Risk Factors for Late Life Anxiety

晚年焦虑的危险因素

基本信息

批准号：
7059918
负责人：
John E Calamari
金额：
$ 14.84万
依托单位：
ROSALIND FRANKLIN UNIV OF MEDICINE & SCI
依托单位国家：
美国
项目类别：
财政年份：
2005
资助国家：
美国
起止时间：
2005-05-01 至 2009-04-30
项目状态：
已结题

项目摘要

DESCRIPTION (provided by applicant): Anxiety disorders are common among older adults, yet there is little information on risk or protective factors. Increased understanding of the developmental trajectory of late-life anxiety is needed to improve interventions and reduce the prevalence of these common conditions. In the three proposed studies, we use sequential regression analysis and path analysis to test whether specific, malleable psychological characteristics (affective traits) interact with specific late-life developmental changes or general stressors to produce excessive concern about health status, cognitive functioning, or reactivity to other stressors. We test whether health concerns, cognitive functioning concerns and stress reactivity lead to increased anxiety symptoms at three future time points. Six preliminary studies with older adults that evaluate specific aspects of the proposed model are reviewed. Associations were found between fear of anxiety and panic symptoms in preliminary study 1. In preliminary study 2, specific negative affect (NA) traits predicted coping with the rigors of ventilator weaning and early weaning success. In preliminary study 3, several NA traits predicted unique variance in health distress/illness fears (HD) and affective traits interacted with objective health status to predict HD. Older adults with more health difficulties and higher scores on a measure of the fear of anxiety-related bodily sensations experienced more HD. In preliminary study 4, roughly equal levels of subjective memory complaints (SMCs) were found in cognitively intact, mildly impaired, and significantly impaired older adults, and depression score correlated with these complaints. In preliminary study 5, mental incapacitation fear, a component of a fear of anxiety, predicted SMCs after controlling objective memory functioning and other NA traits. Relations between core affective traits and HD were evaluated in preliminary study 6 in an ethnically diverse, older adult sample. In preliminary data analysis, depression (D), Trait anxiety (TA) and anxiety sensitivity (AS) were correlated with HD (re = .59, .66, .40) and HD correlated with scores on the Hamilton Anxiety Rating Scale (HARS; r =.75, p<.05). In Proposed Study 1, a longitudinal analysis is employed to determine relations between health status, D, TA, AS, HD, and anxiety symptoms and disorders in 350 cognitively intact participants. We test a moderator-mediator model and predict that NA traits at time 1 will interact with objective health status producing increased HD at times 2, 3, and 4. We predict that older adults with more health problems and elevated NA traits will experience more HD, and that HD at time 2,3, or 4 will mediate the relation between health status X NA and anxiety symptoms or disorders. In Proposed Study 2, we evaluate relations between cognitive functioning, NA traits, SMCs and anxiety symptoms and disorders in cognitively intact and mild cognitively impaired older adults. We predict that specific NA traits at time 1 will interact with objective memory functioning to predict SMCs at time 2,3, and 4. We predict that SMCs at time 2, 3, and 4 will mediate the relationship between memory functioning X NA traits and anxiety symptoms or disorders at time 2,3 and 4. In Proposed Study 3, our model is tested with stressful life events as the moderator and perceived stress as the mediator. Participants will be 350 older adults 65-years of age or older. Participants will be independent, community-dwelling, older adults or older adults residing in retirement communities and supported living settings. Participants will be ethnically diverse and will be recruited from multiple sites. The proposed studies will provide a basic understanding of the impact of late-life developmental changes (e.g., increased health difficulties; cognitive decline; general stress) on anxiety symptoms and disorders and the role emotion (reflective of long-standing affective traits or late-life affect changes) play in adjusting to age-related changes. Elucidation of these core processes may lead to future refinements in anxiety disorder interventions or the development of prevention programs.

描述（由申请人提供）：焦虑症在老年人中很常见，但关于风险或保护因素的信息很少。需要增加对晚期焦虑的发育轨迹的了解，以改善干预措施并降低这些常见疾病的流行率。在三项提出的研究中，我们使用顺序回归分析和路径分析来测试特定的，可延展的心理特征（情感特征）是否与特定的晚期发育变化或一般压力源相互作用，以使人们过度关注健康状况，认知功能或对其他压力源的反应性。我们测试健康问题，认知功能问题和压力反应性是否会导致在三个未来时间点增加焦虑症状。评估了对拟议模型的特定方面的六项初步研究。在初步研究中发现了对焦虑的恐惧和恐慌症状之间的关联1。在初步研究2中，特定的负面影响（NA）特征预测了应对呼吸机断奶的严格性和早期断奶的成功。在初步研究3中，几个NA特征预测了健康困扰/疾病恐惧（HD）和情感特征与客观健康状况相互作用以预测HD的独特差异。在对与焦虑有关的身体感觉的恐惧中，健康困难更大且得分更高的老年人经历了更多的高清。在初步研究4中，在认知完整，轻度受损和显着损害的老年人中发现了大致相等的主观记忆投诉（SMC），并且抑郁评分与这些抱怨相关。在初步研究5中，精神丧失能力恐惧是对焦虑的恐惧的组成部分，在控制客观记忆功能和其他NA特征后预测了SMC。在初级多样化的老年人样本中，在初步研究6中评估了核心情感性状与HD之间的关系。在初步数据分析中，抑郁症（D），性状焦虑（TA）和焦虑敏感性（AS）与HD相关（RE = .59，.66，.40），HD与Hamilton焦虑量表的分数相关（HARS； HARS； R = .75，P <.05）。在拟议的研究1中，采用纵向分析来确定350名认知完整参与者的健康状况，D，TA，AS，HD，HD，HD和焦虑症状和疾病之间的关系。我们测试了一个主持人定位器模型，并预测，时间1的NA性状将与目标健康状况相互作用，在2、3和4时产生HD的增加。我们预测，患有更多健康问题和升高的NA性状的老年人将经历更多的HD，并且时间为2，3，或4在时间2，3或4将介导健康状况X NA和焦虑症状X NA和焦虑症状和疾病症状或疾病。在拟议的研究2中，我们评估了认知功能，NA性状，SMC和焦虑症状以及认知完整和轻度认知受损的老年人之间的关系。 We predict that specific NA traits at time 1 will interact with objective memory functioning to predict SMCs at time 2,3, and 4. We predict that SMCs at time 2, 3, and 4 will mediate the relationship between memory functioning X NA traits and anxiety symptoms or disorders at time 2,3 and 4. In Proposed Study 3, our model is tested with stressful life events as the moderator and perceived stress as the mediator.参与者将是350名65岁以上的老年人。参与者将是独立的，社区居民，老年人或居住在退休社区和支持生活环境中的老年人。参与者将在种族上多样化，并将从多个站点招募。拟议的研究将提供对晚期发展变化的影响（例如，健康困难；认知能力下降；一般压力）对焦虑症状和疾病的影响以及情感（反映长期存在的情感性状或后期影响）在适应与年龄相关的变化方面发挥的作用。阐明这些核心过程可能会导致焦虑症干预措施或预防计划的发展。