Anxiety and depression in the elderly: do we know any more?

Abstract

The advent of global population ageing raises understandable concerns about the high-prevalence mental disorders in older people. Accordingly, this review covers recently published scientific articles concerning anxiety and depression. There is a paucity of findings on anxiety in older people, although the availability of several new scales suggests increased interest in this topic. The low prevalence of late-life depression in many population surveys does not appear to be due to misattribution of depressive symptoms to physical disorders. Although it is well established that dementia leads to depression, there is now increasing evidence for the proposition that depression leads to cognitive decline and dementia. There is now good evidence also for a bidirectional relationship between obesity and depression. The prognosis of treated late-life depression varies with baseline neuropsychological function and the severity of white matter hyperintensities. An excellent body of research on depression in older people is now available, although more work on both pharmacological and nonpharmacological treatments is needed. More research is urgently required into anxiety disorders in older people. These are highly prevalent and associated with considerable disease burden. As the literature on depression in older people reaches maturity, there should be greater research and clinical interest in anxiety.