Understanding Risk Factors of Recurrent Anxiety Symptomatology in an Older Population with Mild to Severe Depressive Symptoms: A Bayesian Approach

Author:

Maekawa Eduardo12ORCID,de Sá Martins Mariana Mendes3,Nakamura Carina Akemi34ORCID,Araya Ricardo5ORCID,Peters Tim J.6ORCID,Van de Ven Pepijn12ORCID,Scazufca Marcia37ORCID

Affiliation:

1. Department of Electronic and Computer Engineering, University of Limerick, V94 T9PX Limerick, Ireland

2. Health Research Institute, University of Limerick, V94 T9PX Limerick, Ireland

3. Departamento de Psiquiatria, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo 05402-000, Brazil

4. Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA 02115, USA

5. Centre for Global Mental Health, King’s College London, London WC2R 2LS, UK

6. Bristol Dental School, University of Bristol, Bristol BS2 0PT, UK

7. Instituto de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-903, Brazil

Abstract

Anxiety in older individuals is understudied despite its prevalence. Investigating its occurrence can be challenging, yet understanding the factors influencing its recurrence is important. Gaining insights into these factors through an explainable, probabilistic approach can enhance improved management. A Bayesian network (BN) is well-suited for this purpose. This study aimed to model the recurrence of anxiety symptomatology in an older population within a five-month timeframe. Data included baseline socio-demographic and general health information for older adults aged 60 years or older with at least mild depressive symptoms. A BN model explored the relationship between baseline data and recurrent anxiety symptomatology. Model evaluation employed the Area Under the Receiver Operating Characteristic Curve (AUC). The BN model was also compared to four machine learning models. The model achieved an AUC of 0.821 on the test data, using a threshold of 0.367. The model demonstrated generalisation abilities while being less complex and more explainable than other machine learning models. Key factors associated with recurrence of anxiety symptomatology were: “Not being able to stop or control worrying”; “Becoming easily annoyed or irritable”; “Trouble relaxing”; and “depressive symptomatology severity”. These findings indicate a prioritised sequence of predictors to identify individuals most likely to experience recurrent anxiety symptomatology.

Funder

Science Foundation Ireland

Sao Paulo Research Foundation

Joint Global Health Trials initiative

Department of Health and Social Care

Foreign, Commonwealth & Development Office

Medical Research Council

Wellcome

FAPESP

CNPq-Brazil

Publisher

MDPI AG

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