Recognizing and treating anxiety in the elderly.

Anxiety in the elderly is often unrecognized and inadequately treated. Several factors complicate recognition and treatment, including concomitant medical illness, overlap with cognitive disorders, cohort effects, ageism, and cormorbid depression. Although available data from controlled clinical trials are limited for anxiety patients in the geriatric age group, data from young adult studies and clinical experience indicate that pharmacologic treatments are safe and effective for anxious elderly patients. Age-related physiologic changes warrant modifications in dosing, including initial low doses increased in gradual increments. Education and psychotherapy are often recommended whether or not pharmacologic treatment is indicated.