A Longitudinal Analysis of Disparities of Depression and Anxiety Among U.S. Older Adults with Chronic Conditions within Different Age Groups

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Suffering chronic conditions greatly contribute to mental health problems like depression and anxiety among older adults. Although an array of literature has focused on this field of study, little research has examined how depression and anxiety change over time or differs from each age group from a developmental and comprehensive view. Purpose This study aims to understand the disparities of depression and anxiety of older adults with chronic conditions among different age groups. A longitudinal study will provide a holistic understanding of risk and protective factors associated with depression and anxiety to tailor and provide supportive services for older adults according to their changing needs. Methods This study applied the latest rounds (round 5 to round 9) of the National Health and Aging Trends Study (NHATS). In total, 3,541 older adults who were sample persons, had at least one chronic condition, and participated in all 5 rounds were included. The Transactional Theory of Stress and Coping (TTSC) model was utilized to select predictors. Descriptive analysis was conducted for all predictors, and generalized estimating equation (GEE) was applied to explore and identify the risk and protective factors. Results Age, race and ethnicity, self-rated health, number of chronic conditions, cognitive capacity, frequency of negative feelings, self-realization, self-efficacy and resilience, activity participation, and technology use were significantly associated with depression and anxiety. Besides, demographic factors like gender, marital status, and income were significantly associated with anxiety. Furthermore, depression may decrease over time but only happens in a relatively short time, and the extent of decline also slows down gradually. However, anxiety did not change over time. Conclusions The findings highlight the need to provide support and link resources to caregivers and call for efficient chronic condition management to provide early screening, assessment, and diagnosis. Recommendations from healthcare providers, proper education of healthy lifestyle and the dissemination of related information, and prompting older adults to engage in more physical activities can also make a difference in helping older adults gain better physical and mental health to prevent them from suffering depression and anxiety. Detailed implications are discussed.

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