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Predictors of change in quality of life in older adults with generalized anxiety disorder

Published online by Cambridge University Press:  12 December 2014

Srijana Shrestha ,
Melinda A. Stanley ,
Nancy L. Wilson ,
Jeffrey A. Cully ,
Mark E. Kunik ,
Diane M. Novy ,
Howard M. Rhoades  and
Amber B. Amspoker
Srijana Shrestha*
Affiliation:
VA HSR&D Houston Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, (MEDVAMC 152), 2002 Holcombe Blvd., Houston, TX 77030, USA Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA Department of Psychology, University of St. Thomas, Houston, TX, USA VA South Central Mental Illness Research, Education and Clinical Center (a virtual center)
Melinda A. Stanley
Affiliation:
VA HSR&D Houston Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, (MEDVAMC 152), 2002 Holcombe Blvd., Houston, TX 77030, USA Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA VA South Central Mental Illness Research, Education and Clinical Center (a virtual center)
Nancy L. Wilson
Affiliation:
VA HSR&D Houston Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, (MEDVAMC 152), 2002 Holcombe Blvd., Houston, TX 77030, USA Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA
Jeffrey A. Cully
Affiliation:
VA HSR&D Houston Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, (MEDVAMC 152), 2002 Holcombe Blvd., Houston, TX 77030, USA Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA VA South Central Mental Illness Research, Education and Clinical Center (a virtual center)
Mark E. Kunik
Affiliation:
VA HSR&D Houston Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, (MEDVAMC 152), 2002 Holcombe Blvd., Houston, TX 77030, USA Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA VA South Central Mental Illness Research, Education and Clinical Center (a virtual center)
Diane M. Novy
Affiliation:
Department of Anesthesiology and Pain Medicine, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Blvd., Unit 409, Houston, TX 77030, USA
Howard M. Rhoades
Affiliation:
Harris County Psychiatric Center, The University of Texas Health Sciences Center, P.O. Box 20249, Houston, TX 77225, USA
Amber B. Amspoker
Affiliation:
VA HSR&D Houston Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, (MEDVAMC 152), 2002 Holcombe Blvd., Houston, TX 77030, USA Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA
*
Correspondence should be addressed to: Srijana Shrestha, PhD, Psychology Department, 3800 Montrose Blvd. Houston, TX 77006, USA. Email: shrests@stthom.edu.
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Abstract

Background:

Quality of life (QOL) is lower in older adults with generalized anxiety disorder (GAD). QOL generally improves following cognitive-behavioral treatment for GAD. Little is known, however, about additional variables predicting changes in QOL in older adults with GAD. This study examined predictors of change in QOL among older participants in a randomized clinical trial of cognitive behavioral therapy (CBT) for GAD, relative to enhanced usual care (EUC).

Methods:

Hierarchical multilevel mixed-model analyses were used to examine inter-individual and intra-individual factors that predicted QOL over time. Predictors were categorized into treatment, personal and clinical characteristics.

Results:

QOL improved over time, and there was significant variability between participants in change in QOL. Controlling for treatment condition, baseline general self-efficacy, baseline social support, within-person variation in worry and depression and average levels of depression across different time points predicted changes in QOL.

Conclusions:

QOL has increasingly been used as an outcome measure in treatment outcome studies to focus on overall improvement in functioning. Attention to improvement in symptoms of depression and worry, along with psychosocial variables, such as social support and self-efficacy, may help improve QOL in older adults with GAD.

This study was a secondary study of data from a randomized clinical trial (NCT00308724) registered with clinical.trials.gov.

Keywords

generalized anxiety disorderquality of lifepredictorsolder adults
Type
Research Article
Information
International Psychogeriatrics , Volume 27 , Special Issue 7: Late Life Anxiety , July 2015 , pp. 1207 - 1215
Copyright
Copyright © International Psychogeriatric Association 2014 

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