Treatment of anxiety disorders in late life

To provide a current review and synthesis of the present state of knowledge of anxiety disorders and symptoms in the elderly.

Current research derived from a MEDLINE search and references in key textbook articles and other papers were reviewed. These data were combined with the clinical empirical knowledge and experience of the authors.

Anxiety disorders and symptoms are a common presenting problem in the elderly. Current knowledge and research findings are limited. Extrapolation from adult studies are of use, but important limitations are evident because of the nature, uniqueness, and complexity of the geriatric psychiatry patient. Comorbidity, especially with depression, medical conditions, drugs, and dementia, remains an important concept in assessment and approach to management of anxiety in the older person. Comprehensive assessment of anxiety symptoms requires consideration of physical, intellectual, environmental, and social determinants. Major anxiety disorders, as defined by DSM-IV, and anxiety symptoms are significant problems in the older adult population and are responsible for significant morbidity and cost to the health care network.

Anxiety disorders and symptoms in old age, although common, have received little research focus to date. A comprehensive, careful approach by the clinician to assessment and management is required because anxiety is often a comorbid condition in the elderly. Effective treatments are available and should be applied in a flexible, integrated, and specific manner.