Comorbidity of depression and anxiety in the elderly

Abstract

Elderly patients with depression commonly suffer from concurrent symptoms of anxiety or comorbid anxiety disorders. Such comorbidity is associated with a more severe presentation of depressive illness, including greater suicidality. Additionally, most antidepressant treatment studies of elderly individuals with depression have found poorer treatment outcomes in those with comorbid anxiety, for example, delayed or diminished response and increased likelihood of dropout from treatment. In terms of treatment of anxious depression, there is evidence that tricyclic antidepressants and serotonin reuptake inhibitors are not different from each other in terms of efficacy or tolerability. Rather than the specific choice of antidepressant medication, it appears that quality of clinical management has the greatest impact on likelihood of remission in anxious depressed elderly individuals. Co-prescription of benzodiazepines is sometimes warranted for severe anxiety, but increases the risk of cognitive or motor impairment. Psychotherapy, including cognitive-behavioral therapy and interpersonal therapy, which are efficacious for late-life depression in general, should also be considered for treatment alone or in combination with appropriate medication. Future research areas are also addressed in this paper.

Assessment of Depression and Anxiety in Older Adults

“…Even though reported prevalence rates of diagnosable anxiety in older adults vary greatly in the community (2-19%), the best estimate is about 10%, while this rate increases in medically ill populations [ 10 ] . Comorbid anxiety is common in late-life depression, with reports estimating its prevalence up to 65% [ 10 ] and it is associated with lower response to antidepressant medication treatment, longer time to response or remission, and shorter time to recurrence once remission is achieved [11][12][13][14][15] .…”

Efeito de video games ativos sobre a capacidade funcional e o humor de idosos: revisão sistemática e meta-análise

“…está associada à mortalidade em todo o mundo 6,7 . Sendo assim, esses transtornos promovem alterações que afetam a qualidade de vida do idoso, restringindo sua vida social e reduzindo gradualmente sua independência 8 .…”

“…Nesse sentido, os vídeo games ativos (VGAs) podem ser uma alternativa interessante, uma vez que proporcionam uma condição de atividade associada ao entretenimento 6 , além de serem uma opção para aqueles que apresentam dificuldades de se locomover até os locais de prática, podendo ainda, proporcionar maior interação entre o idoso e a família 9,13 . O Nintendo Wii e o Xbox Kinect são os VGAs frequentemente usados pela população em geral 14 .…”

Transdiagnostic CBT Treatment of Co-morbid Anxiety and Depression in an Older Adult: Single Case Experimental Design

“…Co-morbidity of anxiety and depression in older adults is more common than each disorder independently; 50 % suffering from depression also display some form of anxiety disorder (King-Kallimanis, Gum, & Kohn, 2009). Co-morbidity also increases impairment in daily functioning, severity of symptoms and likelihood of suicide (Lenze, 2003). The Department of Health (2009) highlight that one quarter of older adults living in the community have symptoms of depression and anxiety serious enough to warrant assessment and intervention.…”