International journal of geriatric psychiatry · 2026
Global Temporal Trends and Projections of Anxiety Disorders Prevalence Among the Older Adults: An Age-Period-Cohort Analysis Based on the GBD 2021.
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Wang Junwen, Yang Dianmei, Pan Peng, Ping Liangliang, Huang Ying, Shan Qing, Wang Yiming, Xia Kaide
Аннотация
BACKGROUND: Anxiety disorders in older adults impose a markedly greater disease burden than in younger individuals. This study provides an overview and analysis of temporal trends in the prevalence of anxiety disorders in older adults over the past 30 years, examining global, regional, and national patterns with a particular focus on age, period, and birth cohort effects.
METHODS: Estimates and 95% uncertainty intervals (UI) of anxiety disorder prevalence in older adults from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 were analyzed. Age-period-cohort (APC) models were used to estimate the overall annual percentage change in prevalence (net drift), the annual percentage change within each age group (local drift), and longitudinal age-specific ratios adjusted for stage bias (age effect) and period/cohort relative risk (period/cohort effect) from 1992 to 2021 at global, regional, and national levels. Nordpred APC model was utilized for forecasting future epidemiological trajectories.
RESULTS: From 1992 to 2021, the global prevalence of anxiety disorders in older adults increased markedly, with prevalence among women approximately double that among men. Age-standardized prevalence rates (ASPR) rose globally, particularly in low-middle socio-demographic index (SDI) regions, while high SDI regions saw smaller or even negative changes. In age groups, prevalence decreased in those aged 65-69 to 85-89, with little change in the 90+ group. High SDI regions exhibited stable or declining prevalence in younger age groups, whereas low SDI regions saw increased prevalence in older age groups. Gender differences were observed, with women showing higher and more consistent prevalence trends, while men exhibited rising rates in low SDI regions. Projections suggest that global cases of anxiety disorders among older adults will rise to 73.24 million by 2045, characterized by a higher prevalence in females and an increasing ASPR.
CONCLUSION: This study highlights the complex epidemiology of anxiety disorders in older adults, with global prevalence and ASPR projected to rise, demonstrating regional and national heterogeneity. Anxiety disorders will remain a concern for older adults through 2045. Gender differences, especially the increasing prevalence among men, should be considered in intervention strategies.
METHODS: Estimates and 95% uncertainty intervals (UI) of anxiety disorder prevalence in older adults from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 were analyzed. Age-period-cohort (APC) models were used to estimate the overall annual percentage change in prevalence (net drift), the annual percentage change within each age group (local drift), and longitudinal age-specific ratios adjusted for stage bias (age effect) and period/cohort relative risk (period/cohort effect) from 1992 to 2021 at global, regional, and national levels. Nordpred APC model was utilized for forecasting future epidemiological trajectories.
RESULTS: From 1992 to 2021, the global prevalence of anxiety disorders in older adults increased markedly, with prevalence among women approximately double that among men. Age-standardized prevalence rates (ASPR) rose globally, particularly in low-middle socio-demographic index (SDI) regions, while high SDI regions saw smaller or even negative changes. In age groups, prevalence decreased in those aged 65-69 to 85-89, with little change in the 90+ group. High SDI regions exhibited stable or declining prevalence in younger age groups, whereas low SDI regions saw increased prevalence in older age groups. Gender differences were observed, with women showing higher and more consistent prevalence trends, while men exhibited rising rates in low SDI regions. Projections suggest that global cases of anxiety disorders among older adults will rise to 73.24 million by 2045, characterized by a higher prevalence in females and an increasing ASPR.
CONCLUSION: This study highlights the complex epidemiology of anxiety disorders in older adults, with global prevalence and ASPR projected to rise, demonstrating regional and national heterogeneity. Anxiety disorders will remain a concern for older adults through 2045. Gender differences, especially the increasing prevalence among men, should be considered in intervention strategies.