Illness burden and symptoms of anxiety in older adults: optimism and pessimism as moderators

Background: We assessed the association between medical illness burden and anxiety symptoms, hypothesizing that greater illness burden would be associated with symptoms of anxiety, and that optimism would buffer, while pessimism would exacerbate, this relationship. Methods: We recruited 109 older adults, aged 65 years and older, from primary care and geriatric clinics to participate in this cross-sectional, interview-based study. Participants completed the Snaith Clinical Anxiety Scale and the Life Orientation Test -Revised, a measure of optimism/pessimism. A physician-rated measure of illness burden, the Cumulative Illness Rating Scale, was also administered. Results: Supporting our hypotheses, greater levels of overall optimism weakened, and pessimism strengthened, the association between illness burden and anxiety symptoms, after accounting for the effects of demographic, cognitive, functional, and psychological covariates. Conclusions: Bolstering positive and reducing negative future expectancies may aid in the prevention of psychological distress in medically ill older adults. Therapeutic strategies to enhance optimism and reduce pessimism, which may be well-suited to primary care and other medical settings, and to which older adults may be particularly amenable, may contribute to reduced health-related anxiety.