Feature Article

Presentations of anxiety in older people

Elaine Kwan, Chanaka Wijeratne



Anxiety in people aged 65 years or older tends to present with somatic complaints and worry rather than as autonomic anxiety, the more common presentation in younger people. Consideration of the causes and use of psychosocial therapies and, if necessary, pharmacological treatments can significantly improve quality of life for patients.

Key Points

  • Anxiety is less common in people aged 65 years or over than in younger people but can be disabling.
  • Anxiety presents with somatic complaints and worry in older people, rather than as autonomic anxiety.
  • Health anxiety, fear of falling and house boundedness are age-specific anxiety syndromes in older people.
  • Excessive anxiety that causes functional impairment or significant distress is not part of normal ageing.
  • Psychosocial treatments should be trialled before pharmacotherapy.
  • The selective serotonin reuptake inhibitor antidepressants citalopram and sertraline (not TGA-indicated specifically for all anxiety disorders) are the first-line pharmacotherapy as they have efficacy in anxiety in the elderly and are relatively well tolerated.

    Picture credit: © Shironosov/iStockphoto. Model used for illustrative purposes only.