Nutritional Factors, Physical Health and Immigrant Status Are Associated with Anxiety Disorders among Middle-Aged and Older Adults: Findings from Baseline Data of The Canadian Longitudinal Study on Aging (CLSA).

The main purpose of this study was to compare the lifetime prevalence of anxiety disorders among foreign-born and Canadian-born adults in middle and later life. Using baseline data of the Canadian Longitudinal Study on Aging (2010-2015), multivariable binary logistic regression was conducted to investigate anxiety diagnosis and immigrant status, while controlling for socio-economic, health-related, and nutrition covariates. Of 26,991 participants (49.3% men, 82.5% Canadian born, 58.5% aged 45-65 years), the overall prevalence of self-reported physician diagnosis of anxiety disorders was 8.5%, with immigrants being lower than Canadian-born respondents (6.4% vs. 9.3%, p < 0.001). After accounting for all covariates, the adjusted odds ratio (aOR) for anxiety disorders was lower among immigrants (aOR = 0.77, 95% CI: 0.67-0.88) compared to those who were Canadian born. Identified risk factors included: younger age (aORs = 1.79-3.52), being a woman (aOR = 1.25, 95% CI: 1.07-1.46), single status (aOR = 1.27, 95% CI: 1.09-1.48), lower income (aORs = 1.28-2.68), multi-morbidities (aORs = 2.73-5.13), chronic pain (aOR = 1.31, 95% CI: 1.18-1.44), lifetime smoking ≥ 100 cigarettes (aOR = 1.35, 95% CI: 1.23-1.48), BMI < 18.5 (aOR = 1.87, 95% CI: 1.20-2.92), body fat ≥ 26% (aORs = 1.28-1.79), fruit and vegetable intake (< 3/day; aORs = 1.24-1.26), and pastry consumption (> 1/day; aOR = 1.55, 95% CI: 1.12-1.15) (p < 0.05). Targeting socio-economic and nutritional risk factors may reduce the burden of anxiety disorders in middle and late adulthood.