Older people with anxiety often have no help.this is the reason

CNN
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Anxiety is the most common mental disorder affecting adults in the United States. In older people, it is associated with considerable distress and poor health, poor quality of life, and increased rates of disability.

But when a leading independent panel of experts, the United States Preventive Services Task Force, last year proposed screening adults for anxiety, one group of people over the age of 65 was left out.

The main reason cited by the task force was draft recommendation Published September: “(T)Current evidence is insufficient to assess the balance of benefits and harms of anxiety screening in all older adults”. is scheduled for.)

The task force noted that questionnaires used to screen for anxiety may be unreliable for older adults. It involves evaluating people.

Deputy Chief of the Department of Preventive and Behavioral Medicine at the University of Massachusetts Chan College of Medicine and a former member of the task force working on anxiety recommendations.

This ‘we don’t know enough’ stance is unacceptable to some professionals who study and treat anxiety in older adults. Dr. Carmen Andreescu, an associate professor of psychiatry at the University of Pittsburgh, said the task force’s position was puzzling because “it’s well established that anxiety is common in the elderly and that effective treatments exist.” says there is.

Dr. Helen Lavretsky, professor of psychology at UCLA, said:

in a recent editorial JAMA PsychiatryAndreescu and Lavretsky note that only about one-third of older people with generalized anxiety disorder (intense, persistent worry about everyday things) receive treatment. That’s concerning, they said, given the evidence linking anxiety to neurodegenerative diseases such as stroke, heart failure, coronary artery disease, autoimmune disease and dementia.

Other forms of anxiety that are commonly undetected and untreated in older adults include phobias (such as fear of dogs), obsessive-compulsive disorder, panic disorder, and social anxiety disorder (a fear of being evaluated and judged by others). fear), and post-traumatic stress disorder. .

A smoldering disagreement about screening calls attention to the importance of anxiety in later life. This concern grew during his Covid-19 pandemic, which increased stress and anxiety among older people. Here’s what you should know:

According to the book chapter Released in 2020According to the paper, authored by Andreescu and colleagues, up to 15% of people over the age of 65 living outside nursing homes and other institutions have a diagnosable anxiety condition.

Studies show that half of people have anxiety symptoms, including irritability, worry, restlessness, difficulty concentrating, sleep changes, fatigue and avoidance behavior.

Most older people with anxiety suffer from this condition from an early age, but its manifestations can change over time. Experts say people tend to be more anxious about issues such as loss of life, retirement, and cognitive decline. Only a minority of people over the age of 65 become anxious.

Older people often minimize anxiety symptoms by thinking, “This is like getting old,” rather than “This is something I have to deal with.” .

They are also more likely than younger adults to complain of physical symptoms such as dizziness, fatigue, headaches, chest pain, shortness of breath, and gastrointestinal upset, which can be difficult to distinguish from underlying conditions, says Gretchen. Dr. Brenes, Wake He is Professor of Geriatrics and Geriatrics at Forest University School of Medicine.

Some types of anxiety or anxious behaviors—particularly hoarding and fear of falling—are much more common in older adults, but questionnaires aimed at identifying anxiety usually ask about these issues. No. University of Arizona Medical School in Tucson.

Eric Renze, Ph.D., director of psychiatry at the Washington University School of Medicine in St. Louis and third author of the recent JAMA Psychiatry editorial, said that when older people express concern, given the problem of aging, health care delivery too often they ignore it as normal. .

A simple question can help determine if an older person’s anxiety needs to be evaluated. Do you have trouble sleeping? Feeling irritable, stressed or nervous? Having trouble concentrating or thinking? Are you overwhelmed with worries and avoiding the things you usually want to do?

67-year-old Stephen Snyder of Zelienople, Pennsylvania, who was diagnosed with generalized anxiety disorder in March 2019, answered yes to many of these questions. “I’m a type A personality and worry about a lot of things: my family, my finances, my future,” he told me. There was a tendency to

Psychotherapy, particularly cognitive-behavioral therapy, helps people deal with persistent negative thoughts and is generally considered the first choice for anxiety treatment in older people. In a task force review of evidence, researchers noted that this type of therapy can help reduce anxiety in older adults seen in primary care settings.

Relaxation therapies including deep breathing exercises, massage or music therapy, yoga, and progressive muscle relaxation are also recommended.

Mental health practitioners, especially those who specialize in older people’s mental health, are so difficult to find that primary care physicians often recommend medications to ease anxiety.

Two categories of drugs, antidepressants known as SSRIs (selective serotonin reuptake inhibitors) and SNRIs (serotonin-norepinephrine reuptake inhibitors), are commonly prescribed, both appear to help older people. said the expert.

Frequently prescribed to older people, but to be avoided are benzodiazepines, a class of sedatives such as Valium, Ativan, Xanax, and Klonopin. The American Geriatrics Association warns health care providers not to use these in older adults unless other treatments have failed.