Anxiety disorders in later life are associated with increased risk for disability and poor quality of life (Porensky et al., 2009), yet older adults with anxiety are two to three times less likely to seek mental health services than are middle-age or younger adults (Mackenzie, Reynolds, Cairney, Streiner, & Sareen, 2012). Although prevalence rates decline somewhat with age, anxiety disorders are common in older adults, and there is an urgent need to develop and disseminate evidence-based treatments for late-life anxiety.
EPIDEMIOLOGYAnxiety disorders are the most prevalent psychiatric disorder in community-dwelling older adults, yet prevalence estimates vary across studies. Table 2.1 summarizes epidemiological research. Multiple factors may influence prevalence estimates and contribute to the variations found in the literature. Methodological differences in defining age cutoffs and diagnostic criteria represent a significant source of variation within the epidemiology literature (Bryant, Jackson, & Ames, 2008). When comparing rates, careful consideration should be given to the time frame of the estimate since 1-month rates will be inherently lower than 6-or 12-month rates. Similarly, incidence rates should be differentiated from prevalence rates, as the former represents the number of new cases in the population over a given time, whereas the latter is the rate of having the disease at any one time. Despite these differences, it is clear that late-life anxiety is a significant public health concern.
Prevalence in Community-Dwelling Older AdultsOn the basis of findings from the National Comorbidity Survey Replication (NCS-R), the 12-month prevalence rate of any anxiety disorder is 11.6% in community-dwelling older adults (Byers, Yaffe, Covinsky, Friedman, & Bruce, 2010) with a lifetime prevalence of 15.3% (Kessler et al., 2005). Findings from the NCS-R are in line with other epidemiological studies, which place the rate of anxiety in community populations, including those in Latin