Clinical significance of worry and physical symptoms in late-life generalized anxiety disorder.

Abstract

Worry is a hallmark feature of generalized anxiety disorder (GAD). However, age-related changes in symptom presentation raise questions about the clinical significance of these symptom clusters in later life. The aim of this study was to explore the relative contribution of worry and physical symptom frequency to clinical significance associated with late-life GAD. A sample of 637 self-reported worriers (aged 65 years and older) was extracted from Wave 1 of the National Epidemiological Survey of Alcohol and Related Conditions. Consistent with previous findings, we observed reductions in worry frequency and increases in physical symptom frequency with increasing age of participants. Physical symptoms, but not worry symptoms, distinguished older adults with clinical and sub-threshold GAD. Whereas physical symptom count was associated with distress, occupational, and functional disability, worry count was only associated with distress. Among self-reported worriers, worry frequency provides limited clinical utility over and above physical symptom frequency. These findings suggest that physical symptom frequency may become an increasingly important feature of GAD in later life.