Evidence-Based Treatment of Geriatric Anxiety Disorders
Section snippets
Method
MEDLINE and PsychINFO searches were conducted using the population term “aged” and keywords “anxiety disorders,” “treatment,” and “therapy.” The citation index in PsychINFO also was used to locate articles that cited relevant articles on the topic of treatment of anxiety in older adults. Reference lists from review articles and chapters on the treatment of geriatric anxiety also were examined, and investigators working in the field were contacted to solicit unpublished or in-press manuscripts.
Generalized anxiety disorder
Most psychotherapy studies of late-life anxiety have focused on GAD. The first such study [34] compared 14 weeks of group-administered CBT with supportive psychotherapy (SP) in a sample of 48 GAD patients who were at least 55 years of age. Participants were required to discontinue psychotropic medications before enrolling in the study. CBT consisted of education about anxiety, its symptoms, and its triggers; symptom monitoring; progressive, passive, and cue-controlled relaxation training;
Discussion
Overall, the available data suggest the potential value of both CBT and pharmacologic treatments for late-life anxiety disorders, most notably GAD. The CBT literature consistently documents a positive response relative to no treatment, although response rates are lower than is evident for younger adults and there is no consistent evidence of a significant CBT benefit relative to other psychosocial treatment options (eg, supportive therapy). The response to pharmacologic treatment may be more
Summary
Available data point to the potential value of pharmacologic and cognitive-behavioral interventions for the treatment of late-life anxiety disorders, with modest improvement and response rates in most cases. Further efficacy work is needed to investigate the impact of improved psychosocial approaches that allow for more idiosyncratic attention to the needs of older patients and outcomes following a broader range of pharmacologic treatments. Attention in this work needs to be given to long-term
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This work was supported by National Institute of Mental Health grants MH53932, MH067643, and MH064196.