scholarly journals What happens to anxiety disorders in later life?

2002 ◽  
Vol 24 (suppl 1) ◽  
pp. 74-80 ◽  
Author(s):  
Gerard JA Byrne
Keyword(s):  
Anxiety Disorders ◽  
Older People ◽  
Older Patients ◽  
Depressive Disorders ◽  
Late Onset ◽  
Reliability And Validity ◽  
Later Life ◽  
Pharmacological Interventions ◽  
Measuring Change ◽  
Pathological Anxiety

Anxiety disorders decline in prevalence with advancing age but remain more common than depressive disorders. They are often of late-onset and there is frequent comorbidity with depressive disorders and physical illness. While anxiety disorders in older people are likely to respond to the same non-pharmacological interventions that have been shown to work in younger people, there is currently little formal evidence of this. Although there is some evidence that the non-benzodiazepine anxiolytic medication, buspirone, is effective against late life anxiety symptoms, clinical trials in older people with rigorously diagnosed anxiety disorders are needed. An anxiety scale with demonstrated reliability and validity in older people is needed for screening for pathological anxiety and for measuring change in older patients undergoing treatment for anxiety disorders.

Anxiety disorders in older people

2013 ◽  
Author(s):  
Gerard Byrne
Keyword(s):  
Anxiety Disorders ◽  
Older People ◽  
Relaxation Training ◽  
Antidepressant Medication ◽  
Older Person ◽  
Behaviour Therapy ◽  
Pharmacological Interventions ◽  
Cognitive Behaviour ◽  
Other Substances

Anxiety symptoms and anxiety disorders are highly prevalent among older people, including among those with physical frailty and cognitive impairment. Clinicians are advised to consider the effects of prescribed medication and other substances, and the influence of general medical conditions, in the older person presenting with anxiety. Psychological treatments are recommended for older people with anxiety disorders of mild to moderate severity. These include relaxation training, exposure-based interventions, and cognitive behaviour therapy. Pharmacological interventions are in widespread use, although there is little evidence in support of the long-term use of either benzodiazepines or antipsychotics in older people with anxiety disorders. Instead, treatment with antidepressant medication is recommended.

Emotion-modulated startle in anxiety disorders is blunted by co-morbid depressive episodes

2010 ◽  
Vol 41 (1) ◽  
pp. 129-139 ◽  
Author(s):  
A. Taylor-Clift ◽  
B. H. Morris ◽  
J. Rottenberg ◽  
M. Kovacs
Keyword(s):  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Depressive Episode ◽  
Emotional Reactivity ◽  
Depressive Disorders ◽  
Late Onset ◽  
Response Patterns ◽  
Emotional Responding ◽  
Depressive Episodes ◽  
A Current

BackgroundWhile anxiety has been associated with exaggerated emotional reactivity, depression has been associated with blunted, or context insensitive, emotional responding. Although anxiety and depressive disorders are frequently co-morbid, surprisingly little is known about emotional reactivity when the two disorders co-occur.MethodWe utilized the emotion-modulated startle (EMS) paradigm to examine the effects of a concurrent depressive episode on emotional reactivity in young adults with anxiety disorders. Using an archival dataset from a multi-disciplinary project on risk factors in childhood-onset depression, we examined eye-blink startle reactions to late-onset auditory startle probes while participants viewed pictures with affectively pleasant, unpleasant and neutral content. EMS response patterns were analyzed in 33 individuals with a current anxiety (but no depressive) disorder, 24 individuals with a current anxiety disorder and co-morbid depressive episode and 96 healthy controls.ResultsControl participants and those with a current anxiety disorder (but no depression) displayed normative linearity in startle responses, including potentiation by unpleasant pictures. By contrast, individuals with concurrent anxiety and depression displayed blunted EMS.ConclusionsAn anxiety disorder concurrent with a depressive episode is associated with reactivity that more closely resembles the pattern of emotional responding that is typical of depression (i.e. context insensitive) rather than the pattern that is typical for anxiety (i.e. exaggerated).

scholarly journals Lack of interventions for anxiety in older people

2013 ◽  
Vol 203 (1) ◽  
pp. 8-9 ◽  
Author(s):  
Richard C. Oude Voshaar
Keyword(s):  
Clinical Trials ◽  
Anxiety Disorders ◽  
Older People ◽  
Later Life ◽  
Current Treatment ◽  
Treatment Modalities ◽  
Appropriate Treatment ◽  
Psychotherapeutic Techniques

SummaryAlthough anxiety disorders are common in later life, only a minority of patients receive appropriate treatment. The scarcity of clinical trials and decreasing effectiveness of current treatment modalities with advancing age, as shown by Wetherell and colleagues in this issue, argue for more clinical trials and development of age-specific psychotherapeutic techniques.

scholarly journals The prevalence of, and risk factors for, loneliness in later life: a survey of older people in Great Britain

2005 ◽  
Vol 25 (6) ◽  
pp. 357-375 ◽  
Author(s):  
CHRISTINA R. VICTOR ◽  
SASHA J. SCAMBLER ◽  
ANN BOWLING ◽  
JOHN BOND
Keyword(s):  
Risk Factors ◽  
Great Britain ◽  
Older People ◽  
Basic Education ◽  
Rating Scale ◽  
Late Onset ◽  
Later Life ◽  
Social Resources ◽  
Current Health ◽  
Previous Decade

This study examines the prevalence of loneliness amongst older people in Great Britain, and makes comparisons with the findings of studies undertaken during the last five decades. In addition, the risk factors for loneliness are examined using a conceptual model of vulnerability and protective factors derived from a model of depression. Loneliness was measured using a self-rating scale, and measures of socio-demographic status and health/social resources were included. Interviews were undertaken with 999 people aged 65 or more years living in their own homes, and the sample was broadly representative of the population in 2001. Among them the prevalence of ‘severe loneliness’ was seven per cent, indicating little change over five decades. Six independent vulnerability factors for loneliness were identified: marital status, increases in loneliness over the previous decade, increases in time alone over the previous decade; elevated mental morbidity; poor current health; and poorer health in old age than expected. Advanced age and possession of post-basic education were independently protective of loneliness. From this evidence we propose that there are three loneliness pathways in later life: continuation of a long-established attribute, late-onset loneliness, and decreasing loneliness. Confirmation of the different trajectories suggests that policies and interventions should reflect the variability of loneliness in later life, for undifferentiated responses may be neither appropriate nor effective.

Psychopharmacology in older people

2013 ◽  
Author(s):  
Craig W. Ritchie
Keyword(s):  
Older People ◽  
Psychotropic Medication ◽  
Later Life ◽  
The Elderly ◽  
Pharmacological Interventions ◽  
Pharmacodynamic Effects ◽  
Adherence To Medication ◽  
Prescribing Practice ◽  
Altered Pharmacokinetic ◽  
Pharmacokinetic Drug

It is well recognised that older people are particularly sensitive to psychotropic medication. In general, pharmacological interventions in the elderly pose specific problems due to the patient exhibiting both altered pharmacokinetic drug profiles due to gerontological effects on absorption, distribution, metabolism and elimination of drug and pharmacodynamic effects related to aging and polypharmacy. Adherence to medication in later life also mediates sub-optimal pharmacological care. Finally, the effects of comorbidities which accumulate with advancing years should also influence prescribing practice in the elderly. The general principles underlying these changes and observations are discussed with specific examples listed to illustrate these points.

Development of an autobiographical memory test for older electroconvulsive therapy candidates

2021 ◽  
Vol 29 (2) ◽  
pp. 214-217
Author(s):  
Daniel Allan ◽  
Matthew Croucher ◽  
Susan Gee ◽  
Richard Porter
Keyword(s):  
Older People ◽  
Autobiographical Memory ◽  
Life Events ◽  
Electroconvulsive Therapy ◽  
Older Patients ◽  
Memory Loss ◽  
Later Life ◽  
Memory Test ◽  
Face Validity ◽  
Common Life

Objectives: To develop a test of autobiographical memory for monitoring of older people during a course of electroconvulsive therapy (ECT). Method: A list of events commonly experienced in later life was gathered from older people ( n = 26) at a psychogeriatric day clinic and from psychiatrists ( n = 23) who work with older depressed patients. The most common events were chosen as question domains for an autobiographical memory interview. This was piloted with 12 severely depressed older patients. Results: A list of 15 common life events was developed. After pilot testing, a final 30-item questionnaire covering six common life events was proposed. Conclusion: This study developed an autobiographical memory test with good face validity and potential for clinical use. It was modelled on a well-validated scale (The Columbia University Autobiographical Memory Interview, CUAMI-SF) and represented a useful first step in the development of a test for memory loss in older patients receiving ECT. The proposed test may be particularly sensitive to autobiographical memory loss in older people undergoing ECT because it uses recent personal memories, which are relatively commonly experienced in the older depressed population.

Anxiety disorders in older people

2020 ◽  
pp. 655-670
Author(s):  
Gerard Byrne
Keyword(s):  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Older People ◽  
Later Life ◽  
Moderate Increase ◽  
Contemporary Life ◽  
Modern Treatment ◽  
Genetic And Environmental Factors ◽  
The Individual ◽  
Fear And Anxiety

Fear and anxiety are phylogenetically ancient emotions that confer survival advantage across species. They facilitate escape from present danger and prepare the individual to deal rapidly with future threats. In contemporary life, a moderate increase in anxiety is commonly associated with increased performance. However, anxiety that is excessive or prolonged is maladaptive and may represent a mental disorder. Individual differences and contextual factors influence the final form that an anxiety disorder takes. Like many complex behaviours, anxiety disorders result from interactions between genetic and environmental factors. In older people, anxiety often complicates physical frailty and cognitive decline. From a nosological perspective, anxiety can be conceptualized as both dimensional and categorical. Both psychological and pharmacological treatments are commonly applied to anxiety disorders in older people, with moderate efficacy. This chapter deals with classification, epidemiology, scientific underpinnings, phenomenology, and modern treatment approaches to anxiety disorders in later life.

Psychotherapies and Older Adults

2003 ◽  
Vol 37 (5) ◽  
pp. 537-548 ◽  
Author(s):  
Jane Garner
Keyword(s):  
Older People ◽  
Older Patients ◽  
Psychiatric Care ◽  
Later Life ◽  
The Body ◽  
Therapeutic Technique ◽  
Psychotherapeutic Approach ◽  
Cognitive Behavioural ◽  
Old Age Psychiatry ◽  
Better Than

Objective: To confirm clinical experience which suggests that older people are offered psychotherapies significantly less often than younger ones. For those who are able to access psychotherapeutic help the outcome is comparable, sometimes better, than for younger patients. Method: Contemporary and older seminal literature was reviewed for psychodynamic, cognitive–behavioural, reminiscence and systemic family therapies treating older patients. Results: The main findings supported the experience of staff in old age psychiatry that if the reluctance of referrers and sometimes of older patients themselves can be overcome this type of work is valuable and effective. Conclusions: Each patient is unique. Generalizations are not always appropriate, however, with advancing years some common themes emerge in therapeutic work. It may be necessary to make modifications to the therapeutic technique to accommodate the difficulties experienced by people in later life but also to use their strengths. Staff working in this field need to have the capacity to be aware of and to understand their own feelings and prejudices about the second half of life. For patients not offered formal therapy a psychotherapeutic approach will nevertheless enhance their psychiatric care. Although the body of research is growing, more work needs to be done in evaluating all of the psychotherapies offered to older people.

Neurosurgery for obsessive-compulsive disorder, other anxiety disorders and depressive disorders

2014 ◽  
Author(s):  
David MB Christmas ◽  
Ian Crombie ◽  
Sam Eljamel ◽  
Naomi Fineberg ◽  
Bob MacVicar ◽  
...  
Keyword(s):  
Anxiety Disorders ◽  
Obsessive Compulsive Disorder ◽  
Depressive Disorders ◽  
Obsessive Compulsive ◽  
Compulsive Disorder
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