Older adults with chronic obstructive pulmonary disease have more than three times the odds of generalized anxiety disorder than people without COPD, a new study shows.
COPD is an umbrella term for several chronic lung diseases including emphysema and chronic bronchitis. Sleep problems, chronic pain, and functional limitations partially explain some of this excess risk for anxiety, researchers say.
“Even after accounting for 18 possible risk factors for generalized anxiety disorder (GAD), individuals with COPD still had 70 percent higher odds of GAD compared to those without COPD,”
says lead author Esme Fuller-Thomson, chair at the University of Toronto’s Factor-Inwentash Faculty of Social Work.
The study was based upon a representative sample of 11,163 Canadians aged 50 and over drawn from the 2012 Canadian Community Health Survey. More than 700 of these older adults reported that they had been diagnosed by a health professional with COPD. COPD is now the third leading cause of death in the United States.
Screening for Anxiety
The study also investigated predictors of generalized anxiety disorders specifically among the older adults in the sample who had COPD. Key risk factors for GAD among those with COPD include lack of social support and exposure to parental domestic violence during the older adults’ childhood.
Older adults who do not have a confidant available for important decisions had more than seven times the odds of having anxiety in comparison to those with a confidant.
“Our findings suggest that screening for anxiety may be particularly important for patients who lack a strong social network,” says coauthor Ashley Lacombe-Duncan. “Individuals with COPD may be prone to social isolation, particularly if they also experience functional limitations that impair mobility.”
Older adults with COPD who were exposed in childhood to parental domestic violence on more than 10 occasions had five times the odds of generalized anxiety disorders in comparison to those with COPD who had not experienced this early adversity.
“The chronic chaotic and violent home environment may have predisposed individuals to anxiety,” Lacombe-Duncan says. “Further research is needed to understand the pathways through which witnessing chronic parental domestic violence during the respondent’s childhood may increase the prevalence of anxiety disorders among older adults with COPD.”
“[This study] highlights how healthcare providers can play a significant role in identifying and providing promising interventions to reduce anxiety for individuals with COPD, in particular by screening for and addressing pain and functional limitations and targeting those most at risk,” Fuller-Thomson says.