Generalized Anxiety Disorder

Generalized anxiety disorder (GAD) is highly prevalent and disabling in older adults and is frequently comorbid with other conditions such as late-life depression, other anxiety disorders, and substance use disorders. While the condition is underdiagnosed, GAD may be identified using a careful history, mental status examination, focused physical and neurological examination, and appropriate laboratory testing. Evidence supports both pharmacologic and non-pharmacologic treatments for GAD in older adults, although effect sizes tend to be larger for pharmacologic treatments such as selective serotonin reuptake inhibitors due to added nonspecific (i.e., placebo) effects. Combination of pharmacotherapy and psychotherapy may have added benefits over pharmacotherapy alone to reduce worry, but not other anxiety symptoms.