Untangling Anxiety: Assessment, Diagnosis, and Treatment of Anxiety Disorders in Older Adults-View Presentation Slides

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The document highlights the increasing recognition of anxiety disorders among older adults, which were previously underestimated. Recent studies reveal a higher prevalence than previously recorded, with rates up to 17.2% in European adults aged 65 and older. Anxiety disorders significantly impact the elderly, affecting physical activity, quality of life, and escalating healthcare costs.<br /><br />Key objectives include understanding the evaluation and treatment of anxiety in older adults, particularly those with dementia, and recognizing the public health impact. The presentation emphasizes the adaptive versus maladaptive nature of anxiety, with the latter severely impairing function.<br /><br />Risk factors for anxiety disorders in the elderly include a higher prevalence in women and chronicity from earlier life stages, except for Generalized Anxiety Disorder (GAD), which shows both early and late-onset patterns. Anxiety in older adults is often comorbid with depression and physical conditions like arthritis and heart disease, complicating diagnosis and management.<br /><br />The document discusses various treatment approaches, highlighting both pharmacologic (e.g., SSRIs, SNRIs) and non-pharmacologic interventions (e.g., CBT, relaxation training). Pharmacological treatments often show larger effect sizes due to placebo responses, but both approaches are crucial.<br /><br />There's a caution against using benzodiazepines, TCAs, and antipsychotics in older adults due to increased side effect risks, with proposed alternatives like SSRIs being first-line options. Non-pharmacological strategies include enhanced CBT and exercise interventions, but more research is needed to identify effective tactics, especially for GAD.<br /><br />In managing anxiety in dementia, non-pharmacologic interventions are preferred, with medications used cautiously if necessary. The overall summary calls for improved diagnostic criteria sensitive to older adults, acknowledging anxiety's significant but treatable impact on this population.

Keywords

anxiety disorders

older adults

prevalence

dementia

public health

risk factors

comorbidity

pharmacologic treatment

non-pharmacologic interventions

diagnostic criteria