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Treatment considerations for anxiety in the elderly
Eric J Lenze1, Bruce G Pollock, M Katherine Shear
1Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15213, USA. lenzeej@msx.upmc.edu
CNS Spectrums
|February 24, 2004
Summary
Anxiety is common in older adults, often linked to depression or dementia. While benzodiazepines pose risks, antidepressants and cognitive-behavioral therapy are safer, effective first-line treatments for late-life anxiety.
Area of Science:
- Geriatric Psychiatry
- Clinical Psychology
- Neuroscience
Background:
- Anxiety is prevalent in the elderly, manifesting as primary disorders or secondary symptoms.
- Commonly observed in late-life depression and dementia, generalized anxiety disorder is a frequent syndrome.
- Traditional treatments like benzodiazepines carry significant risks, including cognitive impairment and falls.
Purpose of the Study:
- To review current understanding and treatment of anxiety in older adults.
- To highlight safer and more effective therapeutic options.
- To identify gaps in research for late-life anxiety.
Main Methods:
- Literature review of anxiety disorders and symptoms in the elderly.
- Analysis of treatment efficacy and safety profiles.
- Examination of research trends in geriatric anxiety.
Main Results:
- Antidepressants, especially serotonergic agents, are recommended as first-line treatments.
- Cognitive-behavioral therapy shows promise, with ongoing research for geriatric adaptation.
- Anxiety in dementia may respond to atypical antipsychotics, antidepressants, or mood stabilizers.
Conclusions:
- Antidepressants and psychotherapy offer safer alternatives to benzodiazepines for elderly anxiety.
- Further research is needed to address the specific needs and treatments for anxiety in older adults.
- Current treatment guidelines often extrapolate from younger adult studies due to limited geriatric research.