A systematic review of anxiety disorders among older adults: focus on treatment of generalized anxiety disorder
Journal Title: Journal of Geriatric Care and Research - Year 2017, Vol 4, Issue 1
Abstract
Background: Anxiety disorders typically have insidious onset that begin early in life with relatively few people (<1%) developing an anxiety disorder for the first time after the age of 65 years. However, anxiety disorders often are undetected and untreated in older adults. Objective: The aim of this systematic review is to evaluate the medical and psychological treatment for anxiety disorders in older adults with focus on generalized anxiety disorder (GAD). Methods: We conducted an electronic database search of Medline, Embase, PsycINFO, and National Health Service Economic Evaluation Databases for studies from October 2005 to October 2015 on anxiety disorders in older adults with a principal attention on GAD, and their management. Results: Various medications have been tried for anxiety disorders in older patients. There is evidence to suggest that duloxetine, sertraline, escitalopram, pregabalin, buspirone, quetiapine has been more effective than placebo or usual treatment. The efficacy and safety of duloxetine in the treatment of older patients with GAD have been reported. Pregabalin use in anxiety disorders compared to selective serotonin reuptake inhibitors or serotonin–norepinephrine reuptake inhibitors was associated with a reduction in the utilization of health care resources. Buspirone appeared to be superior to sertraline early in the treatment which became comparable later. Quetiapine has been observed to significantly improve anxiety, sleep parameters and quality of life in elderly patients with GAD compared to placebo. Cognitive behaviour therapy has been observed to be more effective than usual care. Conclusion: Although there are supportive evidence about the effectiveness of many medications and cognitive bebaviour therapy in the anxiety disorders of older people, there is a need for further studies to improve the evidence base.
Authors and Affiliations
Jiyeon Baek, Farooq Khan
Keywords
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