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Senior Health

Older Adults and Mental Health: Part 2: Anxiety Disorder

Temporary and chronic are two ways to categorize anxiety. Temporary anxiety refers to the everyday worries or concerns that come and go without much impact on our lives. The following are a few examples of common temporary concerns:

As people age, become ill or face challenges with day-to-day living, many of our worries may become more complex and chronic. The more intense our anxiety, the more likely people are to become obsessive and have uncontrollable thoughts. The following are a few examples of older people's worries that may result in chronic anxiety:

Anxiety disorders are NOT considered part of the normal aging process.
People of all ages experience anxiety from time to time. The complexity of aging and the many changes and challenges involved provides fertile ground for anxiety disorders to flourish. Unidentified or untreated anxiety disorders in older people are a threat to overall wellbeing and adversely affect quality of life.

Evidence suggests that with the older adult population, anxiety occurs almost twice as often as depression, yet depression is addressed more frequently.1 Although there is minimal research and evidence about anxiety and aging, the Office of the U.S. Surgeon General includes anxiety as a major public health issue. The following reflect findings specific to adults ages 55 and older:

Generalized Anxiety Disorders - % age that met criteria:

Example Risk Factors:

In situations where a person is diagnosed with an anxiety disorder, getting the proper treatment is essential. As professionals, it is important to be aware that recurrent, chronic anxiety can complicate or exacerbate illness and pain, which limits the ability to perform daily tasks.

Symptoms of Generalized Anxiety Disorder (GAD), the most common anxiety condition, include:

Because older people tend to attach a negative stigma to mental health issues they often describe anxieties as problems with their "nerves" and being "nervous and upset" about things. They may also describe mental health concerns by complaining about their physical health (e.g. nausea, fatigue, sleep deprivation).

Professionals are in a position to screen older adults who may be suffering from anxiety yet are reluctant to report mental health problems. The Anxiety Disorder Association of America suggests the following questions that may be helpful to identify potential anxiety disorders in older people:

While there is minimal evidence to guide practice, anxiety disorders in older adults are complex and may require a holistic or inter-disciplinary approach. Studies indicate that older people have responded well to interventions such as cognitive behavioral therapy, counseling, and medications.6

Although anxiety disorders are not a part of natural aging and are not inevitable, it is a common problem affecting older people that professionals need to recognize and address because..."Worry never robs tomorrow of its sorrow, it only saps today of its joy." (L.Buscalia)

Recommended Resource - Evelyn's Pick

The American Geriatrics Society, an organization dedicated to improving the health, independence and quality of life of all older people offers the following information on anxiety: www.healthinaging.org/agingintheknow/chapters_print_ch_trial.asp?ch=33

References:

  1. Office of U.S. Surgeon General. U.S. Public Health Service. www.surgeongeneral.gov/library/mentalhealth/chapter5/sec5.html#anxiety
  2. Ibid.
  3. Mauk, K.L. (2006). Gerontological Nursing: Competencies for Care. Sudbury, MA: Jones and Bartlett.
  4. National Institute of Mental Health - www.nimh.nih.gov/health/topics/generalized-anxiety-disorder-gad/index.shtml
  5. Anxiety Disorders Association of America - www.adaa.org/GettingHelp/FocusOn/Elderly.asp
  6. Ibid.

GERO GEMS is a monthly publication of the Center for Aging with Dignity. Compiled by Evelyn Fitzwater, this publication is designed to raise awareness of aging and related issues impacting health care professionals and our society as a whole.

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Last Reviewed: Feb 26, 2008

University of Cincinnati Evelyn L. Fitzwater, DSN, RN
Associate Professor Emerita
Associate Director, Center for Aging with Dignity
College of Nursing
University of Cincinnati
Evelyn L. Fitzwater, DSN, RN