Worried wellness: how meaningful is the concept in managing elderly patients?

The concept of "worried wellness" is poorly defined for research purposes, and little is known about the worried-well elderly. To study the incidence of worried wellness in the elderly and define the clinical utility of the term, researchers conducted a structured interview with 733 independently living community elderly and 250 elderly patients from a family practice residency-teaching practice. The interview combined standard subjective health questions with specific additional measures of worry to form a "worry" scale. The worry data were cross-tabulated with "wellness" parameters that included symptomatology, presence of chronic medical conditions, use of medical equipment, and activities of daily living. A wide range of prevalences for worry were found, depending on the measure used. Wellness data were more consistent: though the vast majority of elderly were fully functional, 9 out of 10 subjects had at least one medical condition. Cross-tabulation based on individual items from the worry and wellness measures yielded a prevalence of one-third or less, depending on the measure used. However, composite analyses for both liberal and conservative measures of worry disclosed very few cases of worried wellness in the patient or community samples. This finding points to a very low incidence of the phenomenon among the elderly and raises significant doubt about the clinical utility of the term "worried wellness."