Bringing the bedside to the bench, and then to the community: a prospectus for intervention research in late-life anxiety disorders.
BACKGROUND
Anxiety disorders are highly prevalent in elderly persons, and they are associated with functional impairment, poorer quality of life, and adverse long-term consequences such as cognitive decline. Intervention research in late-life anxiety disorders (LLAD) lags behind where it ought to be. Research in cognitive neuroscience, aging, and stress intersects in LLAD and provides the opportunity to develop innovative interventions to prevent chronic anxiety and its consequences in this age group.


METHODS
This paper evaluates gaps in the evidence base for treatment of LLAD and synthesizes recent research in cognitive neuroscience, basic behavioral science, stress, and aging.


RESULTS
We examine three intervention issues in LLAD: (1) prevention; (2) acute treatment; and (3) pre-empting adverse consequences. We propose combining randomized controlled trials (RCTs) with mechanistic biobehavioral methodologies as an optimal approach for developing novel, optimized, and personalized treatments. Additionally, we examine three barriers in the field of LLAD research: (1) How do we measure anxiety?; (2) How do we raise awareness?; (3) How will we ensure our research is applicable to underserved populations (particularly minority groups)?


CONCLUSIONS
This prospectus outlines approaches for intervention research that can reduce the morbidity of LLAD.
Lenze
Eric J
EJ
The Department of Psychiatry, Washington University School of Medicine, Washington, USA. lenzee@wustl.edu
Wetherell
Julie Loebach
JL
D000368:Aged; D000375:Aging / Q000502:physiology; D001008:Anxiety Disorders / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D035841:Behavioral Research; D019336:Cognitive Science; D019317:Evidence-Based Medicine; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D012106:Research; D013315:Stress, Psychological