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Anxiety disorders and age-related changes in physiology

Research output: Contribution to journalArticlepeer-review

Original languageEnglish
Pages (from-to)528-537
Number of pages10
JournalBritish Journal of Psychiatry
Issue number3
Early online date6 Jan 2022
Accepted/In press28 Nov 2021
E-pub ahead of print6 Jan 2022
Published14 Sep 2022

Bibliographical note

Funding Information: This research has been conducted using data from UK Biobank, a major biomedical database. This project made use of time on Rosalind HPC, funded by Guy's & St Thomas’ Hospital NHS Trust Biomedical Research Centre (GSTT-BRC), South London & Maudsley NHS Trust Biomedical Research Centre (SLAM-BRC), and Faculty of Natural Mathematics & Science (NMS) at King's College London. Funding Information: J.M. receives studentship funding from the Biotechnology and Biological Sciences Research Council (BBSRC) (ref: 2050702) and Eli Lilly and Company Limited. C.F. was supported by Fondazione Umberto Veronesi ( ). C.M.L. is part-funded by the National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. Funding Information: J.M. receives studentship funding from the Biotechnology and Biological Sciences Research Council (BBSRC) and Eli Lilly and Company Limited. C.F. has been a speaker for Janssen. C.M.L. is a member of the Scientific Advisory Board of Myriad Neuroscience. T.H.H. declares no relevant conflict of interest. Publisher Copyright: Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists.


King's Authors


Background Anxiety disorders are leading contributors to the global disease burden, highly prevalent across the lifespan and associated with substantially increased morbidity and early mortality. Aims The aim of this study was to examine age-related changes across a wide range of physiological measures in middle-aged and older adults with a lifetime history of anxiety disorders compared with healthy controls. Method The UK Biobank study recruited >500 000 adults, aged 37-73, between 2006 and 2010. We used generalised additive models to estimate non-linear associations between age and hand-grip strength, cardiovascular function, body composition, lung function and heel bone mineral density in a case group and in a control group. Results The main data-set included 332 078 adults (mean age 56.37 years; 52.65% females). In both sexes, individuals with anxiety disorders had a lower hand-grip strength and lower blood pressure, whereas their pulse rate and body composition measures were higher than in the healthy control group. Case-control group differences were larger when considering individuals with chronic and/or severe anxiety disorders, and differences in body composition were modulated by depression comorbidity status. Differences in age-related physiological changes between females in the anxiety disorder case group and healthy controls were most evident for blood pressure, pulse rate and body composition, whereas this was the case in males for hand-grip strength, blood pressure and body composition. Most differences in physiological measures between the case and control groups decreased with increasing age. Conclusions Findings in individuals with a lifetime history of anxiety disorders differed from a healthy control group across multiple physiological measures, with some evidence of case-control group differences by age. The differences observed varied by chronicity/severity and depression comorbidity.

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