Bringing the bedside to the bench, and then to the community: a prospectus for intervention research in late‐life anxiety disorders
Open accessAbstract
Background: Anxiety disorders are highly prevalent in elderly persons, and they are associated with functional impairment, poorer quality of life, and adverse long‐term consequences such as cognitive decline. Intervention research in late‐life anxiety disorders (LLAD) lags behind where it ought to be. Research in cognitive neuroscience, aging, and stress intersects in LLAD and provides the opportunity to develop innovative interventions to prevent chronic anxiety and its consequences in this age group. Methods: This paper evaluates gaps in the evidence base for treatment of LLAD and synthesizes recent research in cognitive neuroscience, basic behavioral science, stress, and aging. Results: We examine three intervention issues in LLAD: (1) prevention; (2) acute treatment; and (3) pre‐empting adverse consequences. We propose combining randomized controlled trials (RCTs) with mechanistic biobehavioral methodologies as an optimal approach for developing novel, optimized, and personalized treatments. Additionally, we examine three barriers in the field of LLAD research: (1) How do we measure anxiety?; (2) How do we raise awareness?; (3) How will we ensure our research is applicable to underserved populations (particularly minority groups)? Conclusions: This prospectus outlines approaches for intervention research that can reduce the morbidity of LLAD. Copyright © 2008 John Wiley & Sons, Ltd.
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It is challenging for clinicians and patients to differentiate between functional and pathological anxiety in older adults, and anxiety in elderly adults is regularly considered an epiphenomenon of a physical condition or part of normal aging.
“Also, it seems challenging for both clinicians and patients to differentiate between functional and pathological anxiety in older adults; anxiety in elderly adults is regularly considered to be an epiphenomenon of a physical condition or part of the normal aging process [4, 6].”
From An Internet-based Acceptance and Commitment Therapy intervention for older adults with anxiety complaints: study protocol for a cluster randomized controlled trial. (2018) · cites this paper as [4]
Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredSeveral characteristics of older adults contribute to anxiety symptoms going unrecognized and untreated, including stronger belief in self-reliance, higher perceived stigma, limited willingness to accept treatment, tendency to minimize symptoms, mobility problems, use of different terms to describe psychological problems, and problems with remembering and recognizing symptoms.
“This is due to several characteristics of this age group such as a stronger belief in self-reliance, higher perceived stigma of mental health problems, a limited willingness to accept treatment for such problems, a tendency to minimize symptoms, mobility problems, use of different terms to describe psychological problems, and problems with remembering and recognizing symptoms [4, 5].”
From An Internet-based Acceptance and Commitment Therapy intervention for older adults with anxiety complaints: study protocol for a cluster randomized controlled trial. (2018) · cites this paper as [4]
In “Barrier #1: How do we accurately measure anxiety in late life?” (page unavailable), the paper says older adults may downplay symptoms, use different language for anxiety, and have difficulty remembering or identifying symptoms. “Barrier #2: How do we increase awareness of late-life anxiety?” (page unavailable) also describes poor recognition. Our copy does not support the attributed claims about stronger self-reliance, greater stigma, limited willingness to accept treatment, or mobility problems as reasons symptoms go unrecognized or untreated. (LLM, conf=0.87)
Experimental — accuracy not yet measuredOnly a small proportion of anxious older adults receive adequate psychological help.
“Despite the repeatedly demonstrated negative impact of anxiety in later life, only a small proportion of anxious older adults receive adequate psychological help [7-9].”
From Blended Acceptance and Commitment Therapy Versus Face-to-face Cognitive Behavioral Therapy for Older Adults With Anxiety Symptoms in Primary Care: Pragmatic Single-blind Cluster Randomized Trial. (2021) · cites this paper as [7]
The Introduction (‘The gap’; page not provided) says little research has examined barriers to treatment-seeking in older adults. Barrier #2 describes low awareness of late-life anxiety, but neither section reports what proportion of anxious older adults receive adequate psychological help. Searches for treatment receipt, adequacy, and psychotherapy found no such estimate in our copy. (LLM, conf=0.73)
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References 137 · Cited by 57
- Authors
- Lenze, E. J., & Wetherell, J. L.
- Affiliations
- University of California San Diego (US)
- Corresponding author
- Lenze, Eric J.
- Venue
- International Journal of Geriatric Psychiatry
- Publisher
- Wiley
- Published
- 2008-07-09
- Volume
- 24
- Issue
- 1
- Pages
- 1-14
- ISSN
- 0885-6230 (ISSN-L)
- 1099-1166
- PMC
- PMC3635100
- OpenAlex
- W2123321838
- Cited by
- 57
- References
- 137
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 2 · 2023: 3 · 2022: 2 · 2021: 6 · 2020: 1 · 2019: 1 · 2018: 3 · 2017: 2 · 2016: 5 · 2015: 3 · 2014: 3 · 2013: 6 · 2012: 3
- FWCI
- 0.52
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- International Journal of Geriatric Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- Funders
- National Institutes of Health
- National Institute of Mental Health (R34MH080151, K23MH067643, R01MH070547)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Aging and Gerontology Research
- Keywords
- intervention research, anxiety prevention, cognitive decline, stress and aging, cognitive neuroscience, biobehavioral mechanisms, personalized treatment, anxiety assessment, underserved populations, minority groups, randomized controlled trials
- MeSH terms
- Aged, Aging, Anxiety Disorders, Humans, Research, Stress, Psychological, Randomized Controlled Trials as Topic, Evidence-Based Medicine, Cognitive Science, Behavioral Research
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