Anxiety in the older patient: differential diagnosis and treatment

Anxiety in older patients is more often a symptom of an underlying mental or physical disorder than a primary diagnosis. Its various forms include situational anxiety, adjustment disorder, and phobias. A search for underlying organic causes is important, as age-related diseases, drug side effects, and substance abuse/withdrawal may have etiologic significance. Anxiety may also mask primary psychiatric disorders such as depression or delirium. Therapy requires treating any underlying psychiatric illness and seeking psychosocial intervention for functional causes. If medical therapy is indicated, short-acting benzodiazepines are the first choice, but patients should be followed closely for possible side effects.