[The expressions of anxiety in the elderly. Their diagnosis and therapy]

Among the most common manifestations of anxiety in the elderly are those associated with neurological disorders. The etiology is often unclear, as anxiety and agitation may be a consequence of insight into the cognitive impairment rather than the direct expression of the neurological deficit. Benzodiazepines are the treatment of choice, particularly the 3-OH compounds that are non oxidised and without active metabolites. Concern about the use of benzodiazepines in the elderly may have been overstated. If used judiciously this class of drugs can prove extremely helpful in reducing day-time anxiety and night-time insomnia. Other medications that are commonly used to treat agitation and disruptive behaviour in demented elderly patients include antipsychotics, beta-blockers, trazodone, buspirone, anticonvulsants.