Cognitive behaviour therapy for generalized anxiety disorder: is CBT equally efficacious in adults of working age and older adults?

CBT for GAD is less effective for older adults compared with younger adults.

“Research on the efficacy of CBT for GAD across age generally suggests treatment is less effective for older adults compared with younger adults (Covin et al ., 2008; Hanrahan et al ., 2013; Kishita and Laidlaw, 2017)”

When compared to active control conditions, effect sizes favoring CBT are small in samples of older adults with anxiety symptoms and/or disorders.

“when compared to active control conditions, effect sizes favoring CBT are small in samples of older adults with anxiety symptoms and/or disorders [17].”

Evidence of lower efficacy of cognitive behavioural therapy for generalised anxiety disorder in older people than in working-age adults suggests that an alternative form of psychological intervention may be required.

“However, evidence of a lower efficacy of cognitive behavioural therapy for generalised anxiety disorder in older people than in working-age adults suggests that an alternative form of psychological intervention may be required.”

Evidence suggests lower efficacy of CBT for GAD in older people than in working-age adults.

“evidence of lower efficacy of CBT for GAD in older people than in working-age adults suggests that an alternative form of psychological intervention may be required.”

CBT also works well when delivered remotely, and to a lesser extent in the elderly.

“CBT also works well when delivered remotely [107], and to a lesser extent in the elderly [108,109].”

Meta-analytic evidence shows lower efficacy of CBT for GAD in older people compared to working-age adults.

“Meta-analytic evidence of lower efficacy of CBT for GAD in older people compared to working-age adults [9] suggests that an alternative form of psychological intervention may be required for managing TR-GAD in older people.”

An alternative form of psychological intervention may be required for managing TR-GAD in older people.

“Meta-analytic evidence of lower efficacy of CBT for GAD in older people compared to working-age adults [9] suggests that an alternative form of psychological intervention may be required for managing TR-GAD in older people.”

Some evidence suggests that older adults benefit less from CBT for anxiety than younger adults.

“some evidence suggests that older adults benefit less from CBT for anxiety than younger adults [11,19,20].”

A recent meta-analysis of CBT for GAD reported an overall effect size nearly double in younger people than in older people.

“For example, a recent meta-analysis of CBT for GAD reported an overall effect size that was nearly double that achieved in younger people than in older people {g = 0.94 [95% confidence interval (CI) 0.52 to 1.36] in working-age adults vs. g = 0.55 (95% CI 0.22 to 0.88) in older people}.33”

The overall effect size of CBT for generalized anxiety disorder is large for working-age adults (g = 0.94, 95% CI 0.52 to 1.36) but moderate for older people (g = 0.55, 95% CI 0.22 to 0.88).

“the overall effect size of CBT for GAD was large for adults of working age (g = 0.94, 95% CI 0.52–1.36), but was moderate for older people (g = 0.55, 95% CI 0.22–0.88) [39]”

There is clearly room for improvement in the provision of effective psychological interventions for generalised anxiety disorder in older people.

“As the authors of this meta-analysis noted, there is clearly room for improvement in the provision of effective psychological interventions for GAD in older people.”

A recent meta-analysis of cognitive behavioural therapy for generalised anxiety disorder reported an overall effect size nearly double in younger people than in older people (g = 0.94 in working-age adults vs. g = 0.55 in older people).

“For example, a recent meta-analysis of CBT for GAD reported an overall effect size that was nearly double that achieved in younger people than in older people {g = 0.94 [95% confidence interval (CI) 0.52 to 1.36] in working-age adults vs. g = 0.55 (95% CI 0.22 to 0.88) in older people}.33”

Smaller effect sizes in favour of CBT for GAD, as well as higher drop-out rates, have been reported among older people than among younger people.

“smaller effect sizes in favour of CBT for GAD, as well as higher drop-out rates, have been reported among older people than among younger people; 30,32,33”

Some evidence suggests that CBT is less effective in older adults than in younger samples.

“some evidence suggests that CBT is less effective in older adults than in younger samples [17, 18].”

Conventional CBT for generalised anxiety disorder may be less effective for older adults compared to adults of working age.

“current evidence suggests that conventional CBT for generalised anxiety disorder may be less effective for older adults compared to adults of working age (Kishita & Laidlaw, 2017).”