physical performance over 5 years but are associated with declines in self-reported functioning. Future studies are needed to determine why anxiety has a differential effect on performance-based and self-reported measures of functioning.

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