“With a common disorder that causes so much impairment in quality of life and that has simple, inexpensive, straightforward treatments, I think screening is called for,” he said.
Whatever the final task force recommendation, the discussion of anxiety in older people highlights a prevalent but often neglected mental health concern. “A lot of these cases fly under the radar,” Dr. Andreescu said.
It shows that symptoms of anxiety can vary among older people, whose primary care doctors often lack training to recognize mental health disorders. In addition to severe anxiety, seniors often experience insomnia or irritability; They may develop a fear of falling, engage in hoarding or complain of physical discomforts such as muscle tension, a sensation of suffocation, dizziness or tremors.
But underdiagnosis also stems from the reluctance of older patients to attribute their problems to psychological issues. “Some people resent the label of ‘concerned’,” Dr Andreescu said. “They call it ‘high tension,’ something that does not indicate psychological weakness.”
And since aging involves real sources of fear and distress, from falling apart to bereavement, people may view anxiety as normal, as Ms. Tilton did.
However, this has serious consequences. “It has an impact on the health of our brains and our bodies,” Dr. Andreescu said. Studies have demonstrated links between anxiety and heart disease, with a significantly increased risk of coronary heart disease, heart failure, stroke, and death. Patients with high anxiety levels are also more likely to engage in substance abuse.
Research also consistently shows that anxiety is linked to cognitive decline and dementia. Dr. Andreescu’s neuroimaging studies have found that “anxiety actually shrinks and ages the brain,” she said.