The correlates of anxiety among older adults in nursing homes and other residential aged care facilities: A systematic review

Objective: To synthesize and summarize the studies examining the correlates and predictors of anxiety in older adults living in residential aged care. Methods: Using the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines, five electronic databases were searched using key terms and subject headings, as well as reference lists of relevant papers. The search was limited to peer‐reviewed literature published in English. Eligible studies examined the association between at least one correlate/factor and anxiety disorders or symptoms in aged care residents aged 50+ years. Results: A total of 3741 articles were identified, of which 34 studies (with a total of 1 543 554 participants) were included in this review. Correlates associated with anxiety included pain, use of anti‐depressants/lithium, depression, and lower perceived quality of life. Less consistent and/or less studied variables included younger age, female gender, higher educational level, functional dependence, subjective health status, more prescribed medications, impaired vision, insomnia, external locus of control, fear of falling, attachment, hope, meaning in life, and the influence of social, environmental, and staff/policy correlates. Conclusions: While several variables were found to have strong associations with anxiety in aged care residents, a number of factors have been examined by only one or two studies. Further research (preferably prospective studies) is therefore needed to reliably confirm findings and to help plan and develop preventative and intervention strategies. Copyright © 2016 John Wiley & Sons, Ltd.