Lung Disease Ups Risk of Anxiety Disorder

New research discovers older adults with lung disease experience generalized anxiety disorder (GAD) on a much greater level than older adults without the disease.

Specifically, the prevalence of GAD for adults aged 50 and older with chronic obstructive pulmonary disease (COPD) is much higher compared to older adults without COPD (5.8 percent vs 1.7 percent).

University of Toronto researchers have published their findings in COPD: Journal of Chronic Obstructive Pulmonary Disease. The investigators found that individuals with COPD were three as likely to develop generalized anxiety disorder compared to those without.

COPD is an umbrella term for several chronic lung diseases including emphysema and chronic bronchitis. Individuals with COPD frequently exhibit sleep problems, chronic pain, and functional limitations.

The symptoms can partially explain some of the excess risk for anxiety among those with COPD compared although additional factors may be at play.

“Even after accounting for 18 possible risk factors for GAD, individuals with COPD still had 70 percent higher odds of GAD compared to those without COPD,” said lead author Dr. Esme Fuller-Thomson.

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 U.S.

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 included lack of social support and exposure to parental domestic violence during the older adults’ childhood.

Social support is a significant aid as 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.

Co-author and doctoral student Ashley Lacombe-Duncan said, “Our findings suggest that screening for anxiety may be particularly important for patients who lack a strong social network. Individuals with COPD may be prone to social isolation, particularly if they also experience functional limitations that impair mobility.”

Exposure to parental domestic violence in childhood also seems to play a key factor.

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.

Lacombe-Duncan said, “the chronic chaotic and violent home environment may have predisposed individuals to anxiety.

“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.”

Fuller-Thomson added that this study “highlights how health care 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.”

Source: University of Toronto
Doctor talking with patient about lung disease photo by shutterstock.