Multimorbidity and Anxiety Symptoms among Adults Aged 50 Years and Over from Six Low- and Middle-Income Countries

Abstract

Currently, there are limited data on the association between multimorbidity (i.e., ≥ 2 chronic conditions) and anxiety, especially among the older population in low- and middle-income countries (LMICs). Thus, the aim of the present study was to examine the association between multimorbidity and anxiety symptoms in a large sample of adults aged ≥ 50 years from six LMICs (China, India, Ghana, Mexico, Russia, South Africa). Cross-sectional, nationally representative, community-based data from the Study on Global Ageing and Adult Health (SAGE) were analysed. A total of 11 chronic physical conditions were assessed. Anxiety symptoms referred to extreme/severe problems with worry or anxiety in the past 30 days. Multivariable logistic regression and meta-analyses were conducted. Data on 34,129 adults aged ≥ 50 years were analysed (mean (SD) age 62.4 (16.0) years; 52.1% females). Compared with no chronic conditions, 2, 3, 4, and ≥ 5 chronic conditions were significantly associated with 1.47 (95% CI = 1.08–1.98), 2.46 (95% CI = 1.74–3.47), 3.04 (95% CI = 2.15–4.30), and 4.70 (95% CI = 2.99–7.38) times higher odds of anxiety symptoms, respectively. A country-wise analysis showed that multimorbidity was significantly associated with anxiety symptoms in all six countries (OR = 1.78–12.39) with the overall estimate based on a meta-analysis being OR = 2.29 (95% CI = 1.71–3.07). Multimorbidity was associated with higher odds of anxiety symptoms among older adults in LMICs. Future longitudinal studies are warranted to assess the temporal associations and mechanisms underlying this association.

Prevalence of COVID‐19 anxiety, geriatric anxiety, and related factors among the elderly in Quchan, Iran during the COVID‐19 pandemic: a cross‐sectional study

“…These medications can elevate the risk of falls, drowsiness, and related costs, thereby contributing to increased anxiety. 43 Wongpakara et al also reported a relationship between polypharmacy and heightened anxiety in their study. 44 Furthermore, the elderly often need to invest a significant amount of time searching for health care to manage their multiple health conditions, further exacerbating their anxiety.…”

“…44 Furthermore, the elderly often need to invest a significant amount of time searching for health care to manage their multiple health conditions, further exacerbating their anxiety. 43 In this study, it was observed that elderly individuals who engaged in regular daily walks experienced lower levels of anxiety. This finding aligns with the results of studies conducted by Lu L et al, and Sirin et al 40,45 Exercise, particularly through activities like daily walking, stands out as one of the most important and accessible methods to manage anxiety among the elderly.…”

“…also reported a relationship between polypharmacy and heightened anxiety in their study 44 . Furthermore, the elderly often need to invest a significant amount of time searching for health care to manage their multiple health conditions, further exacerbating their anxiety 43 …”

“…Dealing with multiple diseases simultaneously often requires the elderly to take numerous medications. These medications can elevate the risk of falls, drowsiness, and related costs, thereby contributing to increased anxiety 43 . Wongpakara et al .…”

Research trends in the mental health and multimorbidity of older people from 2002 to 2022: A bibliometric analysis via CiteSpace

“…In addition, mental disorders impede patients from seeking treatments, making multimorbidity management more complex and challenging. Furthermore, A cross-sectional study involving over six low and middle-income countries highlighted increased risks among the elderly with multimorbidity and anxiety ( 9 ).…”