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. 2002 Nov;78(925):674–677. doi: 10.1136/pmj.78.925.674

Anxiety and depression in an older research population and their impact on clinical outcomes in a randomised controlled trial

S Allsup 1, M Gosney 1
PMCID: PMC1742575  PMID: 12496325

Abstract

Introduction: Anxiety and depression are common in older people living in the community. The aim of the study was to investigate their impact on clinical outcomes during a randomised controlled trial investigating the cost benefits of influenza vaccination in fit and healthy, independent living 65–74 year olds.

Subjects and methods: A total of 729 people were recruited. Participants completed the hospital anxiety and depression scale (HADS) and EuroQol EQ-5D quality of life questionnaire immediately before receiving vaccination and every two months for the next six months after this. Side effects three days after vaccination and Barthel score at baseline were also recorded.

Results: At baseline the prevalence of "definite" anxiety in this sample (HADS score ≥11) was 4% and 1.2% of individuals had definite depression (HADS score ≥11). Individuals with anxiety or depression (HADS score ≥8) were more likely to complain of systemic side effects after vaccination and have a lower Barthel index score (p<0.001). Quality of life as measured by the EQ-5D visual analogue scale was reduced (p<0.001) at all time periods in those individuals with both anxiety and depression (HADS score ≥8 on both scales).

Conclusion: Although the prevalence of anxiety and depression in this sample was low, people with anxiety or depression were more likely to suffer from perceived side effects after influenza vaccine and have a lower Barthel and EQ-5D visual analogue score. In future studies the effect of anxiety and depression on older participants should be remembered and care taken to ensure that they do not affect results more than the intervention under study.

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Selected References

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  1. Allsup S. J., Gosney M., Regan M., Haycox A., Fear S., Johnstone F. C. Side effects of influenza vaccination in healthy older people: a randomised single-blind placebo-controlled trial. Gerontology. 2001 Nov-Dec;47(6):311–314. doi: 10.1159/000052820. [DOI] [PubMed] [Google Scholar]
  2. Beekman A. T., Copeland J. R., Prince M. J. Review of community prevalence of depression in later life. Br J Psychiatry. 1999 Apr;174:307–311. doi: 10.1192/bjp.174.4.307. [DOI] [PubMed] [Google Scholar]
  3. Govaert T. M., Dinant G. J., Aretz K., Masurel N., Sprenger M. J., Knottnerus J. A. Adverse reactions to influenza vaccine in elderly people: randomised double blind placebo controlled trial. BMJ. 1993 Oct 16;307(6910):988–990. doi: 10.1136/bmj.307.6910.988. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Gupta A., Makinde K., Morris G., Thomas P., Hasan M. Influenza immunization coverage in older hospitalized patients during winter 1998-99 in Carmarthenshire, UK. Age Ageing. 2000 May;29(3):211–213. doi: 10.1093/ageing/29.3.211. [DOI] [PubMed] [Google Scholar]
  5. Herrmann C. International experiences with the Hospital Anxiety and Depression Scale--a review of validation data and clinical results. J Psychosom Res. 1997 Jan;42(1):17–41. doi: 10.1016/s0022-3999(96)00216-4. [DOI] [PubMed] [Google Scholar]
  6. Silverstone P. H. Poor efficacy of the Hospital Anxiety and Depression Scale in the diagnosis of major depressive disorder in both medical and psychiatric patients. J Psychosom Res. 1994 Jul;38(5):441–450. doi: 10.1016/0022-3999(94)90105-8. [DOI] [PubMed] [Google Scholar]
  7. Wells K. B., Stewart A., Hays R. D., Burnam M. A., Rogers W., Daniels M., Berry S., Greenfield S., Ware J. The functioning and well-being of depressed patients. Results from the Medical Outcomes Study. JAMA. 1989 Aug 18;262(7):914–919. [PubMed] [Google Scholar]
  8. Zigmond A. S., Snaith R. P. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983 Jun;67(6):361–370. doi: 10.1111/j.1600-0447.1983.tb09716.x. [DOI] [PubMed] [Google Scholar]
  9. de Beurs E., Beekman A. T., van Balkom A. J., Deeg D. J., van Dyck R., van Tilburg W. Consequences of anxiety in older persons: its effect on disability, well-being and use of health services. Psychol Med. 1999 May;29(3):583–593. doi: 10.1017/s0033291799008351. [DOI] [PubMed] [Google Scholar]
  10. van Essen G. A., Kuyvenhoven M. M., de Melker R. A. Why do healthy elderly people fail to comply with influenza vaccination? Age Ageing. 1997 Jul;26(4):275–279. doi: 10.1093/ageing/26.4.275. [DOI] [PubMed] [Google Scholar]

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