Anxiety can affect people of all ages, including, and maybe especially, older adults. As people age, they experience significant life changes, such as retirement, losing friends or loved ones, and declining health. These changes can cause stress and anxiety. Additionally, some older adults may have medical conditions or take certain medications that can cause anxiety symptoms.
Although anxiety disorders are common among seniors, there is some debate over whether routine screening for anxiety should be recommended.
The U.S. Preventive Services Task Force, an influential panel of medical experts, has indicated that it is unlikely to recommend routine screening for anxiety in adults aged 65 and older with no symptoms or history of anxiety disorders. The panel’s reasoning is that there is insufficient evidence to support the effectiveness of routine screening in this population.
However, some experts disagree with this position. They argue that anxiety disorders are often underdiagnosed and undertreated in older adults and that routine screening could help identify those who could benefit from treatment. They also point out that anxiety disorders can have serious consequences for older adults, including increased risk of disability and reduced quality of life.
Lori Pbert, associate chief of the preventive and behavioral medicine division at the University of Massachusetts Chan Medical School and a former task force member who worked on the anxiety recommendations, said they are calling for more research on the issue.
“We recognize that many older adults experience mental health conditions like anxiety,” and “we are calling urgently for more research,” said Pbert.
As Dr. Carmen Andreescu, an associate professor of psychiatry at the University of Pittsburgh, notes, untreated anxiety in older adults can have serious consequences for their physical and mental health and also their quality of life. Routine screening could help identify at-risk patients and connect them with appropriate treatment.
“This ‘we don’t know enough yet’ stance doesn’t sit well with some experts who study and treat older people with anxiety,” Dr. Andreescu said. “It’s well-established that anxiety isn’t uncommon in older adults, and effective treatments exist.”
Dr. Andreescu’s perspective highlights an important point in the debate over routine screening for anxiety in older adults. While there may be limited evidence on the effectiveness of screening, it is well-established that anxiety is a common problem among older adults and that effective treatments are available.
“I cannot think of any danger in identifying anxiety in older adults, especially because doing so has no harm, and we can do things to reduce it,” said Dr. Helen Lavretsky, a psychology professor at UCLA.
Ultimately, deciding whether to screen for anxiety in older adults will depend on various factors, including individual risk factors and preferences and available resources for screening and treatment. Older adults and their healthcare providers need to discuss the potential benefits and risks of screening and make an informed decision based on their circumstances.
Anxiety is a Common Mental Concern Among Older People
The prevalence of anxiety disorders in this population is significant. As mentioned in the book chapter by Andreescu, up to 15% of older adults aged 65 and older who live outside nursing homes or other facilities have a diagnosable anxiety condition. However, up to half of older adults may experience symptoms of anxiety that do not meet the criteria for a diagnosis.
Besides, many older adults with anxiety have struggled with the condition since earlier in life, and how it manifests may change over time. Older adults may be more anxious about illness, loss of family and friends, retirement, and cognitive decline. However, it’s worth noting that some older adults may develop anxiety for the first time after turning 65, possibly due to life changes or medical conditions.
It May Be Difficult to Establish Anxiety in Older People
Anxiety can be difficult to identify in older adults, as they usually minimize their symptoms or attribute them to the everyday challenges of aging. Additionally, older adults may be more likely to report physical symptoms that can be difficult to distinguish from underlying medical conditions. This can make it challenging for healthcare providers to identify anxiety in older adults.
Nonetheless, the following simple questions (suggested by the experts) can help determine whether an older adult needs to be evaluated for anxiety.
- Do you have recurrent worries that are hard to control?
- Are you having trouble sleeping?
- Have you been feeling more irritable, stressed, or nervous?
- Are you having trouble with concentration or thinking?
- Are you avoiding things you normally like to do because you’re wrapped up in your worries?
Anxiety in Older People Can Be Treated
Anxiety treatments, including psychotherapy and relaxation therapy, can be effective for older people. Cognitive-behavioral therapy (CBT) has been shown to be effective in reducing anxiety symptoms in older adults. This therapy helps individuals identify and change negative thought patterns contributing to anxiety.
Relaxation therapy can also help manage anxiety in older people. This can include deep breathing exercises, massage, music therapy, yoga, and progressive muscle relaxation. These techniques can help individuals reduce physical symptoms of anxiety, such as muscle tension and breathing difficulties, and promote feelings of calmness and relaxation.
It’s important to note that the effectiveness of these treatments may vary depending on the individual, the severity of their anxiety, and other factors such as the presence of other health conditions. It’s always a good idea to consult a healthcare provider to determine the best treatment approach for an individual’s needs.