Assessing and treating anxiety in elderly persons

Although anxiety disorders appear to occur less frequently in elderly persons, subsyndromal anxiety and anxiety associated with other medical and psychiatric disorders are significant sources of morbidity. Theories of etiology of anxiety range from the psychodynamic to the neurobiologic. Treatment of anxiety syndromes hinges on a thorough diagnostic evaluation, with attention to the tendency of older adults to prefer somatic descriptors and to view psychiatric illness as stigmatizing. The efficacy of nonpharmacologic treatment strategies such as relaxation training and psychotherapy for elderly anxious patients has not been well researched, but these interventions have been reasonably successful with younger adult populations and avoid the potential for harmful side effects of medication. Pharmacologic treatment strategies can be effective when used with appropriate caution.