Key Points
- To examine the longitudinal, bidirectional associations between anxiety symptoms and day-to-day functional disability over three years in individuals with type 2 diabetes.
- Analyzed data from the Evaluation of Diabetes Treatment Study, a community-based observational cohort of 1,691 adults with type 2 diabetes.
- Assessed anxiety symptoms using the Generalized Anxiety Disorder Scale-7 and functioning using the World Health Organization Disability Assessment Schedule 2.0 at baseline and annually for 3 years.
- Conducted cross-lagged path analysis via structural equation modeling, controlling for autoregressive effects, sociodemographic factors, and health covariates including depressive symptoms.
- The structural equation model showed good fit with the data (comparative fit index > 0.99, χ²₆ = 11.44, P = 0.08, root mean square error of approximation = 0.02).
- Elevated anxiety predicted subsequent poor functioning across study waves (β = 0.05 to 0.16, P < 0.04), and poor functioning predicted subsequent elevated anxiety (β = 0.13 to 0.19, P < 0.001).
- Controlling for depressive symptoms maintained overall model fit, with the strongest and most consistent directional path observed from poor functioning to subsequent elevated anxiety.
Structured PICO
Are anxiety symptoms and functioning reciprocally related over time in adults with type 2 diabetes?
PPopulation1691 adults with type 2 diabetes from a community-based observational study (Evaluation of Diabetes Treatment Study)
OOutcomeLongitudinal cross-lagged associations between anxiety symptoms (assessed with Generalized Anxiety Disorder Scale-7) and functioning (assessed with World Health Organization Disability Assessment Schedule 2.0)patient reported
Anxiety symptoms and functioning are reciprocally related over time in individuals with type 2 diabetes, independent of depressive symptoms.