Anxiety in Late Life: An Update on Pathomechanisms

Gerontology. 2019;65(5):465-473. doi: 10.1159/000500306. Epub 2019 Jun 18.

Abstract

Anxiety disorders are common, yet clinically underrecognized in late life, with estimated prevalence rates ranging from 1.2 to 15%. They are highly comorbid with depression, sleep disorders, and substance use disorders, may accelerate cognitive decline, and potentially catalyze morbidity and mortality risk in the elderly. Thus, a more detailed knowledge about the underlying mechanisms of late-life anxiety disorders is urgently warranted. Age-related genetic, neuroimaging, neuroendocrine, and neuropsychological markers as well as late-life specific psychosocial aspects, particularly loss and isolation, have been identified as prominent pathogenetically relevant and thus potentially targetable factors. Personalized treatments based on individual biological and biographic markers, innovative therapeutic approaches, and preventive strategies have great potential to alleviate the high individual and societal burden of late-life anxiety disorders.

Keywords: Anxiety disorders; Comorbidity; Elderly; Late life; Neuroendocrinology; Neuroimaging; Neuropsychology; Older adults.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Aged
  • Aging / psychology*
  • Anxiety / psychology
  • Anxiety Disorders / epidemiology
  • Anxiety Disorders / genetics
  • Anxiety Disorders / metabolism
  • Anxiety Disorders / psychology*
  • Cognitive Aging / psychology
  • Cognitive Dysfunction / epidemiology
  • Cognitive Dysfunction / psychology
  • Comorbidity
  • Depressive Disorder / epidemiology
  • Depressive Disorder / psychology
  • Humans
  • Hypothalamo-Hypophyseal System / metabolism
  • Pituitary-Adrenal System / metabolism
  • Sleep Wake Disorders / epidemiology
  • Sleep Wake Disorders / psychology
  • Social Isolation / psychology
  • Substance-Related Disorders / epidemiology
  • Substance-Related Disorders / psychology