Over the last decade, multiple reports have signaled the association of late-life
anxiety and its phenotypes with increased morbidity and mortality. A 2014 study of
6,019 participants showed that higher anxiety symptoms were prospectively associated
with increased risk of incident stroke independent of all other risk factors, including
depression.
1
The independent effect of anxiety on increasing the risk of cognitive decline has
been documented in several recent studies,
2
including longitudinal studies indicating an increased association between amyloid
burden, and anxiety symptoms in cognitively normal older adults.
- Santabarbara J
- Lipnicki DM
- Olaya B
- et al.
Does anxiety increase the risk of all-cause dementia? An updated meta-analysis of
prospective cohort studies.
J Clin Med. 2020; 9 (Published online Jun 9, 2020. PMCID: PMC7355582.): 1791https://doi.org/10.3390/jcm9061791
3
The effect of anxiety on cognition appears as early as midlife: in the Nurses’ Health
Study, a 4-year longitudinal study of community-dwelling older women (N = 16,351),
higher midlife anxiety was related to worse later-life overall cognitive function,
and verbal memory. Overall, anxiety may be an even stronger risk factor for medical
comorbidity than depression,
4
,5
but the persistent perception of anxiety symptoms as a relatively mild group of heterogenous
"negative affect" symptoms with no relevant impact beyond decreased quality of life
continues to persist in the medical community.To read this article in full you will need to make a payment
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References
- Prospective study of anxiety and incident stroke.Stroke. 2014; 45: 438-443
- Does anxiety increase the risk of all-cause dementia? An updated meta-analysis of prospective cohort studies.J Clin Med. 2020; 9 (Published online Jun 9, 2020. PMCID: PMC7355582.): 1791https://doi.org/10.3390/jcm9061791
- Association of anxiety with subcortical amyloidosis in cognitively normal older adults.Mol Psychiatry. 2020; 25: 2599-2607
- Exaggerated neurobiological sensitivity to threat as a mechanism linking anxiety with increased risk for diseases of aging.Neurosci Biobehav Rev. 2013; 37: 96-108
- The anxious heart in whose mind? A systematic review and meta-regression of factors associated with anxiety disorder diagnosis, treatment and morbidity risk in coronary heart disease.J Psychosom Res. 2014; 77: 439-448
- Reliability and validity of DSM-IV generalized anxiety disorder features.J Anxiety Disord. 2011; 25: 813-821
- Reliability and validity of the dimensional features of generalized anxiety disorder.J Anxiety Disord. 2015; 29: 1-6
- An insular view of anxiety.Biol Psychiatry. 2006; 60: 383-387
- Cognitive-behavioral treatment of late-life generalized anxiety disorder.J Consult Clin Psychol. 2003; 71: 309-319
- Anxiety disorders in the elderly.Adv Exp Med Biol. 2020; 1191: 561-576
- In the grip of worry: cerebral blood flow changes during worry induction and reappraisal in late-life generalized anxiety disorder.Transl Psychiatry. 2017; 7: e1204
Article info
Publication history
Published online: February 26, 2022
Accepted:
February 22,
2022
Received:
February 22,
2022
Identification
Copyright
© 2022 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.
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- Long-Term Effects of Cognitive-Behavioral Therapy and Yoga for Worried Older AdultsThe American Journal of Geriatric PsychiatryVol. 30Issue 9
- PreviewCognitive-behavioral therapy (CBT) and yoga have been shown to decrease worry and anxiety. CBT is the most efficacious non–pharmacologic treatment for worry10 and has the strongest evidence base for treating late-life worry and related symptoms11 although some studies have failed to demonstrate a superior effect of CBT to active comparison interventions.12,13 Regarding the selection of yoga to target worry, following our previous randomized controlled trial (RCT),14 participants provided feedback that they were interested in yoga as a treatment option for worry and anxiety and would like to be able to choose their treatment.
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