Doctors previously thought that anxiety declined with age, possibly because aging adults are more likely to go to the doctor for physical complaints than for psychiatric or emotional issues according to the Anxiety and Depression Association of America (ADAA.) They now know that the prevalence of anxiety in older people is the same as it is in younger people. Many older adults who have anxiety had it when they were younger as well.
The most common type of anxiety in older adults is generalized anxiety disorder (GAD), according to the ADAA. Some older adults have had anxiety for most of their lives, however, they have developed coping methods and have been able to hide the symptoms. Others develop anxiety later in life, although this isn’t as common. One-third of people with GAD have onset after the age of 50 and three percent develop it after the age of 65, according to a report in Current Psychiatry. The ADAA estimates that anywhere from 3.5 to 10.2 percent of aging adults have an anxiety disorder. Anxiety may be triggered by traumatic events, such as a fall or acute illness.
Diagnosing anxiety in aging adults
Anxiety disorders can be hard to spot anxiety in older adults. As people age, they face a variety of stressful situations, such as physical illness, issues with mobility, isolation, or mourning the loss of a spouse or friends. Concerned family and doctors may believe that worry, agitation, or anxiety are situational and due to these types of circumstances rather than believing the older adult has an anxiety disorder. Many aging adults with anxiety describe the symptoms as physical rather than emotional. Anxiety at these ages can appear as headaches, back pain or rapid heartbeat according to the ADAA.
Some older adults might be reluctant to talk about their anxiety symptoms with their children or their doctor. They grew up in a time when anxiety and other mental illnesses were seen as weaknesses rather than illnesses. The negative stigma attached to anxiety disorders might prevent them from seeking help.
It might also be difficult to spot the impairment from an anxiety disorder in those who are retired. Being impaired at work or in your social life are key signs of anxiety. When someone no longer works and has limited social opportunities the symptoms aren’t as clear. Those who have had an anxiety disorder most of their life may have long since adapted and adjusted their life to fit their anxiety symptoms. They no longer see anxiety as a problem, instead it is simply part of their life. They don’t know what life feels like without anxiety
Diagnosing anxiety in people with dementia can be especially hard. Impaired memory may be a sign of either anxiety or dementia and their fears can be exaggerated or realistic according to the ADAA. Anxiety disorders are more common in vascular dementia than in Alzheimer’s disease according to a report in American Journal of Geriatric Psychiatry.
Symptoms of anxiety in aging adults
The symptoms of anxiety in aging adults may appear differently too, according to a report in Current Psychiatry. Some of the ways anxiety shows up in older adults include:
- Express discomfort as pain or physical problems rather than psychological distress
- A high rate of medically unexplained symptoms
- Reduced ability to perform daily activities
- Generalized irritability or agitation
- Problems sleeping
- Refusing activities or avoidance of certain situations
- Concerns and worries seem out of proportion to the situation
- Excessive concern about safety
- Self-medicating with alcohol or pain medication
- Signs of depression such as overall sadness and tearfulness
In older adults, anxiety is often comorbid with major depressive disorder. Approximately 48 percent of people with depression between ages of 55 and 85 also had an anxiety disorder, according to a report in Current Psychiatry.
Treating anxiety in aging adults
Many older adults start with their primary physician when seeking treatment for anxiety disorders. They may be more apt to listen to treatment options or be more open to a referral to a mental health provider when it comes from someone they know and trust, according to a report in the American Journal of Geriatric Psychiatry.
Medications may not be the best choice for aging adults as they are more prone to the side effects and these medications can interact with medications for other health conditions according to Harvard Health. Cognitive behavioral therapy is a good first-line treatment but should be modified for older adults, such as providing homework reminders, going over skills more often and using examples of specific situations that may come up in their life.
It is also important to check current medications for side effects. Some medications can cause agitation and nervousness. It may be necessary to talk to doctors about ways to reduce the side effects.
Physical activity and exercise are an important part of treatment for anxiety in aging adults. Many have limited mobility, according to Harvard Health, which can contribute to or exacerbate feelings of anxiety. Working with a doctor to create an exercise plan can ensure that this treatment is age- and health-appropriate. Start slowly and have them take short walks for a few minutes with someone and build up to longer times.
Untreated anxiety can lead to cognitive impairment, disability, poor physical health, and a poor quality of life. Fortunately, anxiety is treatable with prescription drugs and therapy, according to a report from the Geriatric Mental Health Foundation.
See more helpful articles:
Eating Disorders in Older Adults
Anxiety in Older Adults
Four Medication Concerns for Elderly People With Anxiety
How Fears and Phobias Change as We Age