Skip to main content

Anxiety in Later Life and Across the Lifespan

Progress and Future Directions

Published Online:https://doi.org/10.1024/1662-9647/a000315

Abstract: Research on anxiety in later life has advanced significantly in the last two decades. Within the extant literature, there are both gaps and opportunities for further cross-disciplinary linkages in terms of the assessment, diagnosis, and treatment of late-life anxiety. Research across cultures and cohorts has increased our understanding of the experience of anxiety across groups and thus has advanced measurement efficacy and diagnostic accuracy. Work on addressing social determinants across the lifespan regarding anxiety symptoms and their sequelae may help address anxiety as a globally growing concern.

References

  • Ayers, C. R., Sorrell, J. T., Thorp, S. R., & Wetherell, J. L. (2007). Evidence-based psychological treatments for late-life anxiety. Psychology and Aging, 22(1), 8–17. First citation in articleCrossrefGoogle Scholar

  • Beasley, E., Scott, T., & Pachana, N. A. (2022). Making meaning of integrated care during a pandemic: Learning from older adults. The Clinical Gerontologist, 45(1), 172–188. First citation in articleCrossrefGoogle Scholar

  • Beattie, E., Pachana, N. A., & Franklin, S. J. (2010). Double Jeopardy: Comorbid anxiety and depression in late life. Research in Gerontological Nursing, 3(3), 209–220. First citation in articleCrossrefGoogle Scholar

  • Beaudreau, S. A., & O’Hara, R. (2008). Late-life anxiety and cognitive impairment: A review. The American Journal of Geriatric Psychiatry, 16(10), 790–803. First citation in articleCrossrefGoogle Scholar

  • Beck, A. T., Epstein, N., Brown, G., & Steer, R. A. (1988). An inventory for measuring clinical anxiety: Psychometric properties. Journal of Consulting and Clinical Psychology, 56, 893–897. First citation in articleCrossrefGoogle Scholar

  • Boswell, S. S. (2012). “Old people are cranky”: helping professional trainees’ knowledge, attitudes, aging anxiety, and interest in working with older adults. Educational Gerontology, 38(7), 465–472. First citation in articleCrossrefGoogle Scholar

  • Byrne, G. J. A., & Pachana, N. A. (2011). Development and validation of a short form of the Geriatric Anxiety Inventory–the GAI-SF. International Psychogeriatrics, 23(1), 125–131. First citation in articleCrossrefGoogle Scholar

  • Dissanayaka, N. N. N. W., White, E., O’Sullivan, J. D., Marsh, R., Pachana, N. A., & Byrne, G. J. (2014). The clinical spectrum of anxiety in Parkinson’s disease. Movement Disorders, 29(8), 967–975. First citation in articleCrossrefGoogle Scholar

  • Dissanayaka, N. N. W., O’Sullivan, J. D., Pachana, N. A., Marsh, R., Silburn, P. A., White, E. X., Torbey, E., Mellick, G. D., Copland, D. A., & Byrne, G. J. (2016). Disease-specific anxiety symptomatology in Parkinson’s disease. International Psychogeriatrics, 28(7), 1153–1163. First citation in articleCrossrefGoogle Scholar

  • Dissanayaka, N. W., Pye, D., Mitchell, L. K., Byrne, G. J., O’Sullivan, J. D., Marsh, R., & Pachana, N. A. (2017). Cognitive behaviour therapy for anxiety in Parkinson’s disease: Outcomes for patients and caregivers. Clinical Gerontologist, 40(3), 159–171. First citation in articleCrossrefGoogle Scholar

  • Fuller, H. R., & Huseth-Zosel, A. (2021). Lessons in resilience: Initial coping among older adults during the COVID-19 pandemic. The Gerontologist, 61(1), 114–125. First citation in articleCrossrefGoogle Scholar

  • Gonçalves, D. C., & Byrne, G. J. (2012). Interventions for generalized anxiety disorder in older adults: Systematic review and meta-analysis. Journal of Anxiety Disorders, 26(1), 1–11. First citation in articleCrossrefGoogle Scholar

  • Gould, C., Segal, D. L., Yochim, B. P., Pachana, N. A., Byrne, G. J., & Beaudreau, S. A. (2014). Measuring anxiety in late life: A psychometric examination of the Geriatric Anxiety Inventory and Geriatric Anxiety Scale. Journal of Anxiety Disorders, 28(8), 804–811. First citation in articleCrossrefGoogle Scholar

  • Hajek, A., & König, H. H. (2022). Climate anxiety, loneliness and perceived social isolation. International Journal of Environmental Research and Public Health, 19(22), Article 14991. First citation in articleCrossrefGoogle Scholar

  • Hellwig, S., & Domschke, K. (2019). Anxiety in late life: An update on pathomechanisms. Gerontology, 65(5), 465–473. First citation in articleCrossrefGoogle Scholar

  • Hickman, C., Marks, E., Pihkala, P., Clayton, S., Lewandowski, R. E., Mayall, E. E., Wray, B., Mellor, C., & van Susteren, L. (2021). Climate anxiety in children and young people and their beliefs about government responses to climate change: A global survey. The Lancet Planetary Health, 5(12), e863–e873. First citation in articleCrossrefGoogle Scholar

  • Hoegh-Guldberg, O., Jacob, D., Taylor, M., Guillén Bolaños, T., Bindi, M., Brown, S., Camilloni, I. A., Diedhiou, A., Djalante, R., Ebi, K., Engelbrecht, F., Guiot, J., Hijioka, Y., Mehrotra, S., Hope, C. W., Payne, A. J., Pörtner, H.-O., Seneviratne, S. I., Thomas, A., … Zhou, G. (2019). The human imperative of stabilizing global climate change at 1.5 C. Science, 365(6459), Article eaaw6974. First citation in articleCrossrefGoogle Scholar

  • Lasher, K. P., & Faulkender, P. J. (1993). Measurement of aging anxiety: Development of the Anxiety About Aging Scale. The International Journal of Aging and Human Development, 37(4), 247–259. First citation in articleCrossrefGoogle Scholar

  • Lee, S. A. (2020). Coronavirus Anxiety Scale: A brief mental health screener for COVID-19 related anxiety. Death Studies, 44(7), 393–401. First citation in articleCrossrefGoogle Scholar

  • Lenze, E. J., Mulsant, B. H., Shear, M. K., Alexopoulos, G. S., Frank, E., & Reynolds, C. F. (2001). Comorbidity of depression and anxiety disorders in later life. Depression and Anxiety, 14(2), 86–93. First citation in articleCrossrefGoogle Scholar

  • Lenze, E. J., & Wetherell, J. L. (2011). A lifespan view of anxiety disorders. Dialogues in Clinical Neuroscience, 13(4), 381–399. First citation in articleCrossrefGoogle Scholar

  • Levy, B. (2022). Breaking the age code. Random House. First citation in articleGoogle Scholar

  • Levy, B. R., Slade, M. D., Chang, E. S., Kannoth, S., & Wang, S. Y. (2020). Ageism amplifies cost and prevalence of health conditions. The Gerontologist, 60(1), 174–181. First citation in articleCrossrefGoogle Scholar

  • Levy, B. R., Slade, M. D., Kunkel, S. R., & Kasl, S. V. (2002). Longevity increased by positive self-perceptions of aging. Journal of Personality and Social Psychology, 83(2), 261–270. First citation in articleCrossrefGoogle Scholar

  • Li, Z., Zhao, X., Sheng, A., & Wang, L. (2019). Item response analysis of the Geriatric Anxiety Inventory among the elderly in China: Dimensionality and differential item functioning test. BMC Geriatrics, 19(1), 1–9. First citation in articleCrossrefGoogle Scholar

  • Lowe, P. A., & Reynolds, C. R. (2000). Exploratory analyses of the latent structure of anxiety among older adults. Educational and Psychological Measurement, 60, 100–116. First citation in articleCrossrefGoogle Scholar

  • McCleskey, J., & Gruda, D. (2021). Risk-taking, resilience, and state anxiety during the COVID-19 pandemic: A coming of (old) age story. Personality and Individual Differences, 170, Article 110485. First citation in articleCrossrefGoogle Scholar

  • Márquez-González, M., Losada, A., Fernández-Fernández, V., & Pachana, N. A. (2012). Psychometric properties of the Spanish version of the Geriatric Anxiety Inventory. International Psychogeriatrics, 24(1), 137–144. First citation in articleCrossrefGoogle Scholar

  • Martiny, C., Cardoso de Oliveira, A., Nardi, A. E., & Pachana, N. A. (2011). Translation and cross-cultural adaptation of the Brazilian version of the Geriatric Anxiety Inventory (GAI). Revista de Psiquiatria Clínica, 38(1), 8–12. First citation in articleCrossrefGoogle Scholar

  • Massena, P. N., de Araujo, N. B., Pachana, N. A., Laks, J., & de Padua, A. C. (2015). Validation of the Brazilian Portuguese version of Geriatric Anxiety Inventory – GAI-BR. International Psychogeriatrics, 27(7), 1113–1119. First citation in articleCrossrefGoogle Scholar

  • Matheson, S. F., Byrne, G. J., Dissanayaka, N. N. W., Pachana, N. A., Mellick, G. D., O’Sullivan, J. D., Silburn, P. A., Sellbach, A., & Marsh, R. (2012). Validity and reliability of the Geriatric Anxiety Inventory in Parkinson’s disease patients. Australasian Journal on Ageing, 31(1), 13–16. First citation in articleCrossrefGoogle Scholar

  • Miloyan, B., Byrne, G. J., & Pachana, N. A. (2014). Age-related changes in Generalized Anxiety Disorder symptoms. International Psychogeriatrics, 26(4), 565–572. First citation in articleCrossrefGoogle Scholar

  • Miloyan, B., Bulley, A., Pachana, N. A., & Byrne, G. J. (2014). Social phobia symptoms across the adult lifespan. Journal of Affective Disorders, 168, 86–90. First citation in articleCrossrefGoogle Scholar

  • Miloyan, B., Byrne, G. J., & Pachana, N. A. (2015). Threshold and subthreshold Generalized Anxiety Disorder in later life. American Journal of Geriatric Psychiatry, 23(6), 633–641. First citation in articleCrossrefGoogle Scholar

  • Mohlman, J., Bryant, C., Lenze, E. J., Stanley, M. A., Gum, A., Flint, A., Beekman, A. T. F., Wetherell, J. L., Thorpe, S. R., & Craske, M. G. (2012). Improving recognition of late life anxiety disorders in Diagnostic and Statistical Manual of Mental Disorders: Observations and recommendations of the Advisory Committee to the Lifespan Disorders Work Group. International Journal of Geriatric Psychiatry, 27(6), 549–556. First citation in articleCrossrefGoogle Scholar

  • Molde, H., Hynninen, K. M., Torsheim, T., Bendixen, A. B., Engedal, K., Pachana, N. A., & Nordus, I. H. (2017). A bifactor and item response analysis of the Geriatric Anxiety Inventory. International Psychogeriatrics, 29(10), 1647–1656. First citation in articleCrossrefGoogle Scholar

  • Molde, H., Nordhus, I. H., Torsheim, T., Engedal, K., Bendixen, A. B., Byrne, G. J., Márquez-González, M., Losada, A., Feng, L., Ow, E. K. T., Pisitsungkagarn, K., Taephant, N., Jarukasemthawee, S., Champagne, A., Landreville, P., Gosselin, P., Ribeiro, O., Diefenbach, G. J., Blank, K., … Pachana, N. A. (2020). A cross-national analysis of the psychometric properties of the Geriatric Anxiety Inventory (GAI). Journals of Gerontology: Psychological Sciences, 75(7), 1475–1483. First citation in articleCrossrefGoogle Scholar

  • Nature. (1970). Gerontology: Public anxiety about ageing. Nature, 226, 895–896. https://doi.org/10.1038/226895a0 First citation in articleCrossrefGoogle Scholar

  • Pachana, N. A., Beattie, E., Byrne, G. J., & Brodaty, H. (2020). Covid-19 and psychogeriatrics: The view from Australia. International Psychogeriatrics, 32(10), 1135–1141. First citation in articleCrossrefGoogle Scholar

  • Pachana, N. A., Byrne, G. J., Siddle, H., Koloski, N., Harley, E., & Arnold, E. (2007). Development and validation of the Geriatric Anxiety Inventory. International Psychogeriatrics, 19, 103–114. First citation in articleCrossrefGoogle Scholar

  • Pachana, N. A., Egan, S. J., Laidlaw, K., Dissanayaka, N., Byrne, G. J., Brockman, S., Marsh, R., & Starkstein, S. (2013). Clinical issues in the treatment of anxiety and depression in older adults with Parkinson’s Disease. Movement Disorders, 28(14), 1930–1934. First citation in articleCrossrefGoogle Scholar

  • Pachana, N. A., McLaughlin, D., Leung, J., Byrne, G., & Dobson, A. (2012). Anxiety and depression in adults in their eighties: Do gender differences remain? International Psychogeriatrics, 24(1), 145–150. First citation in articleCrossrefGoogle Scholar

  • Pachana, N. A., & Wahl, H. W. (2022). Healthy aging: Current and future frameworks and developments. Reference Module in Neuroscience and Biobehavioral Psychology. First citation in articleGoogle Scholar

  • Ramos, K., & Stanley, M. A. (2018). Anxiety disorders in late life. Psychiatric Clinics, 41(1), 55–64. First citation in articleGoogle Scholar

  • Reynolds, G. O., Saint-Hilaire, M., Thomas, C. A., Barlow, D. H., & Cronin-Golomb, A. (2020). Cognitive-behavioral therapy for anxiety in Parkinson’s disease. Behavior Modification, 44(4), 552–579. First citation in articleCrossrefGoogle Scholar

  • Ribeiro, O., Paúl, C., Simões, M. R., & Firmino, H. (2011). Portuguese version of the Geriatric Anxiety Inventory: Transcultural adaptation and psychometric validation. Aging & Mental Health, 15(6), 742–748. First citation in articleCrossrefGoogle Scholar

  • Roos, D. S., Klein, M., Deeg, D. J., Doty, R. L., & Berendse, H. W. (2022). Prevalence of prodromal symptoms of Parkinson’s disease in the late middle-aged population. Journal of Parkinson’s Disease, 12(3), 967–974. First citation in articleCrossrefGoogle Scholar

  • Russell, S., Quigley, R., Thompson, F., Sagigi, B., Miller, G., LoGiudice, D., Smith, K., Strivens, E., & Pachana, N. A. (2023). Culturally appropriate assessment of depression and anxiety in older Torres Strait Islanders: Limitations and recommendations. Clinical Geropsychologist, 46(2), 240–252. First citation in articleCrossrefGoogle Scholar

  • Segal, D. L., June, A., Payne, M., Coolidge, F. L., & Yochim, B. (2010). Development and initial validation of a self-report assessment tool for anxiety among older adults: The Geriatric Anxiety Scale. Journal of Anxiety Disorders, 24(7), 709–714. First citation in articleCrossrefGoogle Scholar

  • Shankar, K. K., Walker, M., Frost, D., & Orrell, M. W. (1999). The development of a valid and reliable scale for rating anxiety in dementia (RAID). Aging & Mental Health, 3(1), 39–49. First citation in articleCrossrefGoogle Scholar

  • Shati, M., Mortazavi, S., Malakouti, S. K., Norouzi, A., Mehravaran, S., & Pachana, N. A. (2021). Psychometric properties of the Persian version of the Geriatric Anxiety Inventory (GAI-PV) and its short form. Medical Journal of the Islamic Republic of Iran, 35, Article 47. https://doi.org/10.47176/mjiri.35.47 First citation in articleGoogle Scholar

  • Schuurmans, J., & van Balkom, A. (2011). Late-life anxiety disorders: A review. Current Psychiatry Reports, 13(4), 267–273. First citation in articleCrossrefGoogle Scholar

  • Tay, K. W., Subramaniam, P., & Oei, T. P. (2019). Cognitive behavioural therapy can be effective in treating anxiety and depression in persons with dementia: A systematic review. Psychogeriatrics, 19(3), 264–275. First citation in articleCrossrefGoogle Scholar

  • Thorp, S. R., Ayers, C. R., Nuevo, R., Stoddard, J. A., Sorrell, J. T., & Wetherell, J. L. (2009). Meta-analysis comparing different behavioral treatments for late-life anxiety. The American Journal of Geriatric Psychiatry, 17(2), 105–115. First citation in articleCrossrefGoogle Scholar

  • Wilson, C. B., Arendt, L., Nguyen, M., Scott, T., Neville, C., & Pachana, N. A. (2019). Nonpharmacological interventions for anxiety and dementia in nursing homes: A systematic review. The Gerontologist, 59(6), e731–e742. First citation in articleCrossrefGoogle Scholar

  • World Health Organization. (2021). Global report on ageism. WHO. First citation in articleGoogle Scholar

  • Wu, J., Sun, Y., Zhang, G., Zhou, Z., & Ren, Z. (2021). Virtual reality-assisted cognitive behavioral therapy for anxiety disorders: A systematic review and meta-analysis. Frontiers in Psychiatry, 12, Article 575094. First citation in articleCrossrefGoogle Scholar

  • Wuthrich, V. M., & Rapee, R. M. (2019). Telephone-delivered cognitive behavioural therapy for treating symptoms of anxiety and depression in Parkinson’s disease: A pilot trial. Clinical Gerontologist, 42(4), 444–453. First citation in articleCrossrefGoogle Scholar

  • Xiong, J., Lipsitz, O., Nasri, F., Lui, L. M., Gill, H., Phan, L., Chen-Li, D., Iacobucci, M., Ho, R., Majeed, A., & McIntyre, R. S. (2020). Impact of COVID-19 pandemic on mental health in the general population: A systematic review. Journal of Affective Disorders, 277, 55–64. First citation in articleCrossrefGoogle Scholar

  • Yesavage, J. A., Brink, T. L., Rose, T. L., Lum, O., Huang, V., Adey, M., & Leirer, V. O. (1983). Development and validation of a Geriatric Depression Screening Scale: A preliminary report. Journal of Psychiatric Research, 17, 37–49. First citation in articleCrossrefGoogle Scholar