ANXIETY IN OLDER ADULTS Subtitle

HOW DO WE DEFINE ANXIETY? DEFINITION: we are all familiar with worrying about health, kids, finances etc. Anxiety differs from this worrying. When worrying becomes constant and starts to affect our physical health, our personal and social life, it becomes anxiety disorder

HOW COMMON IS ANXIETY DISORDER IN OLDER ADULTS? 30 % of adults presenting themselves in primary care setting present with anxiety symptoms As baby boomers become “older Adults” the percentage is expected to rise 4-8 times more common than depression in later life and twice as common as Dementia

Geriatric Giants Falls Frailty Dementia Incontinence Medication Issues Anxiety

RISK FACTORS Gender : its more common in women Chronic Medical Conditions : COPD, Diabetes, Stroke etc. Extreme stress or Trauma Single people People who have suffered Stressful Life Events such as death of a spouse People with less formal education Patients with physical limitations Alcohol, caffeine Psychiatric conditions such as Depression, Dementia Medication side effects of prescription as well as OTC medications

Signs of Anxiety Disorder in Older Adults Excessive worry or fear Avoiding social situations Overly concerned about safety Poor sleep Feeling weak and shaky Racing heart, shallow breathing , trembling, nausea, sweating Hoarding behavior Self medication with alcohol

DIAGNOSING ANXIETY in OLDER ADULTS Difficult to Diagnose as Older Adults commonly present themselves with physical symptoms such as palpitations or rapid heart rate, headaches, pain etc, Older Adults may be on several different medications and some of these medication side effects may be causing symptoms similar to those of Anxiety Taking good history is essential Anxiety Scales such as HAM-A is helpful

HAM-A

Treatment of Anxiety in Older Adults Adequate treatment of co-existing conditions Medications for Anxiety-SSRI, SNRI Anxiolytic drug BUSPAR Beta Blockers Short term, very judicious use of Benzodiazepines such as Xanax, Ativan Cognitive Behavior Therapy or CBT Relaxation Techniques

What Is CBT? Therapists help people change the thinking patterns that contribute to their fears and the ways they react to anxiety provoking situations Therapists can teach new coping skills, relaxation techniques Can also use exposure techniques to desensitize the patient to the situations that trigger anxiety. Usually takes 12 or less sessions