Elder Considerations - Anxiety, Anxiety Disorders, and Stress-Related Illness

 ELDER CONSIDERATIONS 

Anxiety that starts for the first time in late life is frequently associated with another condition such as depression, dementia, physical illness, or medication toxicity or with-drawal. Phobias, particularly agoraphobia, and GAD are the most common late-life anxiety disorders. Most people with late-onset agoraphobia attribute the start of the dis-order to the abrupt onset of a physical illness or as a response to a traumatic event such as a fall or mugging. Late-onset GAD is usually associated with depression. Though less common, panic attacks can occur in later life and are often related to depression or a physical illness such as cardiovascular, gastrointestinal, or chronic pul-monary diseases. Ruminative thoughts are common in late-life depression and can take the form of obsessions such as contamination fears, pathologic doubt, or fear of harming others. The treatment of choice for anxiety disor-ders in the elderly is selective serotonin reuptake inhibi-tor (SSRI) antidepressants. Initial treatment involves doses lower than the usual starting doses for adults to ensure the elderly client can tolerate the medication: if started on too high a dose, SSRIs can exacerbate anxiety symptoms in elderly clients (Sakauye, 2008).