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. 2020 Feb 26;17(5):1493.
doi: 10.3390/ijerph17051493.

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)

Karen M Davison  1   2 , Shen Lamson Lin  3 , Hongmei Tong  4 , Karen M Kobayashi  5 , Jose G Mora-Almanza  1 , Esme Fuller-Thomson  3   6
Affiliations

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)

Karen M Davison et al. Int J Environ Res Public Health. .

Abstract

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.

Keywords: CLSA; anxiety disorders; determinants of mental health; immigration; nutrition.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Adjusted odds ratios and 95% confidence intervals for anxiety disorders among immigrants (n = 4733) compared to Canadian-born respondents (n = 22,258). Model 1 (Core)—Demographics: Immigrant status, age, sex; Model 2 (Social and Economic Characteristics)—Model 1 plus: Income, marital status, education; Model 3 (Physical Health)—Model 1 plus: Co-morbidities, hypertension, chronic pain; Model 4 (Health Behaviors)—Model 1 plus: smoking, binge drinking, physical activity, family physician visits; Model 5 (Anthropometric Measures)—Model 1 plus: Disease risk, percent body fat, waist to hip ratio, waist to height ratio; Model 6 (Dietary Intakes)—Model 1 plus: Fiber, pulses/nuts, fat sources, fish sources, omega 3 eggs, fruits and vegetables, pure fruit juice, salty snacks, calcium sources with high vitamin D content, calcium sources with low vitamin D content, pastries, chocolate bars; Model 7 (Complete)—Adjusted for all aforementioned variables.
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