Distinctions between depression and anxiety with fear of being a burden in late life

Abstract

Objectives: The perception of being a burden is a well-known risk factor for dying by suicide. Research on factors that precede the state of perceived burdensomeness, such as fearing being a burden, is necessary. We investigated the extent to which health status, elevated depressive symptoms, and elevated anxiety symptoms are associated with fear of being a burden in late life.

Method: Older adult participants (N = 155) completed the Geriatric Anxiety Scale (GAS), Patient Health Questionnaire (PHQ-8), and demographic and health questions. Fear of being a burden, assessed with a supplemental item on the GAS, was categorically grouped as ‘no fear’ or ‘some fear’. Using logistic regression, we examined predictors of fear of being a burden.

Results: In the first step, elevated depression was associated with fear of being a burden (OR = 2.30, 95% CI: 1.09, 4.89, p = .03), but health status was not significant. In the second step, elevated anxiety was significant (OR = 2.63, 95% CI: 1.15, 5.99, p = .02); depression was no longer significant.

Conclusion: Contrary to expectations, anxiety more strongly predicted fear of being a burden than depression. Future research should further investigate the role of anxiety in fear of being a burden and ways of intervening.

Keywords:

• Fear of being a burden
• late-life anxiety
• late-life depression
• older adults

Acknowledgements

Views expressed in this article are those of the authors and not necessarily those for the Department of Veterans Affairs or the Federal Government.

Disclosure statement

The authors report no conflict of interest.

Author’s contributions

A. Alfaro and C. Gould conceptualized the research question, designed the study, conducted analyses, and drafted the manuscript. C. Carlson collected portions of the data and edited the manuscript. D. Segal edited the manuscript. C. Gould obtained funding for the research, designed the study methodology, and supervised data acquisition.

Disclaimer

The work of Ana J. Alfaro was authored as part of her official duties as an Employee of the United StatesGovernment and is therefore a work of the United States Government. Ana J. Alfaro and Christine E. Gould hereby waive their right to assert copyright, but not their right to be named as co-authors in the article.

Additional information

Funding

This study was supported by a 2014 NARSAD Young Investigator Grant from the Brain & Behavior Research Foundation (PI: Gould) and a Career Development Award (IK2 RX001478; PI: Gould) from the United States (U.S.) Department of Veterans Affairs Rehabilitation Research and Development Service.