The objective of this researh is to examine the prevalence of concurrent depression and anxiety and its relationship with functional status, quality of life and mortality in individuals at age 90.

Keywords include: aged 90 • nonagenarians • primary health care • depression • anxiety • functional status • quality of life • mortality

Methods
In the Leiden 85-plus Study, a population based cohort study, depression (15-item Geriatric Depression Scale 5 points) and anxiety (Anxiety Screening Questionnaire 1 positive answer) were assessed in all 90-year old subjects with 19 points on the Mini Mental State Examination (MMSE). Functional status included: cognitive function (MMSE) and disability in activities of daily living (Groningen Activity Restriction Scale). Quality of life included: loneliness (Loneliness Scale of De Jong-Gierveld) and life satisfaction (Cantril's ladder). For all subjects mortality data were available up to a maximum age of 95.3 years.

Results
Of the subjects aged 90 years with MMSE 19 points (56 men, 145 women), 50 subjects (25%, 95% CI 19-31%) experienced depression and 25 subjects (12%, 95% CI 9-18%) anxiety; of them 34 (17%) experienced depression only, 9 (4%) anxiety only, and 16 (8%) both depression and anxiety. Presence of depression was associated with an overall decreased functional status and quality of life and with increased mortality. Within the depressed group, subjects with anxiety did not differ from subjects without anxiety, except for higher loneliness scores.

Conclusion
Among individuals aged 90 years, depression and anxiety and their co-occurrence are highly prevalent. Anxiety does not add to poor functional status and increased mortality beyond that associated with depression, and is probably part of the phenomenology of depression in old age. Copyright © 2008 John Wiley & Sons, Ltd.

Written by: 

Gerda M. Van der Weele and Anton J. M. De Craen, Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands

Jacobijn Gussekloo, Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands

Margot W. M. De Waal and Roos C. Van der Mast , Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
 
Email: Gerda M. Van der Weele (g.m.van_der_weele@lumc.nl)

*Correspondence to Gerda M. Van der Weele, Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands