Updates in Geriatric Psychiatry-view presentation

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Video Summary
Dr. Brandon Yarns, a geriatric psychiatrist, discusses anxiety disorders in late life in a video presentation. He begins by addressing the impact and prevalence of anxiety disorders in older adults. While anxiety disorders were historically underestimated in this population, recent studies show that they are more common than previously thought. In fact, the prevalence of anxiety disorders in older adults may be up to twice as common as mood disorders. Anxiety symptoms in older adults are associated with reduced physical activity, greater disability, poorer self-perceptions of health, decreased life satisfaction, increased loneliness, worse quality of life, increased healthcare utilization, and an overall greater cost of care. Dr. Yarns explains that anxiety symptoms and anxiety disorders in older adults are often underdiagnosed, likely due to a lack of awareness and diagnostic criteria developed for younger individuals. There are several risk factors for anxiety disorders in older adults, including being female, having comorbid medical conditions, and a family history of anxiety disorders. The presence of anxiety symptoms in older adults is associated with a range of medical illnesses, such as allergies, pain conditions, gastrointestinal disease, and heart disease. Dr. Yarns discusses assessment and differential diagnosis of anxiety disorders in older adults, emphasizing the importance of ruling out medical causes and considering comorbid conditions. He highlights the potential for anxiety symptoms to be attributed to medical disorders, leading to underdiagnosis of anxiety. In terms of treatment, Dr. Yarns discusses the effectiveness of both pharmacologic and non-pharmacologic interventions. While selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are recommended as first-line pharmacologic options, he also mentions other antidepressants, such as mirTazapine, and non-pharmacologic treatments, including relaxation training and cognitive behavioral therapy (CBT) . Dr. Yarns emphasizes the need for more clinical trials to study the best treatment options for anxiety disorders in older adults. He also briefly addresses anxiety in the context of dementia, recommending non-pharmacologic behavioral interventions as first-line treatments. In conclusion, anxiety disorders are common in older adults and often underdiagnosed and undertreated. Pharmacologic and non-pharmacologic treatments have shown effectiveness, but more research is needed to optimize treatment options for this population.
Keywords
anxiety disorders
older adults
prevalence
underdiagnosed
comorbid conditions
pharmacologic interventions
non-pharmacologic interventions
cognitive behavioral therapy
research