Prevalence of mood, anxiety, and substance-abuse disorders for older Americans in the national comorbidity survey-replication

Am J Geriatr Psychiatry. 2009 Sep;17(9):769-81. doi: 10.1097/JGP.0b013e3181ad4f5a.

Abstract

Objectives: Current information on the prevalence of psychiatric disorders among older adults in the United States is lacking. Prevalence of anxiety, mood, and substance disorders was examined by age (18-44, 45-64, 65-74, and 75 years and older) and sex. Covariates of disorders for older adults (65 years and older) were explored.

Design: Cross-sectional epidemiologic study, using data from the National Comorbidity Survey-Replication.

Setting: Community-based epidemiologic survey.

Participants: Representative national sample of community-dwelling adults in the United States.

Measurements: The World Health Organization Composite International Diagnostic Interview was used to assess Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition psychiatric disorders.

Results: Prevalence of 12-month and lifetime mood, anxiety, and substance-use disorders was lower for older adults (65 years and older) than younger age groups: 2.6% for mood disorder, 7.0% for anxiety disorder, 0 for any substance-use disorder, and 8.5% for any of these disorders (for any disorder, 18-44 years = 27.6%, 45-64 years = 22.4%). Among older adults, presence of a 12-month anxiety disorder was associated with female sex, lower education, being unmarried, and three or more chronic conditions. Presence of a 12-month mood disorder was associated with disability. Similar patterns were noted for lifetime disorders (any disorder: 18-44 years = 46.4%, 45-64 years = 43.7%, and 65 years and older = 20.9%).

Conclusions: This study documents the continued pattern of lower rates of formal diagnoses for elders. These rates likely underestimate the burden of late-life psychiatric disorders, given the potential for underdiagnosis, clinical significance of subthreshold symptoms, and lack of representation from high-risk older adults (e.g., medically ill, long-term care residents).

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Anxiety Disorders / diagnosis
  • Anxiety Disorders / epidemiology*
  • Comorbidity
  • Cross-Sectional Studies
  • Female
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Mood Disorders / diagnosis
  • Mood Disorders / epidemiology*
  • Prevalence
  • Sex Factors
  • Socioeconomic Factors
  • Substance-Related Disorders / diagnosis
  • Substance-Related Disorders / epidemiology*
  • Surveys and Questionnaires
  • United States / epidemiology
  • Young Adult