Anxiety Disorders

Clinically relevant symptoms of anxiety in aging adults have been estimated to range between 15% and 52% in a community sample, and between 15% and 56% in medical settings (Jayasinghe et al. Clin Gerontol 40:141–58, 2017). This chapter reviews common anxiety syndromes and age-appropriate treatment strategies. In spite of its prevalence, the identification of anxiety in the aging patient is challenging. Distinguishing anxiety from apprehension of normal aging is difficult; aging by itself may bring worries and increased caution, such as concern over the realistic risk of falling, avoidance of activities such as walking outside, or preoccupation with somatic symptoms or disabled partners. Geriatric individuals may focus on somatic symptoms rather than their anxiety. They may underreport psychological symptoms or use vague terms to describe anxiety, such as “concerns”. And experts differ about how anxiety typically presents in older versus younger adults. Finally, symptoms or signs of systemic medical comorbidities, substance abuse, medication misuse, and medication adverse effects overlap with anxiety disorders. Systemic medical conditions which contribute to anxiety are covered elsewhere (see Chaps. 3 , 7 , and 13 ).