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Am J Geriatr Psychiatry. 2012 Oct;20(10):887-94. doi: 10.1097/JGP.0b013e31822ccd8c.

The relationship of preparation for future care to depression and anxiety in older primary care patients at 2-year follow-up.

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  • 1Department of Psychiatry, University of Rochester School of Medicine and Dentistry, Rochester, NY 14620, USA. silvia



: Preparation for future care needs has been hypothesized to help older adults adjust to inevitable life and health transitions and thereby decrease the likelihood of developing depression or anxiety.


: A total of 190 primary care patients aged 65 years or more completed semistructured research interviews and mail-back surveys at study intake and 2 years later. Interviews included the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, the Hamilton Depression Rating Scale, Clinical Anxiety Scale and a measure of preparation for future care. Multiple regression analyses were used to determine the independent association of preparation for future care at intake with depression and anxiety severity at 2-year follow-up.


: Patients who had made more concrete plans at intake were less likely to meet criteria for depression diagnosis at follow-up. They also had lower anxiety severity scores. Patients who had avoided thinking about future care needs had greater depression symptom severity at follow-up. Findings were independent of potential confounds, including illness burden.


: Failure to prepare for future care is a novel putative risk marker for depression and anxiety in older adulthood. Clinicians should be aware that the lack of care planning and frank avoidance may pose a risk for depression and anxiety older their patients. Future research should explore the mechanisms of care planning's effects on subsequent mood.

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