Purpose <p>To assess the burden of anxiety disorders in the elderly and temporal trends at global, regional, and national levels during 1990-2021.</p> Methods <p>Data on incidence, prevalence, and disability-adjusted life years (DALYs) of anxiety disorders in the elderly over 60 years old were extracted from the Global Burden of Disease Study 2021. Average annual percentage changes were determined to analyze the trends in age-standardized rates between 1990 and 2021. Correlation between age-standardized rates and Socio-demographic Index (SDI) was assessed using Spearman’s rank-correlation analysis. We used a meta-regression model to estimate the incidence, prevalence, and DALY rates before and during the COVID-19 pandemic.</p> Results <p>In 2021, 4.49 million incident cases, 53.07 million prevalent cases, and 5.83 million DALYs were estimated in the elderly worldwide. The age-standardized incidence rate of anxiety disorders in older adults increased slightly, while prevalence and DALY rates remained stable. Middle SDI regions had the highest number of incident cases, prevalent cases, and DALYs, with the highest age-standardized prevalence and DALY rates in high SDI regions. Age-standardized prevalence and DALY rates of anxiety disorders were higher among elderly women than men. During the COVID-19 pandemic, the incidence rate of anxiety disorders among older adults rose by 7.82%, while prevalence and DALY rates increased by approximately 6%.</p> Conclusion <p>Over the past three decades, the increasing burden of anxiety disorders among older adults has significantly added to the global mental health challenges. This burden is intensified by socioeconomic factors, especially in middle SDI regions, and exacerbated by the COVID-19 pandemic.</p>