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Chapter: Psychiatric Mental Health Nursing : Anxiety, Anxiety Disorders, and Stress-Related Illness

Elder Considerations - Anxiety, Anxiety Disorders, and Stress-Related Illness

Anxiety that starts for the first time in late life is frequently associated with another condition such as depression, dementia, physical illness, or medication toxicity or with-drawal.

ELDER CONSIDERATIONS

 

Anxiety that starts for the first time in late life is frequently associated with another condition such as depression, dementia, physical illness, or medication toxicity or with-drawal. Phobias, particularly agoraphobia, and GAD are the most common late-life anxiety disorders. Most people with late-onset agoraphobia attribute the start of the dis-order to the abrupt onset of a physical illness or as a response to a traumatic event such as a fall or mugging. Late-onset GAD is usually associated with depression. Though less common, panic attacks can occur in later life and are often related to depression or a physical illness such as cardiovascular, gastrointestinal, or chronic pul-monary diseases. Ruminative thoughts are common in late-life depression and can take the form of obsessions such as contamination fears, pathologic doubt, or fear of harming others. The treatment of choice for anxiety disor-ders in the elderly is selective serotonin reuptake inhibi-tor (SSRI) antidepressants. Initial treatment involves doses lower than the usual starting doses for adults to ensure the elderly client can tolerate the medication: if started on too high a dose, SSRIs can exacerbate anxiety symptoms in elderly clients (Sakauye, 2008).

 

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Psychiatric Mental Health Nursing : Anxiety, Anxiety Disorders, and Stress-Related Illness : Elder Considerations - Anxiety, Anxiety Disorders, and Stress-Related Illness |


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