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Anxiety symptoms and decline in physical function over 5 years in the health, aging and body composition study
Kala M Mehta1, Kristine Yaffe, Gretchen A Brenes
1Division of Geriatrics, Department of Psychiatry, University of California at San Francisco, San Francisco, California, USA. kala.mehta@ucsf.edu
Objectives:
To examine the relationship between anxiety and functional decline.
Design:
A 5-year longitudinal cohort study of well-functioning adults.
Setting:
The Health, Aging and Body Composition (Health ABC) Study.
Participants:
Two thousand nine hundred forty adults aged 70 to 79 (48% male, 41% black), initially free of self-reported mobility difficulty.
Measurements:
In 1997/98, presence of three anxiety symptoms (feeling fearful, tense or keyed up, or shaky or nervous) from the Hopkins Symptom Checklist were ascertained. Physical function was examined over 5 years using the Health ABC performance battery (continuous range 0-4) consisting of chair stands, usual and narrow course gait speed, and difficulty with standing balance and self-reported mobility, defined as difficulty walking one-quarter of a mile or difficulty climbing 10 steps.
Results:
Participants with anxiety symptoms had similar baseline physical performance scores. After adjustment for potential confounders, subjects with anxiety symptoms had similar declines in physical performance over 5 years as participants without anxiety symptoms. Adults with anxiety symptoms were more likely to report incident mobility difficulty, with a hazard ratio of 1.4 (95% confidence interval=1.3-1.6), compared with adults without anxiety symptoms. These results persisted after adjustment for depressive symptoms, demographics, comorbidity, and use of antianxiety, depressant, and sedative hypnotic medications.
Conclusion:
Anxiety symptoms are not associated with declines in objectively measured physical performance over 5 years but are associated with declines in self-reported functioning. Future studies are needed to determine why anxiety has a differential effect on performance-based and self-reported measures of functioning.
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