{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T21:23:30Z","timestamp":1773091410464,"version":"3.50.1"},"reference-count":39,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2020,12,4]],"date-time":"2020-12-04T00:00:00Z","timestamp":1607040000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["PI18CIII\/00046"],"award-info":[{"award-number":["PI18CIII\/00046"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>This study focuses on the influence of anxiety and depression on individual trajectories of quality of life in old age through a longitudinal approach. A representative sample of adults aged 50+ living in Portugal and participating in wave 4 (W4) and wave 6 (W6) of the Survey of Health, Ageing and Retirement in Europe (SHARE) project was considered. Participants, 1765 at baseline (W4) and 1201 at follow up (W6), were asked about their quality of life (CASP-12) and emotional status (Euro-D scale; five items from the Beck Anxiety Inventory). Linear Mixed Effects models were performed to identify factors associated with changes in quality of life across age. Increasing age was found to have a significant negative effect on quality of life. Lower education and higher levels of depression and anxiety at baseline were also associated with worse quality of life; 42.1% of the variation of CASP-12 across age was explained by fixed and random effects, being depression followed by anxiety as the factors that presented with the highest relative importance. Both depression and anxiety play an important role in quality of life in older adults and must be acknowledged as important intervention domains to foster healthy and active aging.<\/jats:p>","DOI":"10.3390\/ijerph17239039","type":"journal-article","created":{"date-parts":[[2020,12,4]],"date-time":"2020-12-04T11:59:00Z","timestamp":1607083140000},"page":"9039","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":111,"title":["Anxiety, Depression and Quality of Life in Older Adults: Trajectories of Influence across Age"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4740-7951","authenticated-orcid":false,"given":"Oscar","family":"Ribeiro","sequence":"first","affiliation":[{"name":"Center for Health Technology and Services Research (CINTESIS), Department of Education and Psychology, University of Aveiro, 3810-193 Aveiro, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9276-3683","authenticated-orcid":false,"given":"Laetitia","family":"Teixeira","sequence":"additional","affiliation":[{"name":"Center for Health Technology and Services Research (CINTESIS), Institute of Biomedical Sciences Abel Salazar, Department of Population Studies, University of Porto, 4050-313 Porto, Portugal"}]},{"given":"Lia","family":"Ara\u00fajo","sequence":"additional","affiliation":[{"name":"Center for Health Technology and Services Research (CINTESIS), School of Education, Polytechnic Institute of Viseu (ESEV.IPV), 3504-510 Viseu, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3829-0675","authenticated-orcid":false,"given":"Carmen","family":"Rodr\u00edguez-Bl\u00e1zquez","sequence":"additional","affiliation":[{"name":"National Centre of Epidemiology, Carlos III Health Institute and CIBERNED, 28029 Madrid, Spain"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9064-9222","authenticated-orcid":false,"given":"Amaia","family":"Calder\u00f3n-Larra\u00f1aga","sequence":"additional","affiliation":[{"name":"Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and REDISSEC, 17165 Solna, Sweden"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3935-962X","authenticated-orcid":false,"given":"Maria Jo\u00e3o","family":"Forjaz","sequence":"additional","affiliation":[{"name":"National Centre of Epidemiology, Carlos III Health Institute and REDISSEC, 28029 Madrid, Spain"}]}],"member":"1968","published-online":{"date-parts":[[2020,12,4]]},"reference":[{"key":"ref_1","unstructured":"United Nations (2020, October 11). World Population Ageing Highlights. Available online: https:\/\/www.un.org\/en\/development\/desa\/population\/publications\/pdf\/ageing\/WPA2015_Highlights.pdf."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1093\/geront\/gnu028","article-title":"Active and Successful Aging: A European Policy Perspective","volume":"55","author":"Foster","year":"2015","journal-title":"Gerontologist"},{"key":"ref_3","unstructured":"WHO (World Health Organization) (2002). Active Aging: A Policy Framework, World Health Organization."},{"key":"ref_4","unstructured":"ILC (International Longevity Centre)\u2014Brazil (2015). Active Ageing\u2014A Policy Framework in Response to the Longevity Revolution, ILC-Brazil."},{"key":"ref_5","unstructured":"WHO (1997). WHOQOL: Measuring Quality-of-Life, World Health Organization."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1186\/1477-7525-9-13","article-title":"Psychological approach to successful ageing predicts future quality of life in older adults","volume":"9","author":"Bowling","year":"2011","journal-title":"Health Qual. Life Outcomes"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1059","DOI":"10.1007\/s11136-016-1436-x","article-title":"Quality of life in people aged 65+ in Europe: Associated factors and models of social welfare\u2014Analysis of data from the SHARE project (Wave 5)","volume":"26","year":"2017","journal-title":"Qual. Life Res."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1136\/jech.2005.040071","article-title":"Quality of life at older ages: Evidence from the English longitudinal study of aging (wave 1)","volume":"60","author":"Netuveli","year":"2006","journal-title":"J. Epidemiol. Community Health"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1016\/j.ejpsy.2017.11.002","article-title":"Depression and variables associated with quality of life in people over 65 in Spain and Europe - Data from SHARE","volume":"32","year":"2018","journal-title":"Eur. J. Psychiatry"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"S117","DOI":"10.1111\/j.1468-2397.2012.00871.x","article-title":"Active ageing: A strategic policy solution to demographic ageing in the European Union","volume":"21","author":"Walker","year":"2012","journal-title":"Int. J. Soc. Welf."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"181","DOI":"10.3389\/fmed.2017.00181","article-title":"Active Ageing in Old Age and the Relevance of Psychological Factors","volume":"4","author":"Ribeiro","year":"2017","journal-title":"Front. Med."},{"key":"ref_12","unstructured":"Brown, J., Bowling, A., and Flynn, T. (2004). Models of Quality of Life: A Taxonomy, Overview and Systematic Review of the Literature, European Forum on Population Ageing Research."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1260","DOI":"10.1002\/gps.2675","article-title":"Age and anxiety and depressive symptoms: The effect on domains of quality of life","volume":"12","author":"Brown","year":"2011","journal-title":"Int. J. Geriatr. Psychiatry"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1111\/ajag.12102","article-title":"Relationship between anxiety and quality of life in older mental health patients","volume":"33","author":"Sarma","year":"2014","journal-title":"Australas. J. Ageing"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1192\/bjp.bp.115.180463","article-title":"Prevalence of mental disorders in elderly people: The European MentDis_ICF65+ study","volume":"210","author":"Andreas","year":"2017","journal-title":"Br. J. Psychiatry"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"196","DOI":"10.3389\/fmed.2017.00196","article-title":"Anxiety and Depression in the Portuguese Older Adults: Prevalence and Associated Factors","volume":"4","author":"Sousa","year":"2017","journal-title":"Front. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e027218","DOI":"10.1136\/bmjopen-2018-027218","article-title":"Association between anxiety, depression and quality of life: Study protocol for a systematic review of evidence from longitudinal studies","volume":"9","author":"Hohls","year":"2019","journal-title":"BMJ Open"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"B\u00f6rsch-Supan, A. (2019). Survey of Health, Ageing and Retirement in Europe (SHARE) Wave 4, Munich Center for the Economics of Aging (MEA). Release Version: 7.1. SHARE-ERIC.","DOI":"10.1007\/978-3-319-69892-2_348-1"},{"key":"ref_19","unstructured":"Bo\u00f6rsch-Supan, A. (2019). Survey of Health, Ageing and Retirement in Europe (SHARE) Wave 6, Munich Center for the Economics of Aging (MEA). Release Version: 7.0.0; SHARE-ERIC."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"992","DOI":"10.1093\/ije\/dyt088","article-title":"Data Resource Profile: The Survey of Health, Ageing and Retirement in Europe (SHARE)","volume":"42","author":"Brandt","year":"2013","journal-title":"Int. J. Epidemiol."},{"key":"ref_21","unstructured":"Malter, F., and B\u00f6rsch-Supan, A. (2013). SHARE Wave 4: Innovations & Methodology, MEA, Max Planck Institute for Social Law and Social Policy."},{"key":"ref_22","unstructured":"Malter, F., and B\u00f6rsch-Supan, A. (2017). SHARE Wave 6: Panel Innovations and Collecting Dried Blood Spots, MEA, Max Planck Institute for Social Law and Social Policy."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Rodr\u00edguez-Bl\u00e1zquez, C., Ribeiro, O., Ayala, A., Teixeira, L., Ara\u00fajo, L., and Forjaz, M.J. (2020). Measurement attributes of the European Portuguese version of the CASP-12 used in the Survey of Health, Ageing and Retirement in Europe (SHARE) Project. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17186610"},{"key":"ref_24","unstructured":"Borsch-Supan, A., Nrugiavini, A., Jurges, H., Mackenbach, J., Siegriest, J., and Weber, G. (2005). Quality of life and wellbeing. Health, Ageing and Retirement in Europe: First Results from the Survey of Health, Ageing and Retirement in Europe, MEA."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1007\/s11205-007-9220-5","article-title":"The Evaluation of a Self-enumerated Scale of Quality of Life (CASP-19) in the Context of Research on Ageing: A Combination of Exploratory and Confirmatory Approaches","volume":"89","author":"Wiggins","year":"2008","journal-title":"Soc. Indic. Res."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1192\/bjp.174.4.330","article-title":"Development of the EURO-D scale\u2014A European, Union initiative to compare symptoms of depression in 14 European centres","volume":"174","author":"Prince","year":"1999","journal-title":"Br. J. Psychiatry"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"893","DOI":"10.1037\/0022-006X.56.6.893","article-title":"An inventory for measuring clinical anxiety: Psychometric properties","volume":"56","author":"Beck","year":"1988","journal-title":"J. Consult. Clin. Psychol."},{"key":"ref_28","unstructured":"UNESCO (2012). International Standard Classification of Education ISCED 2011, UNESCO Institute for Statistics."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"576","DOI":"10.1080\/13607863.2014.1003279","article-title":"Delineating the third age: Joint models of older people\u2019s quality of life and attrition in Britain 2002\u20132010","volume":"19","author":"Tampubolon","year":"2015","journal-title":"Aging Ment. Health"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1007\/s11136-018-1997-y","article-title":"More than health: Quality of life trajectories among older adults\u2014Findings from the Irish Longitudinal Study of Ageing (TILDA)","volume":"28","author":"Ward","year":"2019","journal-title":"Qual. Life Res."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1093\/bmb\/ldn003","article-title":"Quality of life in older ages","volume":"85","author":"Netuveli","year":"2008","journal-title":"Br. Med. Bull."},{"key":"ref_32","first-page":"361","article-title":"Quality of life and well-being of elderly people: An exploratory study in the Portuguese population","volume":"37","author":"Sousa","year":"2003","journal-title":"Rev. Port. Sa\u00fade Publica"},{"key":"ref_33","unstructured":"Borrat-Besson, C., Ryser, V., and Gon\u00e7alves, J. (2015). An Evaluation of the CASP-12 Scale Used in the Survey of Ageing and Retirement in Europe (SHARE) to Measure Quality of Life among People Aged 50+, FORS."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"532","DOI":"10.1037\/pag0000108","article-title":"Anxiety in late adulthood: Associations with gender, education, and physical and cognitive functioning","volume":"31","author":"Tetzner","year":"2016","journal-title":"Psychol. Aging"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1037\/0882-7974.16.2.187","article-title":"A longitudinal analysis of anxiety and depressive symptoms","volume":"16","author":"Wetherell","year":"2001","journal-title":"Psychol. Aging"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"106073","DOI":"10.1016\/j.ypmed.2020.106073","article-title":"Socioeconomic position and quality of life among older people: The mediating role of social support","volume":"135","author":"Henriques","year":"2020","journal-title":"Prev. Med."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1007\/s10433-009-0112-1","article-title":"Welfare states and quality of later life: Distributions and pre- dictions in a comparative perspective","volume":"6","author":"Betzin","year":"2009","journal-title":"Eur. J. Ageing"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1195","DOI":"10.1007\/s11205-017-1828-5","article-title":"What is Happening with Quality of Life Among the Oldest People in Southern European Countries? An Empirical Approach Based on the SHARE Data","volume":"140","year":"2018","journal-title":"Soc. Indic. Res."},{"key":"ref_39","unstructured":"EU (European Union) (2019). Ageing Europe: Looking at the Lives of Older People in the EU, Publications Office of the European Union."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/17\/23\/9039\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T10:41:21Z","timestamp":1760179281000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/17\/23\/9039"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,12,4]]},"references-count":39,"journal-issue":{"issue":"23","published-online":{"date-parts":[[2020,12]]}},"alternative-id":["ijerph17239039"],"URL":"https:\/\/doi.org\/10.3390\/ijerph17239039","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,12,4]]}}}