The prevalence of anxiety disorders among older patients with COPD: Systematic review and meta-analysis

Background: The prevalence of anxiety disorders in older COPD patients varies across studies. Systematic reviews and meta-analyses are needed to clarify the prevalence and guide recommendations for improving early detection and patient care. The objective of this study is to assess the prevalence of anxiety disorders among older patients with COPD using systematic review and meta-analysis. Methods: "Older" patients were defined as those aged 60 years and above. The PubMed, Scopus and PsycINFO databases were searched for published articles through April-May 2024. Pooled prevalence of anxiety disorders in older COPD patients was assessed using the random- effect model. The risk of bias was evaluated using the JBI Critical Appraisal Tool. Results: A total of 11 studies, including 136,608 patients, were reviewed. The studies comprised five cohort studies, four cross-sectional studies, one retrospective and one study with an unspecified design. Risk of bias scores averaged 6.5, ranging from 5 to 8, indicating moderate to high overall quality of evidence. The pooled prevalence of anxiety disorders in older COPD patients was 36% (95% CI: 19-53%, I² = 90.58%, p = 0.00). In univariate meta-regression, anxiety disorders in COPD patients were negatively associated with anxiety assessment tools (p = 0.048). Sensitivity analysis adjusted this prevalence to 39% (95% CI: 22-57%), with reduced heterogeneity (I² = 78.56%, p = 0.00). Conclusion: One-third of older COPD patients experience anxiety disorders. Using appropriate anxiety assessment tools to support effective screening and diagnosis is crucial. High quality studies are needed to explore anxiety disorders in older COPD patients, particularly in low- and middle-income countries. © 2025 Elsevier B.V., All rights reserved.