Senior men drinking tea together and chatting
2023 has become the year of mental illness. There is a lot of discussion about this. However, there is a segment of the population that has been forgotten, the elderly.
Anxiety is the most common mental health disorder; A 2017 study of older adults in six countries found that more than 17 percent had experienced an anxiety disorder within the past year.
Generalized anxiety disorder is the most common type among seniors. “The most prominent symptom is severe, difficult-to-control worry,” said Dr. Carmen Andreescu, a geriatric psychiatrist at the University of Pittsburgh School of Medicine and an author of a recent editorial on late-life anxiety in JAMA Psychiatry.
“There’s this continuing fear that something bad is going to happen,” she added. “It can be all-consuming.”
Other forms of anxiety include social anxiety disorder, phobias, panic disorder and post-traumatic stress disorder. Anxiety frequently occurs alongside depression, complicating diagnosis and treatment. The coronavirus pandemic, of course, led to rising anxiety and depression in all adult age groups.
Recently, attention to anxiety has increased because of a draft recommendation from the United States Preventive Services Task Force, an independent expert panel that reviews research on preventive measures.
The panel concluded that adults ages 18 to 64, including those who are pregnant and postpartum, should be screened for anxiety and gave that recommendation a “B” rating, meaning it had “moderate net benefit.” (Screening means testing patients who don’t exhibit symptoms or raise concerns about a particular health problem but may be experiencing it nonetheless.)
For people 65 and older, though, the task force issued an “I” rating, meaning it found insufficient evidence of benefits and harms.
“It’s a very scientifically rigorous process,” said Lori Pbert, a clinical psychologist and health behavior researcher at the University of Massachusetts Chan Medical School who served on the panel.
When it came to older adults, “evidence was lacking on the accuracy of screening tools and the benefits and harms of screening,” she said. The team also wanted more evidence of treatment effectiveness.
“It’s a strong call for the clinical research that’s needed,” Dr. Pbert said. The task force will publish its final recommendation later this year.
Dr. Andreescu and the other authors of the editorial, including Dr. Lenze, politely but strongly disagree. An “I” rating “makes people not look for or treat something that’s already an undertreated condition,” Dr. Lenze said.
“With a common disorder that causes a lot of impairment of quality of life and that has simple, inexpensive, straight-forward kinds of treatment, I think screening is called for,” he added.
Whatever the final task force recommendation, the discussion of anxiety in older people highlights a prevalent but often overlooked mental health concern. “A lot of these cases fly under the radar,” Dr. Andreescu said.
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