Anxiety symptoms and generalized anxiety disorder in the elderly: a review

Anxiety is a common but underestimated, undertreated, and poorly studied problem in the elderly. Generalized anxiety disorder (GAD) and nonspecific anxiety symptoms that do not fall under a specific anxiety disorder are good examples. The current literature on the epidemiology, consequences, phenomenology, assessment, and treatment implications of these challenging problems is reviewed. A variety of limitations are observed. They include limited understanding of the expression of GAD in this age group, variable definitions of "elderly" (specifically with regard to the minimum age), limited ability of currently available diagnostic instruments to identify GAD in the elderly, and the availability of only a few trials addressing treatment of GAD specifically in this group. Despite these limitations there is enough evidence suggesting GAD in the elderly has a potential for negative consequences independent of the common comorbidity with major depressive disorder. The treatments reviewed are promising but need further research in order to document their safety and efficacy. The limitations of our current knowledge are discussed, with recommendations for future research.