Late-Onset Agoraphobia: General Population Incidence and Evidence for a Clinical Subtype
Abstract
Objective
Method
Results
Conclusions
Method
Sample
Measures
Standardized health interview.
Standardized clinical examination.
Standardized psychiatric interview.
Cognitive functioning.
Childhood environment.
Statistical Analysis
Results
Variable | Total (N=1,968) (%) | Agoraphobia | p | |
---|---|---|---|---|
Absent (N=1,764) (%) | Present (N=204) (%) | |||
Age (years) | 0.22 | |||
65–69 | 31.66 | 31.52 | 32.84 | |
70–74 | 35.37 | 34.81 | 40.20 | |
75–79 | 21.34 | 21.77 | 17.65 | |
≥80 | 11.64 | 11.90 | 9.31 | |
Sex | <0.001 | |||
Male | 41.77 | 43.65 | 25.49 | |
Female | 58.23 | 56.35 | 74.51 | |
Education level | 0.01 | |||
Low | 23.63 | 23.19 | 27.45 | |
Average | 29.17 | 28.23 | 37.25 | |
High | 47.21 | 48.58 | 35.29 | |
Body mass index | 0.84 | |||
<25 | 53.79 | 53.49 | 56.37 | |
25–29 | 37.91 | 38.16 | 35.78 | |
≥30 | 8.30 | 8.35 | 7.84 | |
Regular use of anti-inflammatory drugs for joint or back pain | 0.08 | |||
No | 87.74 | 87.40 | 90.69 | |
Yes | 12.26 | 12.60 | 9.31 | |
Hypertension (resting blood pressure ≥160/95 mmHg) or treated hypertension | 0.96 | |||
No | 55.18 | 55.05 | 56.37 | |
Yes | 44.82 | 44.95 | 43.63 | |
Cholesterol (quartiles) | 0.02 | |||
Lowest | 50.87 | 50.60 | 53.23 | |
Middle two | 25.05 | 26.16 | 15.42 | |
Highest | 24.08 | 23.24 | 31.34 | |
Diabetes (glycemia ≥7 mmol/L) or treated diabetes | 0.61 | |||
No | 91.02 | 91.01 | 91.09 | |
Yes | 8.98 | 8.99 | 8.91 | |
Respiratory problems (dyspnea, asthma, or bronchitis) | 0.006 | |||
No | 85.95 | 86.71 | 79.41 | |
Yes | 14.05 | 13.29 | 20.59 | |
Stroke | 0.90 | |||
No | 97.29 | 97.20 | 98.03 | |
Yes | 2.71 | 2.80 | 1.97 | |
Cardio- and cerebrovascular pathologies | 0.56 | |||
No | 76.68 | 76.64 | 76.96 | |
Yes | 23.32 | 23.36 | 23.04 | |
Osteoporosis monitoring | 0.17 | |||
No | 81.46 | 82.41 | 73.27 | |
Yes | 18.54 | 17.59 | 26.73 | |
Hospitalization for cancer (past 2 years) | 0.10 | |||
No | 98.58 | 98.70 | 97.55 | |
Yes | 1.42 | 1.30 | 2.45 | |
Chronic pathologies (number) | 0.11 | |||
0 | 36.74 | 36.90 | 35.29 | |
1–2 | 57.06 | 57.20 | 55.88 | |
≥3 | 6.20 | 5.90 | 8.82 | |
Benton Visual Retention Test score (lowest tertile) | 0.22 | |||
No | 61.48 | 62.21 | 55.17 | |
Yes | 38.52 | 37.79 | 44.83 | |
Isaacs Set Test score (lowest tertile, at 30 seconds) | 0.01 | |||
No | 67.79 | 68.74 | 59.50 | |
Yes | 32.21 | 31.26 | 40.50 | |
Hearing or visual deficiency | 0.93 | |||
No | 89.29 | 89.26 | 89.53 | |
Yes | 10.71 | 10.74 | 10.47 | |
Depressive symptoms | <0.001 | |||
None | 69.78 | 71.39 | 55.94 | |
Mild | 16.24 | 16.23 | 16.34 | |
Severe | 13.98 | 12.39 | 27.72 | |
History of major depression | 0.02 | |||
No | 74.82 | 75.87 | 65.67 | |
Yes | 25.18 | 24.13 | 34.33 | |
Spielberger trait anxiety scale score (highest tertile) | <0.001 | |||
No | 69.24 | 70.87 | 55.05 | |
Yes | 30.76 | 29.13 | 44.95 | |
Confinement (to bed, home, or neighborhood) | 0.35 | |||
No | 94.95 | 95.11 | 93.60 | |
Yes | 5.05 | 4.89 | 6.40 | |
Mobility limitation | 0.001 | |||
No | 61.69 | 63.10 | 49.50 | |
Yes | 38.31 | 36.90 | 50.50 | |
Incapacity for activities of daily living | 0.27 | |||
No | 96.01 | 96.17 | 94.58 | |
Yes | 3.99 | 3.83 | 5.42 | |
Falls (past months) | 0.002 | |||
No | 80.17 | 81.23 | 71.08 | |
Yes | 19.83 | 18.77 | 28.92 | |
Serious life event (at least one) | 0.43 | |||
No | 41.08 | 40.85 | 43.23 | |
Yes | 58.92 | 59.15 | 56.77 |
Variable | Two-Year Follow-Up (N=1,376)a | Four-Year Follow-Up (1,260)a | Analysis (N=1,461)a | ||||
---|---|---|---|---|---|---|---|
N | % | N | % | Odds Ratiob | 95% CI | p | |
Sex | |||||||
Male | 623 | 5.94 | 563 | 5.33 | 1.00 | ||
Female | 753 | 7.57 | 697 | 7.75 | 1.45 | 0.94–2.23 | 0.09 |
Education level | |||||||
Low | 291 | 9.62 | 272 | 4.04 | 1.00 | ||
Average | 381 | 6.30 | 350 | 10.0 | 0.82 | 0.45–1.47 | 0.50 |
High | 703 | 5.97 | 638 | 5.96 | 1.20 | 0.70–2.08 | 0.50 |
Body mass index | |||||||
<25 | 738 | 6.78 | 680 | 7.21 | 1.00 | ||
25–29 | 522 | 7.85 | 478 | 5.86 | 0.99 | 0.64–1.55 | 0.99 |
≥30 | 108 | 1.85 | 96 | 6.25 | 0.46 | 0.18–1.19 | 0.10 |
Regular use of anti-inflammatory drugs for joint or back pain | |||||||
No | 1,206 | 6.88 | 1,097 | 6.93 | 1.00 | ||
Yes | 161 | 5.59 | 155 | 4.52 | 0.69 | 0.34–1.39 | 0.30 |
Hypertension (resting blood pressure ≥160/95 mmHg) or treated hypertension | |||||||
No | 765 | 7.97 | 703 | 7.54 | 1.00 | ||
Yes | 611 | 5.40 | 557 | 5.57 | 0.69 | 0.44–1.07 | 0.10 |
Cholesterol (quartiles) | |||||||
Lowest | 697 | 7.03 | 640 | 6.72 | 1.00 | ||
Middle two | 343 | 6.12 | 316 | 7.28 | 1.05 | 0.62–1.79 | 0.84 |
Highest | 327 | 7.34 | 297 | 6.06 | 1.02 | 0.55–1.88 | 0.95 |
Diabetes (glycemia ≥7 mmol/L) or treated diabetes | |||||||
No | 1,246 | 6.42 | 1,144 | 6.82 | 1.00 | ||
Yes | 120 | 11.67 | 108 | 5.56 | 1.54 | 0.77–3.08 | 0.22 |
Respiratory problems (dyspnea, asthma, or bronchitis) | |||||||
No | 1,221 | 6.55 | 1,119 | 6.70 | 1.00 | ||
Yes | 150 | 9.33 | 133 | 6.77 | 1.50 | 0.78–2.85 | 0.22 |
Stroke | |||||||
No | 1,332 | 6.61 | 1,220 | 6.56 | 1.00 | ||
Yes | 34 | 11.76 | 30 | 6.67 | 2.07 | 0.59–7.24 | 0.25 |
Cardio- and cerebrovascular pathologies | |||||||
No | 1,073 | 6.62 | 979 | 7.05 | 1.00 | ||
Yes | 303 | 7.59 | 281 | 5.34 | 1.08 | 0.64–1.81 | 0.77 |
Osteoporosis monitoring | |||||||
No | 1,132 | 7.16 | 1,037 | 6.65 | 1.00 | ||
Yes | 230 | 5.22 | 212 | 7.08 | 0.82 | 0.45–1.47 | 0.50 |
Hospitalization for cancer (past 2 years) | |||||||
No | 1,363 | 6.82 | 1,246 | 6.66 | 1.00 | ||
Yes | 13 | 7.69 | 14 | 7.14 | 1.23 | 0.18–9.42 | 0.80 |
Number of chronic pathologies | |||||||
0 | 525 | 6.67 | 477 | 6.71 | 1.00 | ||
1–2 | 781 | 6.91 | 723 | 6.78 | 1.18 | 0.74–1.85 | 0.48 |
≥3 | 70 | 7.14 | 60 | 5.00 | 1.15 | 0.41–3.25 | 0.79 |
Benton Visual Retention Test score (lowest tertile) | |||||||
No | 880 | 5.68 | 799 | 6.51 | 1.00 | ||
Yes | 484 | 8.68 | 451 | 7.10 | 1.53 | 0.98–2.39 | 0.06 |
Isaacs Set Test score (lowest tertile, at 30 seconds) | |||||||
No | 912 | 6.47 | 841 | 6.42 | 1.00 | ||
Yes | 440 | 7.73 | 398 | 7.04 | 1.26 | 0.81–1.98 | 0.30 |
Hearing or visual deficiency | |||||||
No | 1,164 | 6.79 | 1,074 | 6.89 | 1.00 | ||
Yes | 123 | 8.13 | 109 | 3.67 | 0.94 | 0.44–2.01 | 0.87 |
Depressive symptoms | |||||||
None | 1,005 | 5.17 | 922 | 6.18 | 1.00 | ||
Mild | 206 | 5.83 | 190 | 7.37 | 1.29 | 0.71–2.36 | 0.41 |
Severe | 148 | 17.57 | 133 | 9.02 | 3.81 | 2.08–6.97 | <0.001 |
History of major depression | |||||||
No | 1,066 | 6.10 | 981 | 6.01 | 1.00 | ||
Yes | 299 | 9.03 | 269 | 8.92 | 1.70 | 1.05–2.74 | 0.03 |
Spielberger trait anxiety scale score (highest tertile) | |||||||
No | 967 | 5.27 | 896 | 5.47 | 1.00 | ||
Yes | 387 | 10.59 | 347 | 10.09 | 2.48 | 1.58–3.90 | <0.001 |
Confinement (to bed, home, or neighborhood) | |||||||
No | 1,341 | 6.71 | 1,218 | 6.81 | 1.00 | ||
Yes | 30 | 10.00 | 38 | 2.63 | 1.11 | 0.27–4.64 | 0.88 |
Mobility limitation | |||||||
No | 5.55 | 901 | 5.83 | 823 | 1.00 | ||
Yes | 8.74 | 446 | 8.29 | 410 | 2.33 | 1.43–3.81 | <0.001 |
Incapacity for activities of daily living | |||||||
No | 1,333 | 6.68 | 1,211 | 6.69 | 1.00 | ||
Yes | 32 | 12.50 | 37 | 5.41 | 1.82 | 0.53–6.19 | 0.34 |
Falls (past months) | |||||||
No | 1,113 | 6.56 | 1,026 | 7.12 | 1.00 | ||
Yes | 258 | 7.75 | 230 | 4.78 | 0.98 | 0.56–1.7 | 0.95 |
Serious life event (at least one) | |||||||
No | 560 | 6.79 | 505 | 5.74 | 1.00 | ||
Yes | 787 | 6.86 | 723 | 7.47 | 1.26 | 0.81–1.97 | 0.30 |
Discussion
Prevalence, Incidence, and Comorbidity
Risk Factors
References
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