presented by Elizabeth Galik
Anxiety disorders are common among older adults, and symptom presentation differs from that of a younger population. The most common anxiety disorders among older adults include generalized anxiety disorder, panic disorder, anxiety due to a medical condition or medication, and phobias. Untreated or partially treated anxiety disorders are associated with increased functional disability, use of health services and medication use, and decreased cognition and quality of life. This session will describe the epidemiology and unique features of common anxiety disorders among older adults by utilizing case examples. Challenges associated with the assessment of anxiety symptoms and methods to overcome challenges will also be discussed. Additionally, the course will discuss the use of a variety of non-pharmacological and pharmacological interventions, including the importance of de-prescribing medications and substances that may aggravate underlying anxiety symptoms. Anxiety disorders among older adults can be effectively treated when individualized non-pharmacological and pharmacological strategies are utilized.
Elizabeth Galik is a Professor at the University of Maryland School of Nursing. She received a BSN from the University of Pennsylvania, an MSN from Villanova University, a post-master's Adult Nurse Practitioner Certificate from Johns Hopkins University, and a PhD from the University of Maryland. Her research interest is in developing and testing interventions to improve functional performance, physical activity, and quality of life among older adults with dementia. Dr. Galik practices clinically as a nurse practitioner in community and long-term care settings and focuses on the medical and neuropsychiatric care of individuals with dementia. In addition to her research, she also teaches in the adult and geriatric nurse practitioner program. Dr. Galik was awarded a John A. Hartford Foundation pre-doctoral fellowship, and has received extramural research funding from the Alzheimer's Association, Foundation of the American Medical Directors’ Association, and the American Academy of Nurse Practitioners. She is a Board Member of the Maryland Gerontological Association, and the President Elect for the Gerontological Advanced Practice Nurses Association. Her memberships include Sigma Theta Tau International, Phi Kappa Phi, Southern Nursing Research Society, Gerontological Association of America, and the American Academy of Nurse Practitioners.
This chapter will define and describe the prevalence of anxiety disorders among older adults. Additionally, the clinical presentation of the most common anxiety disorders, including generalized anxiety disorder, panic disorder, anxiety due to a medical condition or medication, and phobias, will be reviewed using a case-based approach. It is important to be able to identify the unique symptoms of different anxiety disorders, as treatment approaches may vary.
This chapter will describe the assessment of anxiety among older adults. Screening recommendations and tools will be discussed in addition to the comprehensive assessment of anxiety when screening is positive.
This chapter will describe a variety of non-pharmacological interventions including psychoeducation, relaxation/meditation, cognitive/behavioral therapy, bibliotherapy, exposure therapy/systematic desensitization, and physical activity/exercise. Having an understanding of the different non-pharmacological treatments is important so that care can be individualized for the older adult.
This chapter will discuss the potential benefits and risks associated with different classes of anti-anxiety medications. Additionally, the importance of de-prescribing medications that may aggravate anxiety symptoms will be addressed. A case-based approach will be utilized to apply knowledge of the assessment and treatment of anxiety disorders among older adults.