title: Anxiety disorders in older adults.
abstract: Recent epidemiologic surveys indicate that anxiety disorders in older adults are more common than previously believed. Despite this, knowledge regarding the clinical characteristics of anxiety disorders in elderly patients is emerging slowly. In addition, detection of anxiety symptoms in elders is complicated by several factors, including a confounding of symptom picture by high medical comorbidity, frequent use of multiple prescribed and over-the-counter medications, difficulty of differentiating anxiety from depression, and a tendency of some older adults to resist psychiatric evaluation. Nonetheless, a comprehensive evaluation that includes a clinical interview, self-report measures, and laboratory results, can improve detection and accurate assessment of anxiety in elderly patients. Empirically validated knowledge regarding appropriate pharmacologic interventions in elderly patients is still sparse, and inferences from data in young and middle-aged populations typically form the basis of clinical practice in elderly patients. SSRIs and SNRIs are considered first-line interventions because of their efficacy and relative tolerability in elderly patients. Psychotherapy, particularly cognitive-behavioral therapy, also has been found to be efficacious for older adults with anxiety disorders. Collaborative care models that address physician, patient, and healthcare service delivery barriers, also hold promise for adequately treating anxiety disorders experienced by older adults.
authors.affiliation: Mental Illness Research, Education, and Clinical Center (MIRECC), Veteran's Affairs Palo Alto Health Care System, 795 Willow Road, 116A\MPD, Menlo Park, CA 94025, USA. slauderd@pittstate.edu
authors.forename: Sean A
authors.initials: SA
authors.lastname: Lauderdale
authors.forename: Javaid I
authors.initials: JI
authors.lastname: Sheikh
mesh_terms: D000368:Aged; D014151:Anti-Anxiety Agents / Q000627:therapeutic use; D001008:Anxiety Disorders / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D001569:Benzodiazepines / Q000627:therapeutic use; D006801:Humans; D011613:Psychotherapy; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use
chemical_list: D014151:Anti-Anxiety Agents; D001569:Benzodiazepines; D017367:Selective Serotonin Reuptake Inhibitors