How is Anxiety Different in Older Adults? Causes, Symptoms, and Treatment Options

It’s normal to feel anxious or worried from time to time. For some, those feelings never really go away, and anxiety can affect their daily life. Although anxiety can occur at any age, researchers have explored what it looks like in older age groups. And it turns out that age plays a big role in how a person experiences anxiety. This means that it may look different — and be treated differently — in older adults. 

What are the symptoms of anxiety in older adults?

There are different types of anxiety. But people usually refer to generalized anxiety disorder (GAD). This is an excessive, long-lasting worry. Someone with GAD will experience anxiety most days and for months at a time. 

Symptoms of anxiety in older adults will be similar to people who experience anxiety at any age. These include:

• Worry about a variety of different things

• Trouble concentrating

• Being easily irritated

• Difficulty falling asleep or sleeping well

Older people often also experience more physical symptoms when anxious, such as:

• Getting easily tired out or fatigued

• Feelings of restlessness

• Having tense or weak muscles

They may describe their anxiety as feeling stressed or tense. And older people may worry about different things compared to younger people, including:

• Getting sick

• Falling and getting hurt 

• Losing a friend or loved one (spouse, sibling, etc.)

• Maintaining financial security 

• Forgetting memories

What are the causes of anxiety in older adults?

Anxiety in older adults can have a variety of causes, including:

• Aging: Natural changes occur in the brain and affect the pathways linked to anxiety.

• Illness: Chronic health conditions can lead to both mental and physical stress, which have been shown to increase the likelihood of developing anxiety.

• Stressful life events: Older adults may experience the loss of a friend or loved one. These events can lead to generalized feelings of anxiety.

• Female sex: Women are more likely to have an anxiety disorder than men. This is especially true for women who have lost their partner or are divorced.

• Loss of independence: Many older adults may need to rely more on others for help with errands and activities. This can lead to feelings of social isolation and less engagement. These all can increase the risk for mental health conditions like anxiety.

• Financial insecurity: Older adults may worry if they have saved enough to support themselves and their loved ones.

Does anxiety get worse as you get older?

Anxiety doesn’t necessarily get worse — or more common — as you age. But the research in this area is a little mixed.

In the past, research suggested that anxiety was less common in older adults. But researchers believe this could be because older adults have:

• Atypical symptoms of anxiety, so they might go unnoticed

• Other health problems, which can mask an anxiety disorder

• Different experiences that couldn’t be properly screened with existing tools

But recent studies show that anxiety is more common in older people. This is particularly true for those in their 80s and 90s and those who have lost a close loved one.

Remember that anxiety is common in people of all ages — but the symptoms and causes can be different. And in older adults, it can lead to a quality of life that feels worse than if a person had a heart attack or type 2 diabetes. So it is important to make sure they find treatment. 

What is the treatment for anxiety in older adults?

Anxiety treatment for older adults doesn’t have to mean taking medication. There are ways to help protect the brain and lower the risk of anxiety in older adults, including:

• Social support

• Exercise

• Simple mental exercises

And cognitive behavior therapy (CBT) or talk therapy are also helpful for older adults. This involves talking to a licensed professional. 

But medications are also an option. Two specific types of antidepressants are the first choice for older adults: 

• Selective serotonin reuptake inhibitors (SSRIs): Examples include citalopram (Celexa), escitalopram (Lexapro) and sertraline (Zoloft). 

• Selective norepinephrine reuptake inhibitors (SNRIs): Examples include venlafaxine (Effexor) and duloxetine (Cymbalta).

These groups of medication are generally safe and well-tolerated, with fewer side effects. 

Other antidepressants recommended for elderly people with anxiety are:

• Vortioxetine (Trintellix): This medication belongs to a class of drugs known as serotonin modulators. It may be particularly useful for older adults with anxiety and trouble with memory. 

• Mirtazapine (Remeron): This is another kind of antidepressant. It is generally recommended for older people because it doesn’t lead to many side effects. And it may be useful for people who also have trouble sleeping or a decreased appetite.

Other medications for anxiety — like benzodiazepines — tend to cause more side effects in older adults. This includes increased risk of confusion and falls. 

It can be hard to ask for help for anxiety, particularly for older adults. But speaking about mental health is important, since anxiety can hurt quality of life. If you don’t feel like yourself, talk to someone. And if you are worried that a loved one is suffering from anxiety, reach out to them. Having an open conversation may give the courage needed to talk to a professional about finding support.

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Written by:

Cherilyn Davis, MD

Cherilyn Davis, MD, is a board-certified pediatrician in NYC. She's held local and national roles at the American Medical Women's Association, including board member of the physician division and physician chair of social media.

Edited by:

Katie E. Golden, MD

Katie E. Golden, MD, is a board-certified emergency medicine physician and a medical editor at GoodRx.

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