Past Issues

Risks of Mortality in the Elderly with Anxiety Comorbid with Physical Illness

Wei Hung Chang, I Hui Lee, Wei Tseng Chen, Po See Chen, Yen Kuang Yang, Kao Chin Chen

Objectives: Anxiety disorders may increase the risks of physical comorbidities
in the elderly, but the results of mortality rates are inconsistent. In this study,
we intended to explore (A) whether anxiety disorders increase the risks of mortality
in the elderly, and (B) whether the mortality risks could be different in different
physical illnesses. Methods: We included subjects aged over 60 years using the
National Health Insurance Research Database (NHIRD). We included 247 subjects
with anxiety disorders (generalized anxiety disorders, panic disorders, phobic disorders)
and 987 control subjects without anxiety disorders in an eight-year longitudinal
follow-up using the database analysis from 2000 to 2008. Certain specifi c
physical illnesses related to anxiety disorders were analyzed. The hazard ratios
(HRs) were calculated for the mortality risks between two groups. Results: The
mortality risks of subjects with anxiety disorders and with physical comorbidities
increased signifi cantly (HR = 3.29, 95% confi dence interval = 1.92 - 5.62, p <
0.001). Furthermore, congestive heart failure (CHF) (HR = 2.84, 95% CI =1.73 -
4.66, p < 0.001) was the most signifi cant predictive factor for mortality risks. Cerebrovascular
disease (HR = 1.86, 95% CI = 1.19 - 2.93, p < 0.01), cardiac arrhythmia
(HR = 1.7, 95% CI = 1.01 - 2.86, p < 0.05), and peptic ulcers (HR = 1.56, 95%
CI = 1.07 - 2.28, p < 0.01) also signifi cantly infl uenced the mortality risks. Additionally,
CHF (HR = 6.63, 95% CI = 22.97 - 14.79, p < 0.001) was the only predictive
factor for mortality risks in the elderly with anxiety disorders. Conclusions:
Several physical illnesses could enhance mortality risks in the elderly. Cardiovascular
related illnesses could be the mediators of anxiety disorders in the elderly to
increase mortality risks.
Key Word elderly, anxiety disorder, physical illnesses, mortality risks
Editorial Committe, Taiwanese Journal of Psychiatry
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