A Lifespan View of Anxiety Disorders

Overview

Journal Dialogues Clin Neurosci

Specialty Neurology

Date 2012 Jan 26

PMID 22275845

Citations 73

Authors

Eric J Lenze

Julie Loebach Wetherell

Affiliations

Soon will be listed here.

Abstract

Neurodevelopmental changes over the lifespan, from childhood through adulthood into old age, have important implications for the onset, presentation, course, and treatment of anxiety disorders. This article presents data on anxiety disorders as they appear in older adults, as compared with earlier in life. In this article, we focus on aging-related changes in the epidemiology, presentation, and treatment of anxiety disorders. Also, this article describes some of the gaps and limitations in our understanding and suggests research directions that may elucidate the mechanisms of anxiety disorder development later in life. Finally we describe optimal management of anxiety disorders across the lifespan, in "eight simple steps" for practitioners.

Citing Articles

Effects of Client-Centered Occupational Therapy Intervention in Older Adults With Depression: A Randomized Controlled Trial.

Jeong H, Kim D Occup Ther Int. 2025; 2025:5559899.

PMID: 40007511 PMC: 11858707. DOI: 10.1155/oti/5559899.

Unraveling the relationship between stress exposure and childhood anxiety: Considering accumulation, impact, and type in the first five years of life.

Valdes V, Craighead L, Nelson C, Bosquet Enlow M PLoS One. 2024; 19(12):e0315019.

PMID: 39724082 PMC: 11670961. DOI: 10.1371/journal.pone.0315019.

Factors associated with anxiety and fear of falling in older adults: A rapid systematic review of reviews.

Whitmore C, Neil-Sztramko S, Grenier S, Gough A, Goodarzi Z, Weir E PLoS One. 2024; 19(12):e0315185.

PMID: 39693333 PMC: 11654959. DOI: 10.1371/journal.pone.0315185.

Mental and physical health characteristics of older and younger adults receiving medication for opioid use disorder.

Walker T, Mohankumar R, Kraus S, Cotton B, Renn B Front Public Health. 2024; 12:1418690.

PMID: 39600404 PMC: 11588491. DOI: 10.3389/fpubh.2024.1418690.

An Application of : A Spiritual, Cost-Effective, Indigenous Low-Intensity Psychological Intervention to Manage Common Mental Disorders: A Cross-Sectional Pilot Study in India.

Balkrishna A, Gupta A, Ghosh S, Arya V J Evid Based Integr Med. 2024; 29:2515690X241284280.

PMID: 39403733 PMC: 11526240. DOI: 10.1177/2515690X241284280.

References

Raffa S, Stoddard J, White K, Barlow D, Gorman J, Shear M . Relapse following combined treatment discontinuation in a placebo-controlled trial for panic disorder. J Nerv Ment Dis. 2008; 196(7):548-55. DOI: 10.1097/NMD.0b013e31817cf6f7. View

Sapolsky R, Romero L, Munck A . How do glucocorticoids influence stress responses? Integrating permissive, suppressive, stimulatory, and preparative actions. Endocr Rev. 2000; 21(1):55-89. DOI: 10.1210/edrv.21.1.0389. View

Bishop S . What do we really know about mindfulness-based stress reduction?. Psychosom Med. 2002; 64(1):71-83. DOI: 10.1097/00006842-200201000-00010. View

Thorp S, Ayers C, Nuevo R, Stoddard J, Sorrell J, Wetherell J . Meta-analysis comparing different behavioral treatments for late-life anxiety. Am J Geriatr Psychiatry. 2009; 17(2):105-15. PMC: 2794407. DOI: 10.1097/JGP.0b013e31818b3f7e. View

Kern S, Oakes T, Stone C, McAuliff E, Kirschbaum C, Davidson R . Glucose metabolic changes in the prefrontal cortex are associated with HPA axis response to a psychosocial stressor. Psychoneuroendocrinology. 2008; 33(4):517-29. PMC: 2601562. DOI: 10.1016/j.psyneuen.2008.01.010. View

Gagnon N, Flint A, Naglie G, Devins G . Affective correlates of fear of falling in elderly persons. Am J Geriatr Psychiatry. 2005; 13(1):7-14. DOI: 10.1176/appi.ajgp.13.1.7. View

Paukert A, Phillips L, Cully J, LoboPrabhu S, Lomax J, Stanley M . Integration of religion into cognitive-behavioral therapy for geriatric anxiety and depression. J Psychiatr Pract. 2009; 15(2):103-12. DOI: 10.1097/01.pra.0000348363.88676.4d. View

Mohlman J, Bryant C, Lenze E, Stanley M, Gum A, Flint A . Improving recognition of late life anxiety disorders in Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition: observations and recommendations of the Advisory Committee to the Lifespan Disorders Work Group. Int J Geriatr Psychiatry. 2011; 27(6):549-56. PMC: 4048716. DOI: 10.1002/gps.2752. View

Gum A, King-Kallimanis B, Kohn R . Prevalence of mood, anxiety, and substance-abuse disorders for older Americans in the national comorbidity survey-replication. Am J Geriatr Psychiatry. 2009; 17(9):769-81. DOI: 10.1097/JGP.0b013e3181ad4f5a. View

10.

Stanley M, Beck J, Novy D, Averill P, Swann A, Diefenbach G . Cognitive-behavioral treatment of late-life generalized anxiety disorder. J Consult Clin Psychol. 2003; 71(2):309-19. DOI: 10.1037/0022-006x.71.2.309. View

11.

Shapiro S, Oman D, Thoresen C, Plante T, Flinders T . Cultivating mindfulness: effects on well-being. J Clin Psychol. 2008; 64(7):840-62. DOI: 10.1002/jclp.20491. View

12.

Flint A, Rifat S . Anxious depression in elderly patients. Response to antidepressant treatment. Am J Geriatr Psychiatry. 1997; 5(2):107-15. View

13.

Woo S, Prince S, Petrella J, Hellegers C, Doraiswamy P . Modulation of a human memory circuit by subsyndromal depression in late life: a functional magnetic resonance imaging study. Am J Geriatr Psychiatry. 2008; 17(1):24-9. PMC: 2614878. DOI: 10.1097/JGP.0b013e318180056a. View

14.

Kimura M, Tateno A, Robinson R . Treatment of poststroke generalized anxiety disorder comorbid with poststroke depression: merged analysis of nortriptyline trials. Am J Geriatr Psychiatry. 2003; 11(3):320-7. View

15.

Andreescu C, Lenze E, Dew M, Begley A, Mulsant B, Dombrovski A . Effect of comorbid anxiety on treatment response and relapse risk in late-life depression: controlled study. Br J Psychiatry. 2007; 190:344-9. DOI: 10.1192/bjp.bp.106.027169. View

16.

Bremmer M, Beekman A, Deeg D, Penninx B, Dik M, Hack C . Inflammatory markers in late-life depression: results from a population-based study. J Affect Disord. 2007; 106(3):249-55. DOI: 10.1016/j.jad.2007.07.002. View

17.

Hays R, Bjorner J, Revicki D, Spritzer K, Cella D . Development of physical and mental health summary scores from the patient-reported outcomes measurement information system (PROMIS) global items. Qual Life Res. 2009; 18(7):873-80. PMC: 2724630. DOI: 10.1007/s11136-009-9496-9. View

18.

Brenes G, Kritchevsky S, Mehta K, Yaffe K, Simonsick E, Ayonayon H . Scared to death: results from the Health, Aging, and Body Composition study. Am J Geriatr Psychiatry. 2007; 15(3):262-5. PMC: 2879643. DOI: 10.1097/JGP.0b013e31802e21f0. View

19.

Rewston C, Clarke C, Moniz-Cook E, Waddington R . Distinguishing worry from rumination in older people: a preliminary investigation. Aging Ment Health. 2007; 11(5):604-11. DOI: 10.1080/13607860701529619. View

20.

Chou K . Age at onset of generalized anxiety disorder in older adults. Am J Geriatr Psychiatry. 2009; 17(6):455-64. DOI: 10.1097/jgp.0b013e31818f3a93. View