Anxiety disorders and age-related changes in physiology

Abstract

Objective: Anxiety disorders are leading contributors to the global disease burden, highly prevalent across the lifespan, and associated with substantially increased morbidity and early mortality. The aim of this study was to examine age-related changes across a wide range of physiological measures in middle-aged and older adults with a lifetime history of anxiety disorders compared to healthy controls. Methods: The UK Biobank study recruited >500,000 adults, aged 37-73, between 2006-2010. We used generalised additive models to estimate non-linear associations between age and hand-grip strength, cardiovascular function, body composition, lung function and heel bone mineral density in cases vs. controls. Results: The main dataset included 332,078 adults (mean age = 56.37 years; 52.65% females). In both sexes, individuals with anxiety disorders had lower hand-grip strength and blood pressure, while their pulse rate and body composition measures were higher than in healthy controls. Case-control differences were larger when considering individuals with chronic and/or severe anxiety disorders, and differences in body composition were modulated by depression comorbidity status. Differences in age-related physiological changes between female anxiety disorder cases and healthy controls were most evident for blood pressure, pulse rate and body composition, while in males for hand-grip strength, blood pressure and body composition. Most differences in physiological measures between cases and controls tended to decrease with age increase. Conclusion: Individuals with a lifetime history of anxiety disorders differed from healthy controls across multiple physiological measures, with some evidence of case-control differences by age. The differences observed varied by chronicity/severity and depression comorbidity.

Frailty in individuals with depression, bipolar disorder and anxiety disorders: longitudinal analyses of all-cause mortality

“…This could have resulted in attenuated differences in frailty between individuals with and without mental disorders and reduced the corresponding mortality risk. For a discussion of the potential limitations regarding the ascertainment of individuals with mental disorders in the UK Biobank, see our previous studies [13][14][15]. There is conceptual overlap between frailty and some of the symptoms that characterise mental disorders, which could partially explain differences in frailty observed between individuals with and without mental disorders.…”

“…We identified individuals with a lifetime history of depression, bipolar disorder or anxiety disorders using criteria that we have reported elsewhere [13][14][15]. Cases were ascertained from multiple data sources: the modified Composite International Diagnostic Interview Short Form (CIDI-SF), self-report questions on (hypo) mania and a question on psychiatric diagnoses (UK Biobank data field 20544) which were assessed as part of the MHQ; the nurse-led baseline interview in which participants reported medical diagnoses (field 20002); hospital inpatient records (ICD-10 codes); primary care records (Read v2 or CTV3 codes) and self-report questions on mood disorders from the baseline assessment (field 20126).…”

“…A recent systematic review found that the prevalence of frailty in individuals with severe mental illness varied from 10.2 to 89.7% [10]. Individuals with mental disorders are at an increased risk of physical comorbidities [11], have a lower life expectancy [12], differ from individuals without mental disorders in physiological markers [13][14][15] and may experience accelerated biological ageing [16,17]. Frailty is associated with molecular indicators of ageing such as DNA methylation [18] and provides complementary information to other biomarkers [19,20].…”