OBJECTIVE: The author reviewed the epidemiology and comorbidity of
anxiety disorders in the elderly. METHOD: Data from 1970 onward were
obtained through a computerized literature search, a review of Index
Medicus, and the bibliographies of retrieved articles. Eight random- sample
community surveys of anxiety disorders in persons 60 years of age or older
were identified. Studies relating to the comorbidity of late-life anxiety
and depression, dementia, alcoholism, and medical illness were also
reviewed. RESULTS: The majority of studies showed that anxiety disorders
are less common in the elderly than in younger adults. Generalized anxiety
disorder and phobias account for most anxiety in late life; panic disorder
is rare. Agoraphobia, and possibly obsessive-compulsive disorder in
females, may occur as a primary disorder for the first time in old age,
whereas simple phobia, obsessive-compulsive disorder in males, and panic
disorder either persist from younger years or arise in the context of
another psychiatric or medical disorder. There is considerable comorbidity
of geriatric depression and generalized anxiety disorder and phobias,
although the depression usually goes untreated or is inappropriately
treated with benzodiazepines. The rate of comorbidity of anxiety and
medical illness and alcoholism is lower in the elderly than in younger
persons. CONCLUSIONS: Epidemiologic data on the prevalence of posttraumatic
stress disorder (PTSD) and the first occurrence of generalized anxiety
disorder and PTSD in late life are still needed. Further comorbidity
studies are needed to determine the extent to which anxiety arises
secondary to depression, as well as the optimal treatment and prognosis for
this mixed state.Abstract Teaser