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Anxiety disorders in older adults
Sean A Lauderdale1, Javaid I Sheikh
1Mental Illness Research, Education, and Clinical Center (MIRECC), Veteran's Affairs Palo Alto Health Care System, 795 Willow Road, 116A\MPD, Menlo Park, CA 94025, USA. slauderd@pittstate.edu
Clinics in Geriatric Medicine
|March 18, 2004
Summary
Anxiety disorders are increasingly recognized in older adults, yet diagnosis is challenging due to medical issues and overlapping symptoms. Effective treatments include SSRIs, SNRIs, and cognitive-behavioral therapy.
Area of Science:
- Geriatric Psychiatry
- Clinical Psychology
- Epidemiology
Background:
- Anxiety disorders in older adults are more prevalent than previously thought.
- Clinical understanding and detection of anxiety in the elderly are limited.
- Diagnosis is complicated by medical comorbidities, polypharmacy, and symptom overlap with depression.
Purpose of the Study:
- To review the current understanding of anxiety disorders in older adults.
- To highlight challenges in diagnosing anxiety in elderly patients.
- To discuss evidence-based treatment approaches for geriatric anxiety.
Main Methods:
- Literature review of epidemiologic surveys and clinical studies.
- Analysis of factors complicating anxiety diagnosis in the elderly.
- Evaluation of pharmacologic and psychotherapeutic interventions.
Main Results:
- Anxiety disorders are common in older adults, but often underdiagnosed.
- Comprehensive assessment including clinical interviews and self-report measures aids detection.
- Selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and cognitive-behavioral therapy (CBT) are effective treatments.
Conclusions:
- Accurate assessment of anxiety in older adults requires a thorough evaluation.
- SSRIs and SNRIs are first-line pharmacologic treatments.
- Psychotherapy and collaborative care models show promise for treating anxiety in the elderly.