Week 3
What are common s/s of anxiety in elderly?
Constipation
Nausea
HA
Worrying about health, disability, finances
What are phobic disorders?
Anxiety from a specific feared object or situation.
Person feels anxiety is excessive or unreasonable.
Often leads to distress or avoiding the fear.
Often lifelong, common in older adults.
What is generalized anxiety disorder (GAD)?
Often 20-30yrs of excessive worry about health, family, finances w/insomnia, muscle tension,
restlessness, fatigue, irritability, memory problems.
What is PTSD?
Re-experiencing a traumatic event w/increased anxiety, avoiding thoughts of the trauma, feeling
numb/uninterested, perceiving future as short.
What is panic disorder?
Involves recurrent, often unexpected attacks of severe anxiety w/one month of worry about fu-
ture attacks and consequences.
May include changes in behavior.
Rare in older adults, less severe/frequent than in younger adults.
Usually keeps them from leaving home.
What is agoraphobia?
Avoiding places where escape is difficult or embarrassing.
Rare in older adults, usually does not occur w/panic attacks.
What is OCD?
Obsessions that cause anxiety or distress and/or compulsions that reduce anxiety.
Rare in older adults.
Usually lifelong.
, What is treatment for anxiety?
Should reduce symptoms and improve function.
First-line: SSRI (citalopram/Celexa, escitalopram/Lexapro, sertraline/Zoloft). For elderly, these
have lowest risk of drug interactions, SE, or worsening existing conditions.
Effective but not recommended due to falls/confusion: benzos (lorazepam/Ativan, alprazolam/
Xanax, clonazepam/Klonopin)
What are signal symptoms of depression?
Feeling sad
Discouraged
Lack of pleasure in usual activities
Unmotivated
Low energy
Sleep/appetite disturbances
The symptoms of depression may encompass what 4 domains?
Affect/mood
Cognition
Physiological
Behavior
What is treatment goal for depression?
Full remission and recovery
What are first-line meds for depression?
SSRIs:
fluoxetine (Prozac)
sertraline (Zoloft)
paroxetine (Paxil)
citalopram (Celexa)
escitalopram (Lexapro)
flovoxamine (Luvox)
What is transient insomnia?
Lasts a few nights.
Related to emotional stress.
Usually resolves w/out meds when elderly adapts to or removes change.
What is short-term insomnia?
Similar to transient insomnia.
Lasts <1mo
What are common s/s of anxiety in elderly?
Constipation
Nausea
HA
Worrying about health, disability, finances
What are phobic disorders?
Anxiety from a specific feared object or situation.
Person feels anxiety is excessive or unreasonable.
Often leads to distress or avoiding the fear.
Often lifelong, common in older adults.
What is generalized anxiety disorder (GAD)?
Often 20-30yrs of excessive worry about health, family, finances w/insomnia, muscle tension,
restlessness, fatigue, irritability, memory problems.
What is PTSD?
Re-experiencing a traumatic event w/increased anxiety, avoiding thoughts of the trauma, feeling
numb/uninterested, perceiving future as short.
What is panic disorder?
Involves recurrent, often unexpected attacks of severe anxiety w/one month of worry about fu-
ture attacks and consequences.
May include changes in behavior.
Rare in older adults, less severe/frequent than in younger adults.
Usually keeps them from leaving home.
What is agoraphobia?
Avoiding places where escape is difficult or embarrassing.
Rare in older adults, usually does not occur w/panic attacks.
What is OCD?
Obsessions that cause anxiety or distress and/or compulsions that reduce anxiety.
Rare in older adults.
Usually lifelong.
, What is treatment for anxiety?
Should reduce symptoms and improve function.
First-line: SSRI (citalopram/Celexa, escitalopram/Lexapro, sertraline/Zoloft). For elderly, these
have lowest risk of drug interactions, SE, or worsening existing conditions.
Effective but not recommended due to falls/confusion: benzos (lorazepam/Ativan, alprazolam/
Xanax, clonazepam/Klonopin)
What are signal symptoms of depression?
Feeling sad
Discouraged
Lack of pleasure in usual activities
Unmotivated
Low energy
Sleep/appetite disturbances
The symptoms of depression may encompass what 4 domains?
Affect/mood
Cognition
Physiological
Behavior
What is treatment goal for depression?
Full remission and recovery
What are first-line meds for depression?
SSRIs:
fluoxetine (Prozac)
sertraline (Zoloft)
paroxetine (Paxil)
citalopram (Celexa)
escitalopram (Lexapro)
flovoxamine (Luvox)
What is transient insomnia?
Lasts a few nights.
Related to emotional stress.
Usually resolves w/out meds when elderly adapts to or removes change.
What is short-term insomnia?
Similar to transient insomnia.
Lasts <1mo
