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Review
. 2011;13(4):381-99.
doi: 10.31887/DCNS.2011.13.4/elenze.

A lifespan view of anxiety disorders

Eric J Lenze  1 , Julie Loebach Wetherell
Affiliations
Review

A lifespan view of anxiety disorders

Eric J Lenze et al. Dialogues Clin Neurosci. 2011.

Abstract
in English, Spanish, French

Neurodevelopmental changes over the lifespan, from childhood through adulthood into old age, have important implications for the onset, presentation, course, and treatment of anxiety disorders. This article presents data on anxiety disorders as they appear in older adults, as compared with earlier in life. In this article, we focus on aging-related changes in the epidemiology, presentation, and treatment of anxiety disorders. Also, this article describes some of the gaps and limitations in our understanding and suggests research directions that may elucidate the mechanisms of anxiety disorder development later in life. Finally we describe optimal management of anxiety disorders across the lifespan, in "eight simple steps" for practitioners.

Los cambios en el neurodesarrollo durante el curso de la vida, desde la niñez pasando por la adultez y hasta la vejez, tienen importantes repercusiones para la instalación, presentación, curso y tratamiento de los trastornos ansiosos. Este artículo presenta datos acerca de los trastornos ansiosos en la forma cómo ellos aparecen en los adultos mayores en comparación con los más jóvenes. Este artículo se centra en los cambios relacionados con la edad en la epidemiología, presentación y tratamiento de los trastornos ansiosos. Además, este articulo describe algunas de las brechas y limitaciones en nuestra comprensión del trastorno ansioso y sugiere directrices de la investigación que puedan aclarar los mecanismos de aquellos cuadros que se desarrollan más tardíamente en la vida. Finalmente se describe el manejo óptimo para los clínicos de los trastornos ansiosos a lo largo de la vida en “ocho pasos simples”.

Les modifications neurodéveloppementales survenant tout au long de la vie, de l'enfance à l'âge adulte jusqu'à la vieillesse, ont des implications importantes sur la survenue, le cours et le traitement des troubles anxieux. Cet article présente des données sur les troubles anxieux tels qu'ils apparaissent chez les adultes plus âgés, comparés à ceux moins avancés en âge. Nous nous intéressons ici aux modifications liées au vieillissement dans l'épidémiologie, la présentation et le traitement des troubles anxieux. Cet article décrit aussi les lacunes et les limites de notre compréhension et suggère des directions de recherche pouvant élucider les mécanismes du développement du trouble anxieux plus tard dans la vie. Enfin, nous décrivons la prise en charge optimale des troubles anxieux au cours de la vie, en « huit étapes simples » pour le médecin.

Keywords: antidepressant; anxiety; cortisol; diagnosis; elderly; neuropsychology; psychotherapy.

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Figures

Figure 1.
Figure 1.. Changes in anxiety disorder presentation across the lifespan. PTSD, post-traumatic stress disorder
Figure 2.
Figure 2.. Proposed model of how a biological stress response in late-life anxiety produces cognitive impairment, and how mindfulness-based treatment for late-life anxiety disorders may reverse this cognitive impairment. CRH, corticotropin-releasing hormone; ACTH: adrenocorticotropin hormone
See this image and copyright information in PMC

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