IPA Task Forces

Late-Life Anxiety

The first meeting of this IPA Task Force was held in Santiago de Compostela, Spain in September 2010, at IPA’s International Meeting.  The Task Force welcomes all members of IPA who express an interest in being on an e-mail contact list and/or attending meetings to discuss matters relating to the etiology, diagnosis, assessment and treatment of anxiety disorders in later life

Background

1. Rationale for the Late-Life Anxiety Task Force
The high prevalence of anxiety disorders in later life, the relative neglect of late-life anxiety disorders in the scientific literature and the poor treatment of these disorders in general practice makes a task force aimed at increasing knowledge about diagnostics and treatment modalities for both patients and mental health care providers important. Given a recent upsurge in interest around the etiology, assessment, diagnosis and treatment of late-life anxiety disorders, a task force led by IPA is extremely relevant for the field at the present time. The Task Force will be multi-disciplinary, time-limited and focused on output consisting both of reviews of the extant literature but also guidelines for best practice, taking into account a variety of treatment settings and an international perspective.

2. Who will chair the group?
Nancy Pachana (Australia) and Richard Oude Voshaar (Netherlands) jointly chair this IPA task force.

3. Issues facing the Task Force
With greater numbers of older people, mental health professionals will need to develop greater awareness, understanding, and appreciation of disorders in later life to deliver optimally effective services to this population (Laidlaw & Pachana, 2009). In particular, knowledge of incidence and prevalence rates of psychiatric illnesses most affecting older adults, as well as specific and empirically validated assessment tools and treatment approaches which are effective with these disorders, are required (Calleo & Stanley, 2008).

Anxiety in later life, which has a relatively high prevalence and is associated with considerable disease burden, is a prime example of a group of psychiatric disorders that remains less well studied in terms of assessment and treatment strategies than many others, including depression. This is despite the fact that clinically significant anxiety is much more common in later life than depression. Anxiety in older adults is associated with poorer treatment outcomes, increased disease burden, deterioration in functionality and aggravation of symptom expression in a variety of other psychiatric and neurological disease in later life.

Co-morbid depression and anxiety in late-life present particular challenges for mental health care providers. Accurate identification of anxiety symptoms is often complicated by their similarity to the symptoms of other mental and physical disorders and medication side effects common in older populations; when coupled with symptoms of mood disorder, such anxiety symptoms may remain undetected. In addition, the symptoms of agitation or restlessness common in anxiety may be misinterpreted as symptoms of a dementia, particularly in the presence of cognitive declines. The potent co-morbidity of anxiety and depressive disorders can be conceived as double jeopardy in older adults, impeding effective care and further diminishing quality of life (Beattie & Pachana, 2010). Geriatric health care providers need to understand psychiatric co-morbidity of this type for accurate diagnosis and select assessment tools and interventions appropriately.

4. Current initiatives for the Late-Life Anxiety Task Force
We organized a very successful and well-attended symposium on late-life anxiety disorders at the IPA International Meeting in Santiago de Compostela, Spain in September 2010. We are planning several symposia on late-life anxiety for the IPA Congress at The Hague, The Netherlands, in September, 2011.  

Richard and I will organize meetings with all persons interested in the work of this task force at each IPA conference. We also want to keep in touch with interested researchers and clinicians between meetings, and as such are setting up an email discussion group for IPA members on late-life anxiety. If you would like to be part of such a group please contact Nancy Pachana at npachana@psy.uq.edu.au.

5. Expected outcomes for the Late-Life Anxiety Task Force
Outcomes from this task force are modeled on other successful IPA task forces such as the Mental Health Service Provision in Nursing Homes and Residential Care Facilities Task Force. We expect to facilitate papers by experts presented at symposia at IPA conferences, as well as future educational opportunities for researchers and clinicians.  

We are also planning a consensus meeting on late-life anxiety for the proposed IPA International Meeting in Cairns, Australia, in 2012. This consensus meeting will have a broad multi-disciplinary composition and will address epidemiological aspects of anxiety disorders in later life, etiology and approaches to studying the neurobiological substrate of anxiety in later life, as well as diagnostic issues, particularly those arising from proposed changes to DSM-V. Assessment and treatment of anxiety in later life will also be a focus. We are looking both to generate papers from this meeting to form a special issue of International Psychogeriatrics, as well as to publish a brief consensus statement on late-life anxiety from this IPA task force. 

Nancy A. Pachana, Ph.D., FAPS
Professor, School of Psychology
The University of Queensland
Brisbane, Qld 4072, Australia
Tel: +617 3365-6832
Fax: +617 3365-4466
e-mail: npachana@psy.uq.edu.au

Universitair Centrum Psychiatrie
Universitair Medisch Centrum Groningen
Hanzeplein 1, Postbus 30.001
9700 RB  Groningen
T: +31-50-3612367
F: +13-50-3619283
E: r.c.oude.voshaar@psy.umcg.nl

References:
Beattie, E., Pachana, N. A., & Franklin, S. J. (2010). Double jeopardy: Comorbid anxiety and depression in late life. Research in Gerontological Nursing, 3(3), 209-220. 

Calleo, J., & Stanley, M. (2008). Anxiety disorders in later life: Differentiated diagnosis and treatment strategies. Psychiatric Times, 25(8), 24-27. 

Laidlaw, K., & Pachana, N. A. (2009). Aging, mental health, and demographic change: Challenges for psychotherapists. Professional Psychology: Research and Practice, 40(6), 601-608.

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