Zvi D. Gellis and Stanley G. McCracken*
Significance
ô€‚ Anxiety Disorders often are associated with common age-related
medical and psychosocial problems.
Epidemiological evidence suggests that anxiety is a common and major problem in
later life, yet it has received less attention than depressive disorders have. Anxiety
disorders are often associated with common age-related medical and chronic conditions
such as asthma, thyroid disease, coronary artery disease, dementia, and sensory loss
(Diala & Muntaner, 2003).
ô€‚ Late life anxiety is a risk factor for greater disability in general, less
successful recruitment and engagement in rehabilitation services.
Anxiety in later life has been identified as a risk factor for greater disability among
older adults in general and has also been associated with less successful recruitment
into and outcomes of geriatric rehabilitation services (Bowling, Farquhart, & Grundy,
1996). Researchers and practitioners are beginning to recognize that aging and anxiety
are not mutually exclusive; anxiety is as common in the old as in the young, although
how and when it appears is distinctly different in older adults. Additionally, further
effectiveness research on evidence-based treatments for late life anxiety is needed
(Mitte, 2005).
ô€‚ Diagnostic Difficulties
ô€‚ Medical conditions: It is difficult to separate physical symptoms of anxiety
disorders from medical conditions due to higher prevalence of certain
medical conditions, realistic concerns about physical problems, and higher
use of prescription medications.
ô€‚ Dementia: It is difficult to separate agitation from anxiety; impaired
memory may relate to anxiety or dementia; fear may be excessive or
realistic depending upon the situation.
Gellis & McCracken Mental Health—Anxiety Disorders in Older Adults
2
ô€‚ Depression: In late-life, anxiety may be more likely to include depressive
symptoms.
Recognizing anxiety and anxiety disorders in an older person poses several
challenges. Aging brings with it an increased risk for certain medical conditions; a
number of realistic concerns about physical problems, life situations, and functioning;
and a high use of prescription medications. As a result, separating a medical condition
from physical symptoms of an anxiety disorder is complicated in the older adult.
Diagnosing anxiety in individuals with dementia can be difficult, too: agitation typical
of dementia may be difficult to separate from anxiety, impaired memory may be
interpreted as a sign of anxiety or dementia, and fears may be excessive or realistic
depending on the person's situation.