Anxiety common in elderly, yet often undertreated May 21, 2006
We are decades behind where we need to be in terms of research and treatments for anxiety in this older age group.
Anxiety may be the most common mental disorder experienced by older adults, affecting one in 10 people over the age of 60. As many as 7 percent of people in this age group have generalized anxiety disorder (GAD), a disorder characterized by uncontrollable worries about everyday things. Despite its prevalence, anxiety remains one of the most undiagnosed and undertreated conditions in this population.
An overview of current research in geriatric anxiety disorder will be presented today as part of an industry-sponsored symposium at the Annual Meeting of the American Psychiatric Association, being held May 20-25 in Toronto.
With the first of the 80 million “baby boomers” turning 60 in 2006, researchers are seeing a greater need to focus attention on disorders commonly experienced by people age 60 and older.
“Studies have shown that generalized anxiety disorder is more common in the elderly, affecting 7 percent of seniors, than depression, which affects about 3 percent of seniors. Surprisingly, there is little research that has been done on this disorder in the elderly,” said Eric J. Lenze, M.D., assistant professor of psychiatry, University of Pittsburgh School of Medicine. “Due to the lack of evidence, doctors often think that this disorder is rare in the elderly or that it is a normal part of aging, so they don’t diagnose or treat anxiety in their older patients, when, in fact, anxiety is quite common in the elderly and can have a serious impact on quality of life.”
Anxiety disorders include panic disorder, obsessive compulsive disorder, phobias and GAD. GAD is characterized by excessive, exaggerated worry over routine life events and activities that last for more than six months. While many worrisome events occur as people age, such as deteriorating health and financial concerns, and while it is normal for people to worry or be concerned about these things, people with GAD worry on a more constant basis.
This constant worry can have a number of negative, and sometimes disabling, effects on a person’s life. For instance, many people with GAD have trouble sleeping or limit their daily activities due to their anxiety. Untreated anxiety can lead to anxious depression – a condition that is more difficult to treat and carries a higher risk of suicide than depression. Additionally, anxiety in the elderly is associated with poorer cognition – an effect that is opposite from what researchers see in younger adults with anxiety.
“Anxiety in people over age 60 might have some similarities to anxiety in those younger, but it also has marked differences. We can’t just assume that we can treat the two age groups the same,” said Dr. Lenze. “We are decades behind where we need to be in terms of research and treatments for anxiety in this older age group.”
A small pilot study conducted at the University of Pittsburgh has found that treatment with the selective serotonin reuptake inhibitor (SSRI) citalopram, a drug approved for treating anxiety in younger adults, is equally effective in treating adults over the age of 60. Elderly who took the drug for eight months reported improvement in overall quality of life and mental health.
The University of Pittsburgh researchers are currently conducting a National Institute of Mental Health-funded study to determine further what effects SSRIs have on symptoms of anxiety, quality of life and cognition in people over the age of 60 with anxiety disorder. Additional studies hope to address the role of cognitive behavioral therapy or other therapies for anxiety in the elderly.
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