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Anxiety in Late Life

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Mental Health and Illness of the Elderly

Part of the book series: Mental Health and Illness Worldwide ((MHIW))

Abstract

This chapter focuses on anxiety disorders, which occur at high prevalence throughout the world. It summarizes contemporary findings on prevalence and risk factors. It deals with assessment issues, including rating scales. It explores the available evidence on effective management strategies in older people, including behavior therapy and antidepressant medication. Emphasis is given to the role of non-pharmacological interventions. The chapter deals with several controversial issues, including the limited evidence for the manual-based psychotherapies in late-life anxiety disorders and the role of benzodiazepines and antipsychotics. Anxiety disorders are often underestimated as causes of human distress and disability.

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References

  • American Psychiatric Association. (2013) Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC. 

    Google Scholar 

  • Andreas S, Schulz H, Volkert J, Dehoust M, Sehner S, Suling A, Ausin B, Canuto A, Crawford M, Da Ronch C, Grassi L, Hershkovitz Y, Muñoz M, Quirk A, Rotenstein O, Santos-Olmo AB, Shalev A, Strehle J, Weber K, Wegscheider K, Wittchen HU, Härter M. (2016) Prevalence of mental disorders in elderly people: the European MentDis_ICF65+ study. Br J Psychiatry, Sep 8. pii: bjp.bp.115.180463 (Epub ahead of print]

    Google Scholar 

  • Archer N, Brown RG, Reeves SJ, Boothby H, Nicholas H, Foy C, Williams J, Lovestone S (2007) Premorbid personality and behavioural and psychological symptoms in probable Alzheimer disease. Am J Geriatr Psychiatry 15:202–213

    Article  PubMed  Google Scholar 

  • Baxter AJ, Vos T, Scott KM, Norman RE, Flaxman AD, Blore J, Whiteford HA (2014a) The regional distribution of anxiety disorders: implications for the Global Burden of Disease Study, 2010. Int J Methods Psychiatr Res 23(4):422–438

    Article  PubMed  Google Scholar 

  • Baxter AJ, Vos T, Scott KM, Ferrari AJ, Whiteford HA (2014b) The global burden of anxiety disorders in 2010. Psychol Med 44:2363–2374

    Article  CAS  PubMed  Google Scholar 

  • Byers AL, Yaffe K, Covinsky KE, Friedman MB, Bruce ML (2010) High occurrence of mood and anxiety disorders among older adults: the National Comorbidity Survey Replication. Arch Gen Psychiatry 67:489–496

    Article  PubMed  PubMed Central  Google Scholar 

  • Byrne GJ (2013) Anxiety disorders in older people. Ch 45. In: Dening T, Thomas A (eds) Oxford textbook of old age psychiatry. Oxford University Press, Oxford

    Google Scholar 

  • Byrne GJ, Pachana NA (2011) Development and validation of a short form of the geriatric anxiety inventory – the GAI-SF. Int Psychogeriatr 23:125–131

    Article  PubMed  Google Scholar 

  • Byrne GJ, Raphael B (1997) The psychological symptoms of conjugal bereavement in elderly men over the first 13 months. Int J Geriatr Psychiatry 12:241–251

    Article  CAS  PubMed  Google Scholar 

  • Byrne GJ, Steele SJ, Pachana NA (2015) Delusion-like experiences in older people with anxiety disorders. Int Psychogeriatr 27:1191–1196

    Article  PubMed  Google Scholar 

  • Coelho CM, Goncalves DC, Purkis H, Pocinho M, Pachana NA, Byrne GJ (2010) Specific phobias in older adults: characteristics and differential diagnosis. Int Psychogeriatr 22:702–711

    Article  PubMed  Google Scholar 

  • Darwin C (1872) The expression of the emotions in man and animals. John Murray, London

    Book  Google Scholar 

  • Dissanayaka NN, Sellbach A, Matheson S, O’Sullivan JD, Silburn PA, Byrne GJ, Marsh R, Mellick GD (2010) Anxiety disorders in Parkinson’s disease: prevalence and risk factors. Mov Disord 25:838–845

    Article  PubMed  Google Scholar 

  • Dissanayaka NN, O’Sullivan JD, Pachana NA, Marsh R, Silburn PA, White EX, Torbey E, Mellick GD, Copland DA, Byrne GJ (2016) Disease-specific anxiety symptomatology in Parkinson’s disease. Int Psychogeriatr 28:1153–1163

    Article  PubMed  Google Scholar 

  • Folstein MF, Folstein SE, McHugh PR (1975) “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12:189–198

    Article  CAS  PubMed  Google Scholar 

  • Fung AW, Chan WC, Wong CS, Chen EY, Ng RM, Lee EH, Chang WC, Hung SF, Cheung EF, Sham PC, Chiu HF, Lam M, Chiang TP, van Os J, Lau JT, Lewis G, Bebbington P, Lam LC; Hong Kong Mental Morbidity Survey Team. (2016) Prevalence of anxiety disorders in community dwelling older adults in Hong Kong. Int Psychogeriatr Oct 21:1–9. [Epub ahead of print]

    Google Scholar 

  • Gilbertson MW, Shenton ME, CIszewski A, Kasai K, Lasko NB, Orr SP, Pitman RK (2002) Smaller hippocampal volume predicts pathologic vulnerability to psychological trauma. Nat Neurosci 5:1242–1247

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Gillespie NA, Kirk KM, Evans DM, Health AC, Hickie IB, Martin NG (2004) Do the genetic or environmental determinants of anxiety and depression change with age? A longitudinal study of Australian twins. Twin Res 7:39–53

    Article  PubMed  Google Scholar 

  • Gonçalves DC, Byrne GJ (2012) Sooner or later: age at onset of generalized anxiety disorder in older adults. Depress Anxiety 29:39–46

    Article  PubMed  Google Scholar 

  • Gonçalves DC, Byrne GJ (2013) Interventions for generalized anxiety disorder in older adults: systematic review and meta-analysis. J Anxiety Disord 26:1–11

    Article  Google Scholar 

  • Gould CE, Segal DL, Yochim BP, Pachana NA, Byrne GJ, Beaudreau SA (2014) Measuring anxiety in late life: a psychometric examination of the geriatric anxiety inventory and geriatric anxiety scale. J Anxiety Disord 28:804–811

    Article  PubMed  Google Scholar 

  • Helmes E, Ward BG (2015) Mindfulness-based cognitive therapy for anxiety symptoms in older adults in residential care. Aging Ment Health 13:1–7. [Epub ahead of print]

    Google Scholar 

  • Hollingworth SA, Siskind DJ (2010) Anxiolytic, hypnotic and sedative medication use in Australia. Pharmacoepidemiol Drug Saf 19:280–288

    Article  PubMed  Google Scholar 

  • Hsieh S, Schubert S, Hoon C, Mioshi E, Hodges JR (2013) Validation of the Addenbrooke’s cognitive examination III in frontotemporal dementia and Alzheimer’s disease. Dement Geriatr Cogn Disord 36:242–250

    Article  PubMed  Google Scholar 

  • Laidlaw K, Thompson LW, Dick-Siskin L, Gallagher-Thompson D (2003) Cognitive behaviour therapy with older people. Wiley, Chichester

    Book  Google Scholar 

  • Lam CL, Fong DY, Chin WY, Lee PW, Lam ET, Lo YY (2010) Brief problem-solving treatment in primary care (PST-PC) was not more effective than placebo for elderly patients screened positive for psychological problems. Int J Geriatr Psychiatry 25:968–980

    Article  PubMed  Google Scholar 

  • Liu D, Diorio J, Day JC, Francis DD, Meaney MJ (2000) Maternal care, hippocampal synaptogenesis and cognitive development in rats. Nat Neurosci 3:799–806

    Article  CAS  PubMed  Google Scholar 

  • Miloyan B, Byrne GJ, Pachana NA (2014) Social phobia symptoms across the adult lifespan. J Affect Disord 168:86–90

    Article  PubMed  Google Scholar 

  • Miloyan B, Byrne GJ, Pachana NA (2015) Threshold and subthreshold generalized anxiety disorder in later life. Am J Geriatr Psychiatry 23:633–641

    Article  PubMed  Google Scholar 

  • Nasreddine ZS, Phillips NA, Bedirian V, Charbonneau S, Whitehead V, Collin I, Cummings JL, Chertkow H (2005) The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc 53:695–699

    Article  PubMed  Google Scholar 

  • Nepon J, Belik SL, Bolton J, Sareen J (2010) The relationship between anxiety disorders and suicide attempts: findings from the National Epidemiologic Survey on Alcohol and Related Conditions. Depress Anxiety 27:791–798

    Article  PubMed  PubMed Central  Google Scholar 

  • Nilsson J, Ostline S, Waern M, Karlsson B, Sigstrom R, Guo X, Skoog I (2012) The 1-month prevalence of generalized anxiety disorder according to DSM-IV, DSM-V, and ICD-10 among nondemented 75-year-olds in Gothenburg, Sweden. Am J Psychiatr 20(11):963–972

    Google Scholar 

  • Norrholm SD, Ressler KJ (2009) Genetics of anxiety and trauma-related disorders. Neuroscience 164:272–287

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Olfson M, King M, Schoenbaum M (2015) Benzodiazepine use in the United States. JAMA Psychiatry 72:136–142

    Article  PubMed  Google Scholar 

  • Pachana NA, Byrne GJ, Siddle H, Koloski N, Harley E, Arnold E (2007a) Development and validation of the geriatric anxiety inventory. Int Psychogeriatr 19:103–114

    Article  PubMed  Google Scholar 

  • Pachana NA, Woodward RM, Byrne GJ (2007b) Treatment of specific phobia in older adults. J Clin Interv Aging 2:469–476

    Google Scholar 

  • Prigerson HG, Shear MK, Newsom JT, Frank E, Reynolds CF, Maciejewski PK, Houck PR, Bierhais AJ, Kupfer DJ (1996) Anxiety among widowed elders: is it distinct from depression and grief? Anxiety 2:1–12

    Article  CAS  PubMed  Google Scholar 

  • Prina AM, Ferri CP, Guerra M, Brayne C, Prince M (2011) Prevalence of anxiety and its correlates among older adults in Latin America, India and China: cross-cultural study. Br J Psychiatry 199:485–491

    Article  PubMed  PubMed Central  Google Scholar 

  • Robins Wahlin TB, Byrne GJ (2011) Personality changes in Alzheimer’s disease: a systematic review. Int J Geriatr Psychiatry 26:1019–1029

    Article  PubMed  Google Scholar 

  • Seekles W, van Straten A, Beekman A, van Marwijk H, Cuijpers P (2011) Effectiveness of guided self-help for depression and anxiety disorders in primary care: a pragmatic randomized controlled trial. Psychiatry Res 187:113–120

    Article  PubMed  Google Scholar 

  • Shapiro AM, Benedict RH, Schretlen D, Brandt J (1999) Construct and concurrent validity of the Hopkins Verbal Learning Test-revised. Clin Neuropsychol 13:348–358

    Article  CAS  PubMed  Google Scholar 

  • van der Veen DC, Van Zelst WH, Schoevers RA, Comijs HC, Voshaar RC (2015) Comorbid anxiety disorders in late-life depression: results of a cohort study. Int Psychogeriatr 27:1157–1165

    Article  PubMed  Google Scholar 

  • Voshaar RC, Couvee JE, van Balkom AJ, Mulder PG, Zitman FG (2006) Strategies for discontinuing long-term benzodiazepine use: meta-analysis. Br J Psychiatry 189:213–220

    Article  PubMed  Google Scholar 

  • Voshaar RC, van der Veen DC, Kapur N, Hunt I, Williams A, Pachana NA (2015) Suicide in patients suffering from late-life anxiety disorders: a comparison with younger patients. Int Psychogeriatr 27:1197–1205

    Article  PubMed  Google Scholar 

  • Wetherell JL, Petkus AJ, White KS, Nguyen H, Kornblith S, Andreescu C, Zisook S, Lenze EJ (2013) Antidepressant medication augmented with cognitive-behavioral therapy for generalized anxiety disorder in older adults. Am J Psychiatry 170:782–789

    Article  PubMed  PubMed Central  Google Scholar 

  • Xie P, Kranzler HR, Poling J, Stein MB, Anton RF, Brady K, Weiss RD, Farrer L, Gelernter J (2009) Interactive effect of stressful life events and the serotonin transporter 5-HTTLPR genotype on posttraumatic stress disorder diagnosis in two independent populations. Arch Gen Psychiatry 66:1201–1209

    Article  PubMed  PubMed Central  Google Scholar 

  • Yerkes RM, Dodson JD (1908) The relation of strength of stimulus to rapidity of habit-formation. J Comp Neurol Psychol 18:459–482

    Article  Google Scholar 

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Correspondence to Gerard J. Byrne .

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Byrne, G.J. (2016). Anxiety in Late Life. In: Chiu, H., Shulman, K. (eds) Mental Health and Illness of the Elderly. Mental Health and Illness Worldwide. Springer, Singapore. https://doi.org/10.1007/978-981-10-0370-7_13-1

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  • DOI: https://doi.org/10.1007/978-981-10-0370-7_13-1

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  • Print ISBN: 978-981-10-0370-7

  • Online ISBN: 978-981-10-0370-7

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