Hostname: page-component-586b7cd67f-t7czq Total loading time: 0 Render date: 2024-11-24T08:42:39.192Z Has data issue: false hasContentIssue false

Anxiety disorders in older people

Published online by Cambridge University Press:  08 March 2012

James Lindesay*
Affiliation:
University of Leicester, UK
Robert Stewart
Affiliation:
King's College London (Institute of Psychiatry), London, UK
Jatinder Bisla
Affiliation:
King's College London (Institute of Psychiatry), London, UK
*
Address for correspondence: Professor James Lindesay, Department of Health Sciences, University of Leicester, Leicester General Hospital, Leicester LE5 4PW. Email: [email protected]

Summary

This article reviews the research into anxiety disorders in adults aged 65 years and older that has been published over the past ten years. The topics covered include: the construct of anxiety and its disorders in this age group; epidemiology, including prevalence, incidence, course, outlook, and risk factors; assessment scales; co-morbidity and differential diagnosis (depression, dementia, physical illness); and management, both pharmacological and non-pharmacological. There has been a significant improvement in our understanding of these disorders in older adults over this period, but evidence to support their treatment and prevention is still quite sparse.

Type
Neuropsychiatry of old age
Copyright
Copyright © Cambridge University Press 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Lindesay, J, Marudkar, M. Neurotic disorders. Rev Clin Gerontol 2001; 11: 5170.CrossRefGoogle Scholar
2Goldberg, D, Huxley, P. Common Mental Disorders: a Bio-Social Model. London: Tavistock/Routledge, 1992.Google Scholar
3Lawton, MP, Kleban, MH, Dean, J. Affect and age: cross-sectional comparisons of structure and prevalence. Psychol Aging 1993; 8: 165–75.CrossRefGoogle ScholarPubMed
4Lindesay, J, Baillon, S, Brugha, T, Dennis, M, Stewart, R, Araya, R, Meltzer, H. Worry content across the lifespan: an analysis of 16- to 74-year-old participants in the British National Survey of Psychiatric Morbidity. Psychol Med 2007; 36: 1625–33.CrossRefGoogle Scholar
5Arfken, CL, Lach, HW, Birge, SJ, Miller, JP. The prevalence and correlates of fear of falling in elderly persons living in the community. Am J Public Health 1994; 84: 565–70.Google ScholarPubMed
6Fredrikson, M, Annas, P, Fischer, H, Wik, G. Gender and age differences in the prevalence of specific fears and phobias. Behav Res Ther 1996; 34: 3339.CrossRefGoogle ScholarPubMed
7Jeste, D, Blazer, DG, First, M. Aging-related diagnostic variations: need for diagnostic criteria appropriate for elderly psychiatric patients. Biol Psychiatry 2005; 58: 265–71.CrossRefGoogle ScholarPubMed
8Flint A. Anxiety and its disorders in late life: moving the field forward. Am J Geriatr Psychiatry 2005; 17: 117–23.Google Scholar
9Palmer, B, Jeste, D, Sheikh, J. Anxiety disorders in the elderly: DSM-IV and other barriers to diagnosis and treatment. J Aff Disord 1997; 46: 183–90.CrossRefGoogle ScholarPubMed
10McCrae, RR, Costa, PT Jr, Ostendorf, F, Angleitner, A, Hrebícková, M, Avia, MD, Sanz, J, Sánchez-Bernardos, ML, Kusdil, ME, Woodfield, R, Saunders, PR, Smith, PB. Nature over nurture: temperament, personality and life span development. J Personality Soc Psychol 2000; 78: 173–86.CrossRefGoogle ScholarPubMed
11Wolitzky-Taylor, KB, Castriotta, N, Lenze, EJ, Stanley, MA, Craske, MG. Anxiety disorders in older adults: a comprehensive review. Depress Anxiety 2010; 27: 190211.CrossRefGoogle ScholarPubMed
12Therrien, Z, Hunsley, J. Assessment of anxiety in older adults: a systematic review of commonly used measures. Aging Mental Health 2012; 16: 116.CrossRefGoogle ScholarPubMed
13Kabacoff, RI, Segal, DL, Hersen, M, Van Hasselt, VB (1997). Psychometric properties and diagnostic utility of the Beck Anxiety Inventory and the State-Trait Anxiety Inventory with older adult psychiatric outpatients. J Anxiety Disord; 11: 3347.CrossRefGoogle ScholarPubMed
14Beck, JG, Stanley, MA, Zebb, BJ. Psychometric properties of the Penn State Worry Questionnaire in older adults. J Clin Geropsychol 1995; 1: 3342.Google Scholar
15Copeland, JR, Kelleher, MJ, Kellett, JM, Gourlay, AJ, Gurland, BJ, Fleiss, JL, Sharpe, L. A semi-structured clinical interview for the assessment of diagnosis and mental state in the elderly: the Geriatric Mental State Schedule: I. Development and reliability. Psychol Med 1976; 6; 439–49.CrossRefGoogle Scholar
16Sinoff, G, Ore, L, Zlotogorsky, D, Tamir, A. Short Anxiety Screening Test – a brief instrument for detecting anxiety in the elderly. Int J Geriatr Psychiatry 1999; 14: 1062–71.3.0.CO;2-Q>CrossRefGoogle Scholar
17Krasucki, C, Ryan, P, Ertan, T, Howard, R, Lindesay, J, Mann, A. The FEAR: a rapid screening test for generalized anxiety in elderly primary care attenders. Int J Geriatr Psychiatry 1000; 14: 6068.Google Scholar
18Wisocki, PA, Handen, B, Morse, CK. The Worry Scale as a measure of anxiety among homebound and community active elderly. Beh Ther 1986; 9: 9195.Google Scholar
19Shankar, KK, Walker, M, Frost, D, Orrell, M. The development of a valid and reliable scale for rating anxiety in dementia (RAID). Aging Mental Health 1999; 3: 3949.CrossRefGoogle Scholar
20Pachana, NA, Byrne, GJ, Siddle, H, Koloski, N, Harley, E, Arnold, E. Development and validation of the Geriatric Anxiety Inventory. Int Psychogeriatrics 2006; 18: 103–14.Google Scholar
21Boddice, G, Pachana, NA, Byrne, GJ. The clinical utility of the Geriatric Anxiety Inventory in older adults with cognitive impairment. Nurs Older People 2008; 20: 3639.CrossRefGoogle ScholarPubMed
22Diefenbach, GJ, Tolin, DF, Meunier, SA, Gilliam, CM. Assessment of anxiety in older home care recipients. Gerontologist 2009; 49: 141–53.CrossRefGoogle ScholarPubMed
23Byrne, GJ, Pachana, NA. Development and validation of a short form of the Geriatric Anxiety Inventory – the GAI-SF. Int Psychogeriatrics 2011; 23: 125–31.CrossRefGoogle Scholar
24Bryant, C, Jackson, H, Ames, D. The prevalence of anxiety in older adults: Methodological issues and a review of the literature. J Aff Disord 2008; 109: 233–50.CrossRefGoogle Scholar
25Mehta, KM, Simonsick, EM, Penninx, BW, Schulz, R, Rubin, SM, Satterfield, S, Yaffe, K. Prevalence and correlates of anxiety symptoms in well-functioning older adults: findings from the Health Aging and Body Composition Study. J Am Geriatr Soc 2003; 51: 499504.CrossRefGoogle ScholarPubMed
26Schaub, RT, Linden, M. Anxiety and anxiety disorders in the old and very old – results from the Berlin Aging Study. Comp Psychiatry 2000; 41: 4854.CrossRefGoogle ScholarPubMed
27Copeland, JR, Gurland, BJ, Dewey, ME, Kelleher, MJ, Smith, AM, Davidson, IA. Is there more dementia, depression and neurosis in New York? A comparative study of the elderly in New York and London using the computer diagnosis AGECAT. Br J Psychiatry 1987; 151: 466–73.CrossRefGoogle ScholarPubMed
28Ritchie, K, Artero, S, Beluche, I. Prevalence of DSM-IV disorder in the French elderly population. Br J Psychiatry 2004; 184: 147–52.CrossRefGoogle ScholarPubMed
29Lindesay, J, Banerjee, S. Phobic disorder in the elderly: a comparison of three diagnostic systems. Int J Geriatr Psychiatry 1993; 8: 387–93.CrossRefGoogle Scholar
30Hunt, C, Issakidis, C, Andrews, G. DSM-IV Generalised Anxiety Disorder in the Australian National Survey of Mental Health and Well-Being. Psychol Med 2002; 32: 649–59.CrossRefGoogle ScholarPubMed
31Uhlenhuth, EH, Balter, MB, Mellinger, GD, Cisin, IH, Clinthorne, J. Symptom checklist syndromes in the general population: correlations with psychotropic drug use. Arch Gen Psychiatry 1983; 40: 1167–73.CrossRefGoogle Scholar
32van Zelst, WH, de Beurs, E, Beekman, AT, Deeg, DJ, van Dyck, R. Prevalence and risk factors of posttraumatic stress disorder in older adults. Psychother Psychosom 2003; 72: 333–42.CrossRefGoogle ScholarPubMed
33Ames, D, Flynn, E, Harrigan, S. Prevalence of psychiatric disorders among in-patients in an acute geriatric hospital. Aus J Aging 1994; 13: 811.CrossRefGoogle Scholar
34Ames, D, Tuckwell, V. Psychiatric disorders among elderly patients in a general hospital. Med J Aus 1994; 160: 671–75.CrossRefGoogle ScholarPubMed
35Tolin, D, Robinson, J, Gaztambide, S, Blank, K. Anxiety disorders in older Puerto Rican primary care patients. Am J Geriatr Psychiatry 2005; 13: 150–56.CrossRefGoogle ScholarPubMed
36Byers, AL, Yaffe, K, Covinsky, KE, Friedman, MB, Bruce, ML. High occurrence of mood and anxiety disorders among older adults: the national Comorbidity Survey Replication. Arch Gen Psychiatry 2010; 67: 489–96.CrossRefGoogle ScholarPubMed
37Goncalves, DC, Pachana, NA, Byrne, GJ. Prevalence and correlates of generalized anxiety disorder among older adults in the Australian National Survey of Mental Health and Well-being. J Affect Disord 2011; 132: 223–30.CrossRefGoogle ScholarPubMed
38Grenier, S, Préville, M, Boyer, R, O'Connor, K, Béland, SG, Potvin, O, Hudon, C, Brassard, J; Scientific Committee of the ESA Study. The impact of DSM-IV symptom and clinical significance criteria on the prevalence estimates of subthreshold and threshold anxiety in the older adult population. Am J Psychiatry 2011; 19: 316–26.Google Scholar
39Lindesay, J, Briggs, K, Murphy, E. The Guy's/Age Concern Survey: prevalence rates of cognitive impairment, depression and anxiety in an urban elderly community. Br J Psychiatry 1989; 155: 317–29.CrossRefGoogle Scholar
40Manela, M, Katona, C, Livingston, G. How common are the anxiety disorders in old age? Int J Geriatr Psychiatry 1996; 11: 6570.3.0.CO;2-M>CrossRefGoogle Scholar
41Jeste, D, Hays, J, Steffens, D. Clinical correlates of anxious depression among elderly patients with depression. J Aff Disord 2006; 90: 3741.CrossRefGoogle ScholarPubMed
42Tyrer, P. The division of neurosis: a failed classification. J Royal Soc Med 1990; 83: 614–16.CrossRefGoogle ScholarPubMed
43Lindesay, J. Neurotic disorders. In Ames, D, Chiu, E (eds), Functional Disorders in the Elderly. New York: Cambridge University Press, 1996.Google Scholar
44Haslam, N. Categorical versus dimensional models of mental disorder: the taxometric evidence. Aust NZ J Psychiatry 2003; 37: 696704.CrossRefGoogle ScholarPubMed
45Evans, O, Singleton, N, Meltzer, H et al. The Mental Health of Older People. London: HMSO, 2003.Google Scholar
46Robins, L, Regier, D (eds). Psychiatric Disorders in America. New York, Free Press, 1991.Google Scholar
47Jenkins, R, Lewis, G, Bebbington, P, Brugha, T, Farrell, M, Gill, B, Meltzer, H. The National Psychiatric Morbidity Surveys of Great Britain – initial findings from the Household Survey. Psychol Med 1997; 27: 775–89.CrossRefGoogle ScholarPubMed
48Spiers, N, Bebbington, P, McManus, S, Brugha, TS, Jenkins, R, Meltzer, H. Age and birth cohort differences in the prevalence of common mental disorder in England: National Psychiatric Morbidity surveys 1993–2007. Br J Psychiatry 2011; 198: 479–84.CrossRefGoogle ScholarPubMed
49Shaub, RT, Linden, M. Anxiety and anxiety disorders in the old and very old – results from the Berlin Aging Study (BASE). Compr Psychiatry 2000; 41: 4854.CrossRefGoogle Scholar
50Gum, AM, King-Kallimanis, B, Kohn, R. Prevalence of mood, anxiety, and substance-abuse disorders for older Americans in the national Comorbidity Survey Replication. Am J Geriatr Psychiatry 2009; 17: 769–81.CrossRefGoogle ScholarPubMed
51Beekman, AT, Bremmer, MA, Deeg, DJ, van Balkom, AJ, Smit, JH, de Beurs, E, van Dyck, R, van Tilburg, W. Anxiety disorders in later life: a report from the Longitudinal Aging Study Amsterdam. Int J Geriatr Psychiatry 1998; 13: 717726.3.0.CO;2-M>CrossRefGoogle ScholarPubMed
52Klerman, GL. The current age of youthful melancholia: Evidence for increase in depression among adolescents and young adults. Br J Psychiatry 1988; 152: 414.CrossRefGoogle ScholarPubMed
53Blazer, DG, Hughes, D, George, LK et al. Generalized anxiety disorder. In Robins, LN, Regier, DA (eds), Psychiatric Disorders in America. New York: Free Press, 1990.Google Scholar
54Chou, KL. Age at onset of generalized anxiety disorder in older adults. Am J Geriatr Psychiatry 2009; 17: 455–64.CrossRefGoogle ScholarPubMed
55Goncalves, DC, Byrne, GJ. Sooner or later: age at onset of generalized anxiety disorder in older adults. Depress Anxiety 2012; 29: 3946.CrossRefGoogle ScholarPubMed
56Schuurmans, J, Comijs, HC, Beekman, AT, de Beurs, E, Deeg, DJ, Emmelkamp, PM, van Dyck, R. The outcome of anxiety disorders in older people at 6-year follow-up: results from the Longitudinal Aging Study Amsterdam. Acta Psychiatr Scand 2005; 111: 420–28.CrossRefGoogle ScholarPubMed
57Karlsson, B, Sigström, R, Waern, M, Ostling, S, Gustafson, D, Skoog, I. The prognosis and incidence of social phobia in an elderly population. Acta Psychiatr Scand 2010; 122: 410.CrossRefGoogle Scholar
58Holwerda, TJ, Schoevers, RA, Dekker, J, Deeg, DJ, Jonker, C, Beekman, AT. The relationship between generalized anxiety disorder, depression and mortality in old age. Int J Geriatr Psychiatry 2007; 22: 241–49.CrossRefGoogle ScholarPubMed
59Mykletun, A, Bjerkeset, O, Overland, S, Prince, M, Dewey, M, Stewart, R. Levels of anxiety and depression as predictors of mortality: the HUNT study. Br J Psychiatry 2009; 195: 118–25.CrossRefGoogle ScholarPubMed
60Brenes, GA, Kritchevsky, SB, Mehta, KM, Yaffe, K, Simonsick, EM, Ayonayon, HN, Rosano, C, Rubin, SM, Satterfield, S, Penninx, BW. Scared to death: Results from the Health, Aging, and Body Composition study. Am J Geriatr Psychiatry 2007; 15: 262–65.CrossRefGoogle ScholarPubMed
61Acierno, R, Ruggiers, KJ, Kilpatrick, DG, Resnick, HS, Galea, S. Risk and protective factors for psychopathology among older versus younger adults after the 2004 Florida hurricanes. Am J Geriatr Psychiatry 2006; 14: 1051–59.CrossRefGoogle ScholarPubMed
62Heun, R, Papassotiropoulos, A, Ptok, U. Subthreshold depressive and anxiety disorders in the elderly. Eur Psychiatry 2000; 15: 173–82.CrossRefGoogle ScholarPubMed
63Vink, D, Aartsen, MJ, Schovers, RA. Risk factors for anxiety and depression in the elderly: A review. J Aff Disord 2008; 106: 2944.CrossRefGoogle ScholarPubMed
64Schoevers, RA, Beekman, AT, Deeg, DJ, Jonker, C, van Tilburg, W. Comorbidity and risk patterns of depression, generalised anxiety disorder and mixed anxiety-depression in later life: results from the Longitudinal Aging Study Amsterdam. Int J Geriatr Psychiatry 2003; 18: 9941001.CrossRefGoogle Scholar
65Beekman, AT, de Beurs, E, van Balkom, AJ, Deeg, DJ, van Dyck, R, van Tilburg, W. Anxiety and depression in later life: co-occurrence and communality of risk factors. Am J Psychiatry 2000; 157: 8995.CrossRefGoogle ScholarPubMed
66de Beurs, E, Beekman, A, Geerlings, S, Deeg, D, Van Dyck, R, Van Tilburg, W. On becoming depressed or anxious in late life: Similar vulnerability factors but different effects of stressful life events. Br J Psychiatry 2001; 179: 426–31.CrossRefGoogle ScholarPubMed
67Forsell, Y. Predictors for depression, anxiety and psychotic symptoms in a very elderly population: data from a 3-year follow-up study. Soc Psychiat Psychiatr Epidemiol 2000; 35: 259–63.CrossRefGoogle Scholar
68Diefenbach, GJ, Disch, WB, Robison, JT, Baez, E, Coman, E. Anxious depression among Puerto Rican and African-American older adults. Aging Ment Health 2009; 13: 118–26.CrossRefGoogle ScholarPubMed
69Ford, BC, Bullard, KM, Taylor, RJ, Toler, AK, Neighbors, HW, Jackson, JS. Lifetime and 12-month prevalence of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition disorders among older African Americans: findings from the National Survey of American Life. Am J Geriatr Psychiatry 2007; 15: 652–59.CrossRefGoogle ScholarPubMed
70Lenze, EJ, Mulsant, BH, Mohlman, J, Shear, MK, Dew, MA, Schulz, R, Miller, MD, Tracey, B, Reynolds, CF 3rd. Generalized anxiety disorder in late life: lifetime course and comorbidity with major depressive disorder. Am J Geriatr Psychiatry 2005; 13: 7780.CrossRefGoogle ScholarPubMed
71Hopko, DR, Bourland, SL, Stanley, MA, Beck, JG, Novy, DM, Averill, PM, Swann, AC. Generalized anxiety disorder in older adults: examining the relationship between clinician severity ratings and patient self-report measures. Depress Anxiety 2000; 12: 1725.3.0.CO;2-6>CrossRefGoogle Scholar
72Bartels, SJ, Coakley, E, Oxman, TE, Constantino, G, Oslin, D, Chen, H, Zubritsky, C, Cheal, K, Durai, UN, Gallo, JJ, Llorente, M, Sanchez, H. Suicidal ideation and death ideation in older primary care patients with depression, anxiety, and at-risk alcohol use. Am J Geriatr Psychiatry 2002; 10: 417–27.CrossRefGoogle ScholarPubMed
73Flint, AJ, Rifat, SL. Anxious depression in elderly patients: response to antidepressant treatment. Am J Geriatr Psychiatry 1997; 5: 107–15.Google ScholarPubMed
74Corna, LM, Cairney, J, Herrmann, N, Veldhuizen, S, McCabe, L, Streiner, D. Panic disorder in later life: results from a national survey of Canadians. Int Psychogeriatr 2007; 19: 1084–96.CrossRefGoogle ScholarPubMed
75King-Kallimanis, B, Gum, AM, Kohn, R. Comorbidity of depressive and anxiety disorders for older Americans in the national comorbidity survey-replication. Am J Geriatr Psychiatry 2009; 17: 782–92.CrossRefGoogle ScholarPubMed
76Cairney, J, Corna, LM, Veldhuizen, S, Hermann, N, Streiner, DL. Comorbid depression and anxiety in later life: patterns of association, subjective well-being, and impairment. Am J Geriatr Psychiatry 2008; 16: 201–8.CrossRefGoogle ScholarPubMed
77Sajatovic, M, Blow, FC, Ignacio, RV. Psychiatric comorbidity in older adults with bipolar disorder. Int J Geriatr Psychiatry 2006; 21: 582–87.CrossRefGoogle ScholarPubMed
78Chou, KL. Social anxiety disorder in older adults: evidence from the National Epidemiologic Survey on alcohol and related conditions. J Affect Disord 2009; 119: 7683.CrossRefGoogle ScholarPubMed
79Mackenzie, CS, Reynolds, K, Chou, KL, Pagura, J, Sareen, J. Prevalence and correlates of generalized anxiety disorder in a national sample of older adults. Am J Geriatr Psychiatry 2011; 19: 305–15.CrossRefGoogle Scholar
80Forsell, Y, Palmer, K, Fratglioni, L. Psychiatric symptoms/syndromes in elderly persons with mild cognitive impairment. Data from a cross-sectional study. Acta Neurol Scand Suppl 2003; 179: 2528.CrossRefGoogle ScholarPubMed
81Sinoff, G, Werner, P. Anxiety disorder and accompanying subjective memory loss in the elderly as a predictor of future cognitive decline. Int J Geriatr Psychiatry 2003; 18: 951–59.CrossRefGoogle ScholarPubMed
82Potvin, O, Forget, H, Grenier, S, Preville, M, Hudon, C. Anxiety, depression, and 1-year incident cognitive impairment in community-dwelling older adults. J Am Geriatr Soc 2011; 59: 1421–28.CrossRefGoogle ScholarPubMed
83Yaffe, K, Vittinghoff, E, Lindquist, K, Barnes, D, Covinsky, KE, Neylan, T, Kluse, M, Marmar, C. Posttraumatic stress disorder and risk of dementia among US veterans. Arch Gen Psychiatry 2010; 67: 608–13.CrossRefGoogle ScholarPubMed
84Cooper, C, Bebbington, P, Lindesay, J, Meltzer, H, McManus, S, Jenkins, R, Livingston, G. The meaning of reporting forgetfulness: a cross-sectional study of adults in the English 2007 Adult Psychiatric Morbidity Survey. Age Ageing 2011; 40: 711–17.CrossRefGoogle ScholarPubMed
85Schaub, RT, Linden, M. Anxiety and anxiety disorder in the old and very-old – results from the Berlin Aging Study (BASE). Compr Psychiatry 2000; 41: 4854.CrossRefGoogle ScholarPubMed
86Hwang, TJ, Masterman, DL, Ortiz, F, Fairbanks, LA, Cummings, JL. Mild cognitive impairment is associated with characteristic neuropsychiatric symptoms. Alz Dis Assoc Disord 2004; 18: 1721.CrossRefGoogle ScholarPubMed
87Seignourel, PJ, Kunik, ME, Snow, L, Wilson, N, Stanley, M. Anxiety in dementia: a critical review. Clin Psychol Rev 2008; 28: 1071–82.CrossRefGoogle ScholarPubMed
88Twelftree, H, Qazi, A. Relationship between anxiety and agitation in dementia. Aging Ment Health 2006; 10: 362–67.CrossRefGoogle ScholarPubMed
89Torado, JF, Shen, BJ, Raffa, SD et al. Prevalence of anxiety disorders in men and women with established coronary heart disease. J Cardiopulm Rehabil 2007; 67: 688–91.Google Scholar
90Vogele, C, von Leupoldt, A. Mental disorders in chronic obstructive pulmonary disease. Respir Med 2008; 102: 764–73.CrossRefGoogle ScholarPubMed
91Gagnon, N, Flint, AJ, Naglie, G, Devins, GM. Affective correlates of fear of falling in elderly persons. Am J Geriatr Psychiatry 2005; 13: 714.CrossRefGoogle ScholarPubMed
92Pontone, GM, Williams, JR, Anderson, KE, Chase, G, Goldstein, SA, Grill, S, Hirsch, ES, Lehmann, S, Little, JT, Margolis, RL, Rabins, PV, Weiss, HD, Marsh, L. Prevalence of anxiety disorders and anxiety subtypes in patients with Parkinson's disease. Movement Disord 2009; 15: 1333–38.CrossRefGoogle Scholar
93Mehta, KM, Yaffe, K, Brenes, GA, Newman, AB, Shorr, RI, Simonsick, EM, Ayonayon, HN, Rubin, SM, Covinsky, KE. Anxiety symptoms and decline in physical function over 5 years in the health, aging and the body composition study. J Am Geriatr Soc 2007; 55: 265–70.CrossRefGoogle ScholarPubMed
94Norhus, IH, Hynninen, MJ. Treating late-life anxiety in chronic medical illness and cognitive impairment: two case studies. In Pachana, NA, Laidlaw, K, Knight, BG (eds). Casebook of Clinical Geropsychology. Oxford: Oxford University Press, 2010.Google Scholar
95National Institute for Health and Clinical Excellence. Generalised anxiety disorder (with or without agoraphobia) in adults: Clinical Guideline 113. www.nice.org.uk/guidance/CG113Google Scholar
96van't Veer-Tazelaar, PJ, van Marwijk, HW, van Oppen, P, van Hout, HP, van der Horst, HE, Cuijpers, P, Smit, F, Beekman, AT. Stepped-care prevention of anxiety and depression in late life: a randomized controlled trial. Arch Gen Psychiatry 2009; 66: 297304.CrossRefGoogle ScholarPubMed
97van't Veer-Tazelaar, PJ, van Marwijk, HW, van Oppen, P, van der Horst, HE, Smit, F, Cuijpers, P, Beekman, AT. Prevention of late-life anxiety and depression has sustained effects over 24 month: a pragmatic randomized trial. Am J Geriatr Psychiatry 2011; 19: 230–39.CrossRefGoogle ScholarPubMed
98Wilson, K, Mottram, PG, Vassilas, C. Psychotherapeutic treatments for older people. The Cochrane Library. Available at: http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004853.pub2/abstract;jsessionid=D89D65D53FC626B3BF171DB8E87FD73C.d02t04 (published online 21 Jan 2009).Google Scholar
99Hendriks, GJ, Oude Voshaar, RC, Keijsers, GP, Hoogduin, CA, van Balkom, AJ. Cognitive-behavioural therapy for late-life anxiety disorders: a systematic review and meta-analysis. Acta Psychiat Scand 2008; 117: 403–11.CrossRefGoogle ScholarPubMed
100Thorp, SR, Ayers, CR, Nuevo, R, Stoddard, JA, Sorrell, JT, Wetherell, JL. Meta-analysis comparing different behavioural treatments for late-life anxiety. Am J Geriatr Psychiatry 2009; 17: 105–15.CrossRefGoogle ScholarPubMed
101Ayers, CR, Sorrell, JT, Thorp, SR, Wetherall, JL. Evidence-based psychological treatments for late-life anxiety. Psychol Aging 2007; 22: 817.CrossRefGoogle ScholarPubMed
102Bradford, A, Cully, J, Rhoades, H, Kunik, M, Kraus-Schuman, C, Wilson, N, Stanley, M. Early response to psychotherapy and long-term change in worry symptoms in older adults with generalized anxiety disorder. Am J Geriatr Psychiatry 2011; 19: 347–56.CrossRefGoogle ScholarPubMed
103Hendriks, GJ, Keijsers, GP, Kampman, M, Oude Voshaar, RC, Verbraak, MJ, Broekman, TG, Hoogduin, CA. A randomized controlled study of paroxetine and cognitive-behavioural therapy for late-life panic disorder. Acta Psychiatr Scand 2010; 122: 1119.CrossRefGoogle ScholarPubMed
104Stanley, MA, Wilson, NL, Novy, DM, Rhoades, HM, Wagener, PD, Greisinger, AJ, Cully, JA, Kunik, ME. Cognitive behaviour therapy for generalized anxiety disorder among older adults in primary care: a randomized clinical trial. JAMA 2009; 301: 1460–67.CrossRefGoogle ScholarPubMed
105Mohlman, J. Psychosocial treatment of late-life generalized anxiety disorder: current status and future directions. Clin Psychol Rev 2004; 24: 149–69.CrossRefGoogle ScholarPubMed
106Schuurmans, J, Comijs, H, Emmelkamp, PM, Weijnen, IJ, van den Hout, M, van Dyck, R. Long-term effectiveness and prediction of treatment outcome in cognitive behavioural therapy and sertraline for late-life anxiety disorders. Int Psychogeriatr 2009; 21: 1148–59.CrossRefGoogle ScholarPubMed
107Kunik, ME, Veazey, C, Cully, JA, Souchek, J, Graham, DP, Hopko, D, Carter, R, Sharafkhaneh, A, Goepfert, EJ, Wray, N, Stanley, MA. COPD education and cognitive behavioural therapy group treatment for clinically significant symptoms of depression and anxiety in COPD patients: a randomized controlled trial. Psychol Med 2008; 38: 385–96.CrossRefGoogle ScholarPubMed
108Caudle, DD, Senior, AC, Wetherell, JL, Rhoades, HM, Beck, JG, Kunik, ME, Snow, AL, Wilson, NL, Stanley, MA. Cognitive errors, symptom severity, and response to cognitive behaviour therapy in older adults with generalized anxiety disorder. Am J Geriatr Psychiatry 2007; 15: 680–89.CrossRefGoogle ScholarPubMed
109Kraus, CA, Seignourel, P, Balasubramanyam, V, Snow, AL, Wilson, NL, Kunik, ME, Schulz, PE, Stanley, MA. Cognitive-behavioral treatment for anxiety in patients with dementia: two case studies. J Psychiatr Pract 2008; 14: 186–92.CrossRefGoogle ScholarPubMed
110Goncalves, DC, Byrne, GJ. Interventions for generalized anxiety disorder in older adults: Systematic review and meta-analysis. J Anxiety Disord 2012; 26: 111.CrossRefGoogle ScholarPubMed
111Pinquart, M, Duberstein, PR. Treatment of anxiety disorders in older adults: a meta-analytic comparison of behavioural and pharmacological interventions. Am J Geriatr Psychiatry 2007; 15: 639–51.CrossRefGoogle ScholarPubMed
112Lenze, EJ, Mulsant, BH, Shear, MK, Dew, MA, Miller, MD, Pollock, BG, Houck, P, Tracey, B, Reynolds, CF 3rd. Efficacy and tolerability of citalopram in the treatment of late-life anxiety disorders: results from an 8-week randomized, placebo-controlled trial. Am J Psychiatry 2005; 162: 146–50.CrossRefGoogle ScholarPubMed
113Goodman, WK, Bose, A. Wang Q. Treatment of generalized anxiety disorder with escitalopram: pooled results from double-blind, placebo-controlled trials. J Affect Disord 2005; 87: 161–67.CrossRefGoogle ScholarPubMed
114Flint, AJ. Generalised anxiety disorder in elderly patients: epidemiology, diagnosis and treatment options. Drugs Aging 2005; 22: 101–14.CrossRefGoogle ScholarPubMed
115Katz, IR, Reynolds, CF, Alexopoulos, GS, Hackett, D. Venlafaxine ER as a treatment for generalized anxiety disorder in older adults: a pooled analysis of five randomized placebo-controlled clinical trials. J Am Geriatr Soc 2002; 50: 1825.CrossRefGoogle Scholar
116Baldwin, DS, Woods, R, Lawson, R, Taylor, D. Efficacy of drug treatments for generalised anxiety disorder: systematic review and meta-analysis. BMJ 2011; 342: 1199.CrossRefGoogle ScholarPubMed
117Flint, AJ, Gagnon, N. Diagnosis and management of panic disorder in older patients. Drugs Aging 2003; 20: 881–91.CrossRefGoogle ScholarPubMed
118Dorman, T. The management of depression, and the use of lofepramine in the elderly. Br J Clin Pract 1988; 42: 459–64.CrossRefGoogle ScholarPubMed
119Madhusoodanan, S, Bogunovic, OJ. Safety of benzodiazepines in the geriatric population. Expert Opin Drug Saf 2004; 3: 485–93.CrossRefGoogle ScholarPubMed
120Wagner, AK, Zhang, F, Soumerai, SB, Walker, AM, Gurwitz, JH, Glynn, RJ, Ross-Degnan, D. Benzodiazepine use and hip fractures in the elderly: who is at greatest risk? Arch Intern Med 2004; 164: 1567–72.CrossRefGoogle ScholarPubMed
121Gray, SL, LaCroix, AZ, Hanlon, JT, Penninx, BW, Blough, DK, Leveille, SG, Artz, MB, Guralnik, JM, Buchner, DM. Benzodiazepine use and physical disability in community-dwelling older adults. J Am Geriatr Soc 2006; 54: 224–30.CrossRefGoogle ScholarPubMed
122Chessick, CA, Allen, MH, Thase, M, Batista Miralha da Cunha, AB, Kapczinski, FF, de Lima, MS, dos Santos Souza, JJ. Azapirones for generalized anxiety disorder. Cochrane Database Syst Rev 2006; 3: CD006115.Google Scholar
123Robinson, D, Napoliello, MJ, Schenk, J. The safety and usefulness of buspirone as an anxiolytic drug in elderly versus young patients. Clin Ther 1988; 10: 740–46.Google ScholarPubMed
124Böhm, C, Robinson, DS, Gammans, RE, Shrotriya, RC, Alms, DR, Leroy, A, Placchi, M. Buspirone therapy in anxious elderly patients: a controlled clinical trial. J Clin Psychopharmacol 1990; 10: 4751S.CrossRefGoogle ScholarPubMed
125Majercsik, E, Haller, J. Interactions between anxiety, social support, health status and buspirone efficacy in elderly patients. Prog Neuropsychopharmacol Biol Psychiatry 2004; 28: 1161–69.CrossRefGoogle ScholarPubMed
126Montgomery, S, Chatamra, K, Pauer, L, Whalen, E, Baldinetti, F. Efficacy and safety of pregabalin with generalised anxiety disorder. Br J Psychiatry 2008; 193: 389–94.CrossRefGoogle ScholarPubMed
127LaLonde, CD, Van Lieshout, RJ. Treating generalized anxiety disorder with second generation antipsychotics: a systematic review and meta-analysis. J Clin Psychopharmacol 2011: 31: 326–33.CrossRefGoogle ScholarPubMed
128Maher, AR, Maglione, M, Bagley, S, Suttorp, M, Hu, JH, Ewing, B, Wang, Z, Timmer, M, Sultzer, D, Shekelle, PG. Efficacy and comparable effectiveness of atypical antipsychotic medications for off-label use: a systematic review and meta-analysis. JAMA 2011; 306: 1359–69.CrossRefGoogle ScholarPubMed