Prevalence and correlates of agoraphobia in older adults

Objective: Agoraphobia has been previously found to be a relatively prevalent disorder in the older adult. However, little is known about the nature of this disorder in the elderly population. The purpose of this study was to identify risk factors, illness characteristics, and comorbidity of agoraphobia in the elderly. Methods: This was a national community mental health survey that included 12,792 individuals >= 55 years. Agoraphobia was assessed using the World Mental Health Composite International Diagnostic Interview. Social, demographic, psychiatric, and physical variables previously found to be associated with agoraphobia in the adult population were measured. Bivariate and logistic regression analyses were used to examine these associations. Results: The prevalence of agoraphobia in adults over 55 was 0.61% (95% confidence interval [CI]: 0.40 - 0.82). In bivariate analysis, the condition was more common in the younger age groups, women, and those widowed or divorced. It was also more common in individuals with chronic health conditions and those with comorbid psychiatric disorders. However, in the multivariate model, chronic health conditions and panic disorder were no longer significant. Most cases of agoraphobia in the elderly were of early onset (age < 55 years). The majority of patients with agoraphobia did not have concurrent panic disorder. Conclusion: Lower prevalence rates of agoraphobia in the elderly were found compared with previous studies. The degree to which this is a measurement issue is discussed. The low correlation between agoraphobia and panic disorder raises further questions about the nature and etiology of agoraphobia in the elderly. Implications for future research and clinical practice are discussed.