title: Efficacy of cognitive behavioral therapy for anxiety disorders in older people: a meta-analysis and meta-regression of randomized controlled trials.
abstract: OBJECTIVE
  To review the magnitude and duration of and factors associated with effects of cognitive behavioral therapy (CBT) for anxiety disorders in older people.
  
  
  METHODS
  Electronic literature databases and the Cochrane Trials Registry were searched for articles. A systematic critical review, random-effects meta-analysis, and meta-regression of randomized controlled trials were conducted.
  
  
  METHODS
  Community outpatient clinics.
  
  
  METHODS
  People with diagnoses of anxiety disorders.
  
  
  METHODS
  Outcome measures of anxiety and depression.
  
  
  RESULTS
  Twelve studies were included. CBT was significantly more effective than treatment as usual or being on a waiting list at reducing anxiety symptoms at 0-month follow-up, with the effect size being moderate, but when CBT was compared with an active control condition, the between-group difference in favor of CBT was not statistically significant, and the effect size was small. At 6- but not 3- or 12-month follow-up, CBT was significantly more effective at reducing anxiety symptoms than an active control condition, although the effect size was again small. Meta-regression analyses revealed only one factor (type of control group) to be significantly associated with the magnitude of effect sizes.
  
  
  CONCLUSIONS
  The review confirms the effectiveness of CBT for anxiety disorders in older people but is suggestive of lower efficacy in older than working-age people. The small effect sizes in favor of CBT over an active control condition illustrate the need to investigate other treatment approaches that may be used to substitute or augment CBT to increase the effectiveness of treatment of anxiety disorders in older people.
authors.affiliation: Department of Old Age Psychiatry, Institute of Psychiatry, King's College London, UK. rebecca.gould@kcl.ac.uk
authors.forename: Rebecca L
authors.initials: RL
authors.lastname: Gould
authors.forename: Mark C
authors.initials: MC
authors.lastname: Coulson
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Howard
mesh_terms: D000368:Aged; D001008:Anxiety Disorders / Q000628:therapy*; D015928:Cognitive Behavioral Therapy; D006801:Humans; D016032:Randomized Controlled Trials as Topic / Q000592:standards*; D012044:Regression Analysis