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Research Article

Anxiety Symptoms and Generalized Anxiety Disorder in the Elderly: A Review

Pages 180-193 | Published online: 03 Jul 2009

  • Himmelfarb S, Murrell SA. The prevalence and correlates of anxiety symptoms in older adults. J Psychol 1984;116:159-67.
  • Zung WW. Prevalence of clinically significant anxiety in a family practice setting. Am J Psychiatry 1986;143:1471-2.
  • Regier DA, Boyd JH, Burke JD Jr, Rae DS, Myers JK, Kramer M, et al. One-month prevalence of mental disorders in the United States. Based on five Epidemiologic Catchment Area sites. Arch Gen Psychiatry 1988;45:977-86.
  • Beekman AT, Bremmer MA, Deeg DJ, van Balkom AJ, Smit JH, de Beurs E, et al. Anxiety disorders in later life: a report from the Longitudinal Aging Study Amsterdam. Int J Geriatr Psychiatry 1998;13:717-26.
  • Henderson AS, Kay DW. The epidemiology of mental disorders in the aged. In: Kay DWK, Burrows GD, eds. Handbook of studies in psychiatry and old age. Amsterdam: Elsevier, 1984:53-88.
  • Bland RC, Newman SC, Om H. Prevalence of psychiatric disorders in the elderly in Edmonton. Acta Psychiatr Scand Suppl 1988;338:57-63.
  • Fuentes K, Cox BJ. Prevalence of anxiety disorders in elderly adults: a critical analysis. J Behav Ther Exp Psychiatry 1997;28:269-79.
  • Blazer D, George LK, Hughes D. The epidemiology of anxiety disorders: an age comparison. In: Salzman C, Lebowitz BD, eds. Anxiety in the elderly: treatment and research. Springer: New York, 1991:17-30.
  • Uhlenhuth EH, Baiter MB, Mellinger GD, Cisin IH, Clinthorne J. Symptom checklist syndromes in the general population. Correlations with psychotherapeutic drug use. Arch Gen Psychiatry 1983;40:1167-73.
  • Krasucki C, Howard R, Mann A. The relationship between anxiety disorders and age. Int J Geriatr Psychiatry 1998;13:79-99.
  • de Beurs E, Beekman AT, van Balkom AJ, Deeg DJ, van Dyck R, van Tilburg W. Consequences of anxiety in older persons: its effect on disability, well-being and use of health services. Psychol Med 1999;29:583-93.
  • Kubzansky LD, Kawachi I, Spiro A 3rd, Weise ST, Vokonas PS, Sparrow D. Is worrying bad for your heart? A prospective study of worry and coronary heart disease in the Normative Aging Study. Circulation 1997;95:818-24.
  • Jonas BS, Franks P, Ingram DD. Are symptoms of anxiety and depression risk factors for hypertension? Longitudinal evidence from the National Health and Nutrition Examination Survey I Epidemiologic Follow-up Study. Arch Fam Med 1997;6:43-9.
  • Fava M, Abraham M, Pava J, Shuster J, Rosenbaum J. Cardiovascular risk factors in depression. The role of anxiety and anger. Psychosomatics 1996;37:31-7.
  • Wittchen HU, Carter RM, Pfister H, Montgomery SA, Kessler RC. Disabilities and quality of life in pure and comorbid generalized anxiety disorder and major depression in a national survey, bit Clin Psychopharmacol 2000;15:319-28.
  • Shapiro S, Skinner EA, Kessler LG, Von Korff M, German PS, Tischler GL, et al. Utilization of health and mental health services. Three Epidemiologic Catchment Area sites. Arch Gen Psychiatry 1984;41:971-8.
  • Goldberg D, Bridges K. Detecting anxiety and depression in general medical settings. BMJ 1988;297:897-9.
  • Mendlowicz MV, Stein MB. Quality of life in individuals with anxiety disorders. Am J Psychiatry 2000;157:669-82.
  • Beck JG, Stanley MA, Zebb BJ. Characteristics of generalized anxiety disorder in older adults: a descriptive study. Behav Res Ther 1996;34:225-34.
  • Diefenbach GJ, Stanley MA, Beck JG. Worry content reported by older adults with and without generalized anxiety disorder. Aging Ment Health 2001;5:269-74.
  • Powers CB, Wisocki PA, Whitbourne SK. Age differences and correlates of worrying in young and elderly adults. Gerontologist 1992;32:82-8.
  • Maier W, Gansicke M, Freyberger HJ, Linz M, Heun R, Lecrubier Y. Generalized anxiety disorder (ICD-10) in primary care from a cross-cultural perspective: a valid diagnostic entity? Acta Psychiatr Scand 2000;101:29-36.
  • Judd LL, Kessler RC, Paulus MP, Zeller PV, Wittchen HU, Kunovac JL. Comorbidity as a fundamental feature of generalized anxiety disorders: results from the National Comorbidity Study (NCS). Acta Psychiatr Scand Suppl 1998;393: 6-11.
  • Beekman AT, de Beurs E, van Balkom AJ, Deeg DJ, van Dyck R, van Tilburg W. Anxiety and depression in later life: co-occurrence and communality of risk factors. Am J Psychiatry 2000;157:89-95.
  • Lenze EJ, Mulsant BH, Shear MK, Schulberg HC, Dew MA, Begley AE, et al. Comorbid anxiety disorders in depressed elderly patients. Am J Psychiatry 2000;157:722-8.
  • Parmelee PA, Katz IR, Lawton MP. Anxiety and its association with depression among institutionalized elderly. Am J Geriatr Psychiatry 1993;1:46-58.
  • Mulsant BH, Reynolds CF 3rd, Shear MK, Sweet RA, Miller M. Comorbid anxiety disorders in late-life depression. Anxiety 1996;2:242-7.
  • Flint AJ, Rifat SL. Anxious depression in elderly patients: response to antidepressant treatment. Am J Geriatr Psychiatry 1997;5:107-15.
  • Flint AJ, Rifat SL. Effect of demographic and clinical variables on time to antidepressant response in geriatric depression. Depress Anxiety 1997;5:103-7.
  • Flint AJ, Rifat SL. Two-year outcome of elderly patients with anxious depression. Psychiatry Res 1997;66:23-31.
  • Coryell W, Endicott J, Winokur G. Anxiety syndromes as epiphenomena of primary major depression: outcome and familial psychopathology. Am J Psychiatry 1992;149: 100-7.
  • Kessler RC, DuPont RL, Berglund P, Wittchen H-U. Impairment in pure and comorbid generalized anxiety disorder and major depression at 12 months in two national surveys. Am J Psychiatry 1999;156:1915-23.
  • Clayton PJ, Grove WM, Coryell W, Keller M, Hirschfeld R, Fawcett J. Follow-up and family study of anxious depression. Am J Psychiatry 1991;148:1512-7.
  • Bruce SE, Machan JT, DyckI, Keller MB. Infrequency of "pure" GAD: impact of psychiatric comorbidity on clinical course. Depress Anxiety 2001;14:219-25.
  • Sallis JF, Lichstein KL. Analysis and management of geriatric anxiety. Int J Aging Hum Dev 1982;15:197-211.
  • Turnbull JM. Anxiety and physical illness in the elderly. J Clin Psychiatry 1989;50(suppl):40-5.
  • Kathol RG, Turner R, Delahunt J. Depression and anxiety associated with hyperthyroidism: response to antithyroid therapy. Psychosomatics 1986;27:501-5.
  • Lustman PJ, Griffith LS, Clouse RE, Cryer PE. Psychiatric illness in diabetes mellitus. Relationship to symptoms and glucose control. J Nerv Ment Dis 1986;174:736-42.
  • Popkin MK, Callies AL, Lentz RD, Colon EA, Sutherland DE. Behavioral assessment of anxiety in older adults. Prevalence of major depression, simple phobia, and other psychiatric disorders in patients with long-standing type I diabetes mellitus. Arch Gen Psychiatry 1988;45:64-8.
  • Beitman BD, Kushner M, Lamberti JW, Mukerji V. Panic disorder without fear in patients with angiographically normal coronary arteries. J Nerv Ment Dis 1990;178:307-12.
  • Karajgi B, Riflrin A, Doddi S, Kolli R. The prevalence of anxiety disorders in patients with chronic obstructive pulmonary disease. Am J Psychiatry 1990;147:200-1.
  • Yellowlees PM, Alpers JH, Bowden JJ, Bryant GD, Ruffin RE. Psychiatric morbidity in patients with chronic airflow obstruction. Med J Aust 1987;146:305-7.
  • Kane FJ Jr, Strohlein J, Harper RG. Nonulcer dyspepsia associated with psychiatric disorder. South Med J 1993;86: 641-6.
  • Stein MB, Heuser IJ, Juncos JL, Uhde TW. Anxiety disorders in patients with Parkinson's disease. Am J Psychiatry 1990;147:217-20.
  • Schiffer RB, Kurlan R, Rubin A, Boer S. Evidence for atypical depression in Parkinson's disease. Am J Psychiatry 1988;145:1020-2.
  • Dawson DA, Adams PF. Current estimates from the National Health Interview Survey: United States, 1986. Washington, DC: U.S. Government Printing Office, 1987 [Department of Health and Human Services pub. no. (PHS)87-1502 (Vital and Health Statistics, series 10, no. 164)].
  • Burke KC, Burke JD, Regier DA, Rae DS. Age at onset of selected mental disorders in five community populations. Arch Gen Psychiatry 1990;47:511-8.
  • Lindsay J. Phobic disorders in the elderly. Br J Psychiatry 1991;159:531-41.
  • Goldberg DP, Huxley P. Common mental disorders: a bio-social model. London: Routledge, 1992.
  • de Beurs E, Beekman AT, Deeg DJ, Van Dyck R, van Tilburg W. Predictors of change in anxiety symptoms of older persons: results from the Longitudinal Aging Study Amsterdam. Psychol Med 2000;30:515-27.
  • Astrom M. Generalized anxiety disorder in stroke patients. A 3-year longitudinal study. Stroke 1996;27:270-5.
  • Castillo CS, Starkstein SE, Fedoroff JP, Price TR, Robinson RG. Generalized anxiety disorder after stroke. J Nerv Ment Dis 1993;181:100-6.
  • Teri L, Ferretti LE, Gibbons LE, Logsdon RG, McCurry SM, Kukull WA, et al. Anxiety of Alzheimer's disease: prevalence and comorbidity. J Gerontol A Biol Sei Med Sci 1999;54:M348-52.
  • Chemerinski E, Petracca G, Manes F, Leiguarda R, Starkstein SE. Prevalence and correlates of anxiety in Alzheimer's disease. Depress Anxiety 1998;7:166-70.
  • Ferretti L, McCurry SM, Logsdon R, Gibbons L, Teri L. Anxiety and Alzheimer's disease. J Geriatr Psychiatry Neurol 2001;14:52-8.
  • House A, Dennis M, Mogridge L, Warlow C, Hawton K, Jones L. Mood disorders in the year after first stroke. Br J Psychiatry 1991;158:83-92.
  • Koukopoulos A, Koukopoulos A. Agitated depression as a mixed state and the problem of melancholia. Psychiatr Clin North Am 1999;22:547-64.
  • Clark DA, Steer RA, Beck AT. Common and specific dimensions of self-reported anxiety and depression: implications for the cognitive and tripartite models. J Abnorm Psychol 1994;103:645-54.
  • Garcia-Coll C, Kagan J, Reznick JS. Behavioral inhibition in young children. Child Dev 1984;55:1005-19.
  • Ressler KJ, Nemeroff CB. Role of serotonergic and noradrenergic systems in the pathophysiology of depression and anxiety disorders. Depress Anxiety 2000;12(suppl 1):2-19.
  • American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 3rd ed. Washington, DC: American Psychiatric Association, 1980.
  • White LR, Cartwright WS, Cornoni-Huntley J, Brock DB. Geriatric epidemiology. Annu Rev Gerontol Geriatr 1986;6:215-311.
  • Monane M. Insomnia in the elderly. J Clin Psychiatry 1992;53(suppl):23-8.
  • Akiskal HS. Toward a definition of generalized anxiety disorder as an anxious temperament type. Acta Psychiatr Scand Suppl 1998;393:66-73.
  • McCarthy PR, Katz SR, Foa EB. Cognitive-behavioral treatment of anxiety in the elderly: a proposed model. In: Salzman C, Lebowitz BD, eds. Anxiety in the elderly. New York: Springer, 1991:197-214.
  • Wisodri PA, Handen B, Morse CK. The Worry Scale as a measure of anxiety among homebound and community active elderly. Behav Ther 1986;6:91-5.
  • Spielberger C, Gorsuch R, Lushene R. Manual for the State-Trait Anxiety Inventory. PaIo Alto, CA:Consulting Psychologists Press, 1970.
  • Meyer TJ, Miller ML, Metzger RL, Borkovec TD. Development and validation of the Perm State Worry Questionnaire. Behav Res Ther 1990;28:487-95.
  • Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol 1988;56:893-7.
  • Zigmond AS, Snaith RP. The Hospital Anxiety and Depression Scale. Acta Psychiatr Scand 1983;67:361-70.
  • Marks I, Mathews A. Brief standardized self-rating for phobic patients. Behav Res Ther 1979;17:263-7.
  • Hopko DR, Bourland SL, Stanley MA, Beck JG, Novy DM, Averill PM, et al. Generalized anxiety disorder in older adults: examining the relation between clinician severity ratings and patient self-report measures. Depress Anxiety 2000; 12:217-25.
  • Cox BJ, Cohen E, Direnfeld DM, Swinson RP. Does the Beck Anxiety Inventory measure anything beyond panic attack symptoms? Behav Res Ther 1996;34:949-54.
  • Kvaal K, Laake K, Engedal K. Psychometric properties of the state part of the Spielberger State-Trait Anxiety Inventory (STAI) in geriatric patients. Int J Geriatr Psychiatry 2001;16:980-6.
  • Kabacoff RI, Segal DL, Hersen M, Van Rasselt VB. Psychometric properties and diagnostic utility of the Beck Anxiety Inventory and the State-Trait Anxiety Inventory with older adult psychiatric outpatients. J Anxiety Disord 1997;11:33-47.
  • Spinhoven P, Ormel J, Sloekers PP, Kempen GI, Speckens AE, Van Hemert AM. A validation study of the Hospital Anxiety and Depression Scale (HADS) in different groups of Dutch subjects. Psychol Med 1997;27:363-70.
  • Mykletun A, Stordal E, Dahl AA. Hospital Anxiety and Depression (HAD) scale: factor structure, item analyses and internal consistency in a large population. Br J Psychiatry 2001;179:540-4.
  • Flint AJ, Rifat SL. Factor structure of the hospital anxiety and depression scale in older patients with major depression. Int J Geriatr Psychiatry 2002;17:117-23.
  • Williams JB, Gibbon M, First MB, Spitzer RL, Davies M, Borus J, et al. The Structured Clinical Interview for DSM-III-R (SCID). II. Multisite test-retest reliability. Arch Gen Psychiatry 1992;49:630-6.
  • Di Nardo P, Moras K, Barlow DH, Rapee RM, Brown TA. Reliability of DSM-III-R anxiety disorder categories. Using the Anxiety Disorders Interview Schedule-Revised (ADIS-R). Arch Gen Psychiatry 1993;50:251-6.
  • Hamilton M. The assessment of anxiety states by rating. Br J Med Psychol 1959;32:50-5.
  • Snaith RP, Baugh SJ, Clayden AD, Husain A, Sipple MA. The Clinical Anxiety Scale: an instrument derived from the Hamilton Anxiety Scale. Br J Psychiatry 1982;141:518-20.
  • Kogan JN, Edelstein BA, McKee DR. Assessment of anxiety in older adults: current statue. J Anxiety Disord 2000; 14:109-32.
  • Barlow DH, Rapee RM, Brown TA. Behavioral treatment of generalized anxiety disorder. Behav Ther 1992;23:551-70.
  • Gould RA, Otto MN, Pollack MH, Yap L. Cognitive-behavioral and pharmacological treatment of generalized anxiety disorder: a preliminary meta-analysis. Behav Ther 1997;28:285-305.
  • Stanley MA, Novy DM. Cognitive-behavior therapy for generalized anxiety in late life: an evaluative overview. J Anxiety Disord 2000;14:191-207.
  • Stanley MA, Beck JG, Glassco JD. Treatment of generalized anxiety in older adults. A preliminary comparison of cognitive-behavioral and supportive approaches. Behav Ther 1996;27:565-81.
  • Mohlman J, Gorenstein EE, Kleber M, De Jesus M, German JM, Papp LA. Standard and enhanced cognitive-behavior therapy for late-life generalized anxiety disorder: two pilot investigations. Am J Geriatr Psychiatry 2003;11:24-32.
  • Stanley MA, Hopko DR, Diefenbach GJ, Bourland SL, Rodriguez H, Wagener P. Cognitive-behavior therapy for late-life generalized anxiety disorder in primary care. Am J Geriatr Psychiatry 2003;11:92-6.
  • Pomara N, Tun H, DaSilva D, Hemando R, Deptula D, Greenblatt DJ. The acute and chronic performance effects of alprazolam and lorazepam in the elderly: relationship to duration of treatment and self-rated sedation. Psychopharmacol Bull 1998;34:139-53.
  • Bertz RJ, Kroboth PD, Kroboth FJ, Reynolds IJ, Salek F, Wright CE, et al. Alprazolam in young and elderly men: sensitivity and tolerance to psychomotor, sedative and memory effects. J Pharmacol Exp Ther 1997;281:1317-29.
  • Hemmelgam B, Suissa S, Huang A, Boivin JF, Pinard G. Benzodiazepine use and the risk of motor vehicle crash in the elderly. JAMA 1997;278:27-31.
  • Ryynanen OP, Kivela SL, Honkanen R, Laippala P, Saano V. Medications and chronic diseases as risk factors for falling injuries in the elderly. Scand J Soc Med 1993;21:264-71.
  • Ray WA, Thapa PB, Gideon P. Benzodiazepines and the risk of falls in nursing home residents. J Am Geriatr Soc 2000;48:682-5.
  • Patemiti S, Dufouil C, Alperovitch A. Long-term benzodiazepine use and cognitive decline in the elderly: the Epidemiology of Vascular Aging Study. J Clin Psychopharmacol 2002;22:285-93.
  • Egan M, Moride Y, Wolfson C, Monette J. Long-term continuous use of benzodiazepines by older adults in Quebec: prevalence, incidence and risk factors. J Am Geriatr Soc 2000;48:811-6.
  • Scientific Committee of the First International Consultation on Incontinence. Assessment and treatment of urinary incontinence. Lancet 2000;355:2153-8.
  • Landi F, Cesari M, Russo A, Onder G, Sgadari A, Bernabei R. Benzodiazepines and the risk of urinary incontinence in frail older persons living in the community. Clin Pharmacol Ther 2002;72:729-34.
  • Salzman C, Lebowitz B. Anxiety in the elderly: treatment and research. New York: Springer, 1991.
  • Lader M, Scotto JC. A multicentre double-blind comparison of hydroxyzine, buspirone and placebo in patients with generalized anxiety disorder. Psychopharmacology (Berl) 1998;139:402-6.
  • Pecknold JC, Matas M, Howarth BG, Roes C, Swinson R, Vezeau C, et al. Evaluation of buspirone as an antianxiety agent: buspirone and diazepam versus placebo. Can J Psychiatry 1989;34:766-71.
  • Cohn JB, Rickels K. A pooled, double-blind comparison of the effects of buspirone, diazepam and placebo in women with chronic anxiety. Curr Med Res Opin 1989;11:304-20.
  • Bohm C, Robinson DS, Gammans RE, Shrotriya RC, Ahns DR, Leroy A, et al. Buspirone therapy in anxious elderly patients: a controlled clinical trial. J Clin Psychopharmacol 1990; 10(3 suppl):47S-51S.
  • Davidson JR, DuPont RL, Hedges D, Haskins JT. Efficacy, safety, and tolerability of venlafaxine extended release and buspirone in outpatients with generalized anxiety disorder. J Clin Psychiatry 1999;60:528-35.
  • Bond AJ, Wingrove J, Valerie Curran H, Lader MH. Treatment of generalized anxiety disorder with a short course of psychological therapy, combined with buspirone or placebo. J Affect Disord 2002;72:267-71.
  • Lader M. Psychological effects of buspirone. J Clin Psychiatry 1982;43(12 pt 2):62-8.
  • Moskowitz H, Smiley A. Effects of chronically administered buspirone and diazepam on driving-related skills performance. J Clin Psychiatry 1982;43(12 pt 2):45-55.
  • Rickels K, Downing R, Schweizer E, Hassman H. Antidepressants for the treatment of generalized anxiety disorder. A placebo-controlled comparison of imipramine, trazodone, and diazepam. Arch Gen Psychiatry 1993;50:884-95.
  • Hoehn-Saric R, McLeod DR, Zimmerli WD. Differential effects of alprazolam and imipramine in generalized anxiety disorder: somatic versus psychic symptoms. J Clin Psychiatry 1988;49:293-301.
  • Katz IR, Reynolds CF 3rd, Alexopoulos GS, Hackett D. Venlafaxine ER as a treatment for generalized anxiety disorder in older adults: pooled analysis of five randomized placebocontrolled clinical trials. J Am Geriatr Soc 2002;50:18-25.
  • Allgulander C, Hackett D, Salinas E. Venlafaxine extended release (ER) in the treatment of generalized anxiety disorder: twenty-four-week placebo-controlled dose-ranging study. Br J Psychiatry 2001;179:15-22.
  • Silverstone PH, Salinas E. Efficacy of venlafaxine extended release in patients with major depressive disorder and comorbid generalized anxiety disorder. J Clin Psychiatry 2001;62: 523-9.
  • Pollack MH, Zaninelli R, Goddard A, McCafferty JP, Bellew KM, Burnham DB, et al. Paroxetine in the treatment of generalized anxiety disorder: results of a placebo-controlled, flexible-dosage trial. J Clin Psychiatry 2001;62:350-7.
  • Schmitt JA, Kruizinga MJ, Riedel WJ. Non-serotonergic pharmacological profiles and associated cognitive effects of serotonin reuptake inhibitors. J Psychopharmacol 2001;15: 173-9.
  • Kirby D, Harrigan S, Ames D. Hyponatraemia in elderly psychiatric patients treated with selective serotonin reuptake inhibitors and venlafaxine: a retrospective controlled study in an inpatient unit. Int J Geriatr Psychiatry 2002;17:231-7.
  • Thapa PB, Gideon P, Cost TW, Milam AB, Ray WA. Antidepressants and risk of falls among nursing home residents. N Engl J Med 1998;339:875-82.
  • Liu B, Andersen G, Mittmann N, To T, Axcell T, Shear N. Use of selective serotonin-reuptake inhibitors of tricyclic antidepressants and risk of hip fractures in elderly people. Lancet 1998;351:1303-7.
  • Pacher P, Ungvari Z. Selective serotonin-reuptake inhibitor antidepressants increase the risk of falls and hip fractures in elderly people by inhibiting cardiovascular ion channels. Med Hypotheses 2001;57:469-71.
  • Petrovic M, Vandierendonck A, Mariman A, van Maele G, Afschrift M, Pevemagie D. Personality traits and socioepidemiological status of hospitalised elderly benzodiazepine users. Int J Geriatr Psychiatry 2002;17:733-8.

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