Patient ethnicity and the identification of anxiety in elderly primary care patients.

Objectives: To examine the role of ethnicity and primary care physician (PCP) identification of anxiety in older adults.

Design: A cross-sectional survey conducted between 2001 and 2003.

Setting: Primary care offices in the Baltimore, Maryland, area.

Participants: A sample of 330 adults aged 65 and older from Maryland primary care practices with complete information on psychological status and physician assessments.

Measurements: PCPs were asked to rate anxiety on a Likert scale. Patient interviews included measures of psychological status and patient use of psychotropic medications.

Results: Older black patients were less likely than older white patients to be identified as anxious (unadjusted odds ratio (OR)=0.34, 95% confidence interval (CI)=0.18-0.64) and less likely to be taking psychotropic medications (unadjusted OR=0.40, 95% CI=0.20-0.81). In multivariate models that controlled for potentially influential characteristics including depression and anxiety symptoms, the association between identification (OR=0.30, 95% CI=0.15-0.61) with patient ethnicity remained significantly unchanged.

Conclusion: PCPs were less likely to identify older black Americans as anxious than white patients. An understanding of the role of ethnicity in the identification of anxiety is important for the screening and management of anxiety in elderly people.