Identifying Underlying Anxiety in Older Adults

“Research estimates that about 10% to 12% of older adults have experienced anxiety in the prior year, but it’s underdiagnosed,” she says. “When clinicians look for it and ask specific questions in their assessments, they can more easily catch and address it.” 

Dr. Balasubramaniam offers these three reasons that anxiety may be underdiagnosed in older adults – along with related approaches that can help.

Presentation. Older adults with anxiety may not use that term to describe their symptoms. Instead, they may characterize it as fretting, worrying, or thinking about things too much.

Approach. Fine-tune questions accordingly, such as:

• Are you a worrier? Do you tend to worry more than others around you? 
• Tell me more about the kinds of things that worry you.
• Do you find yourself in a constant loop of worry that’s hard to get out of?
• Do you constantly imagine the worst outcomes?

Assumption. There’s a tendency to expect that people will experience more problems as they age. However, excessive worry and anxiety are not a normal part 
of aging. 

Approach. Do a self-assessment to illuminate any preconceived thoughts related to aging. Keep in mind that if anxiety is identified, treatment can lead to significant improvements in quality of life at any age.

Distinction. Mental health symptoms can overlap with issues related to physical health and medications, making them hard to tease out.

Approach. Get more specific to determine the source of the issue. For example, explore concepts like these:

When anxiety is identified, Dr. Balasubramaniam notes that older adults often do well with a combination of psychotherapy and medication that’s started at low levels and slowly titrated to the point where there’s a positive impact.

“We see older patients of all ages engaging in therapy and attaining positive outcomes in our Senior Link program,” she adds. “Physicians and other clinicians shouldn’t hesitate to refer to a higher level of care if needed.”