Scared to Death: Anxiety Increases Mortality in Older Blacks

Screening for Anxiety as Important as for Depression

NEW ORLEANS—Anxiety symptoms were responsible for a nearly 3-fold increase in mortality among older black adults in a large study reported at the American Association of Geriatric Psychiatry annual meeting.

“We know that depression is associated with increased risk, but anxiety has been less evaluated,” lead investigator Gretchen Brenes, PhD, of Wake Forest University School of Medicine, Winston-Salem, NC, pointed out.

The Health, Aging, and Body Composition Study is an ongoing, prospective, community-based cohort trial of 3015 high-functioning, community-dwelling Medicare beneficiaries aged 70 to 79 years. Anxiety symptoms were assessed using 3 items from the Hopkins Symptom Checklist, and depression was assessed with the Center for Epidemiologic Studies Depression Scale.

After controlling for sociodemographic and disease-related factors, results showed that anxiety symptoms remained a significant predictor of all-cause mortality, with a hazard ratio of 2.86—but only in blacks, not in whites. Similar results were found for cardiovascular and noncardiovascular mortality in both unadjusted and adjusted models, Dr Brenes reported.

Gender was not a significant moderator of the anxiety—mortality association, and depression was not associated with mortality, she added.

“Older black adults who report symptoms of anxiety experience greater-than-expected mortality, independent of depression, sociodemographic, and disease-related factors,” she said. “We speculate that anxiety may be linked with a physical problem that may be associated with mortality, or that anxiety itself causes physiological changes that increase mortality risk.”

She observed that while primary care physicians are cognizant of the need to screen for depression, they give much less thought to anxiety symptoms. “Anxiety is underdetected, and, according to our findings, screening for anxiety can be as important as screening for depression.”