Understanding Anxiety In The Geriatric Population: A Narrative Review of Prevalence, Presentation and Management

Background : Anxiety disorders rank among the most prevalent yet frequently under diagnosed mental illnesses within the older demographic. Anxiety in older persons sometimes goes unrecognised due to unusual symptomatology, concurrent physical ailments, and cognitive deterioration, resulting in diminished functional capacity and quality of life.Objective : This narrative review seeks to thoroughly investigate the existing knowledge of anxiety in the elderly, emphasising its prevalence, etiological variables, clinical symptoms, neurobiological foundations, diagnostic difficulties, and treatment strategies.Materials and Methods: A comprehensive literature review was performed utilising electronic sources such as PubMed, Scopus, ScienceDirect, PsycINFO, Google Scholar, and the Cochrane Library. The review encompassed peer reviewed publications, observational studies, randomised controlled trials, systematic reviews, and policy documents published from 1980 to 2022.Keywords pertaining to geriatric anxiety, its risk factors, diagnosis, and treatment were utilised. Studies were selected based on their relevance, quality, and emphasis on those aged 65 and older.Results: Elderly population were affected by anxiety, with Generalised Anxiety Disorder being the most common kind. Risk factors encompass neurobiological changes, including compromised GABAergic transmission and dysregulation of the HPA axis, and psychosocial stresses such as loneliness, grief, and loss of autonomy. The clinical presentation is frequently somatic and intersects with other medical diseases, hence confounding diagnosis. Cognitive Behavioural Therapy and SSRIs are established therapies, although non-pharmacological approaches such as mindfulness and social interventions demonstrate increasing effectiveness.Conclusion: Anxiety in the elderly is a multifaceted health issue necessitating comprehensive screening and therapeutic strategies. Enhanced knowledge, age appropriate diagnostic instruments, and accessible mental health care are crucial for alleviating the burden of untreated anxiety in elderly people.