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Anxiety disorders in older adults
1University of California, San Diego VA San Diego Healthcare System, 3350 La Jolla Village Drive, San Diego, CA 92161, USA. djeste@ucsd.edu
Current Psychiatry Reports
|July 27, 2001
Summary
Anxiety disorders in older adults are often missed and undertreated. Cognitive-behavioral therapies and low-dose antidepressants are recommended, prioritizing safety and tolerability in this population.
Area of Science:
- Gerontology
- Psychiatry
- Clinical Psychology
Background:
- Anxiety disorders are frequently underdiagnosed and undertreated in the elderly population.
- Age-related factors like depression, cognitive impairment, and physical illness complicate anxiety disorder recognition in older adults.
- Limited research exists on the efficacy and safety of anxiety disorder medications specifically in older populations.
Purpose of the Study:
- To review the challenges and considerations for diagnosing and treating anxiety disorders in older adults.
- To evaluate the effectiveness and safety of various treatment modalities for late-life anxiety.
Main Methods:
- Literature review of epidemiologic studies, clinical trials, and treatment guidelines.
- Analysis of age-related factors influencing diagnosis and treatment.
- Assessment of medication safety, tolerability, and adherence in older adults.
Main Results:
- Prevalence of anxiety disorders generally decreases with age, but recognition is challenging.
- Cognitive and behavioral treatments show promise for anxiety disorders in older individuals.
- Pharmacotherapy requires careful consideration of aging effects; low-dose antidepressants may be useful, with other agents for specific cases.
Conclusions:
- Comprehensive medical evaluation and psychosocial interventions are crucial before pharmacotherapy.
- Antidepressants at low doses are a potential first-line pharmacologic option for late-life anxiety.
- Treatment decisions must prioritize safety, tolerability, and adherence in the elderly.