Adapting Drug Dosage for Elderly with Anxiety
D'Arcy L. Little, MD, CCFP
Director of Education and Research
York Community Services, Toronto, ON
Epidemiology
Many studies and review articles have emphasized the fact that anxiety disorders, in general, are less prevalent among the elderly than among young adults.1-5 However, some degree of controversy regarding the prevalence of anxiety among the elderly does exist in the literature. A recent review by A. Flint of the University of Toronto concludes that these disorders are rare in the elderly.1 Fuentes and Cox of the University of Manitoba argue, on the other hand, that current research on anxiety in the elderly uses instruments and criteria that may not be valid vis-à-vis the elderly. It is their contention, therefore, that these instruments underestimate the validity of findings concerning anxiety in this age group.1,2
Statistically, anxiety disorders are the second most common type of psychiatric disorder affecting older people next to cognitive impairment.2 They are relatively common in late life, and are a cause of significant morbidity.8 While actual prevalence rates vary slightly from study to study, anxiety "feelings" reportedly occur in up to 20%2 of the North American population of elderly people, and anxiety disorders in 3.5 to 5.5% in this population.