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Handbook of Behavioral and Cognitive Therapies with Older Adults pp 33–47Cite as

Treatment of Late-Life Generalized Anxiety Disorder in Primary Care Settings

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Late-life anxiety disorders are twice as prevalent as mood disorders and 4–8 times more prevalent than major depressive episodes (Regier et al., 1988; Weissman et al., 1985). Generalized Anxiety Disorder (GAD) is second only to specific phobias in prevalence among older adults (Krasucki, Howard, & Mann, 1999). Furthermore, the most common anxiety disorder within the primary care setting is GAD (Wittchen et al., 2002), with prevalence estimates ranging from 2.8 to 11.2% (Ansseau, Fischler, Dierick, Mignon, & Leyman, 2005; Roy-Byrne & Wagner, 2004; Tolin, Robison, Gaztambide, & Blank, 2005). Among community samples of older adults, GAD is associated with poor quality of life (Wetherell, Gatz, & Craske, 2003), increased comorbidity (Krasucki, Howard, & Mann, 1998), and increased service use (Stanley, Roberts, Bourland, & Novy, 2001). In primary care settings, GAD in later life is associated with increased worry, depression, and sleep difficulties, as well as decreased quality of life and reduced perceptions of general health, mental health, and vitality (Stanley et al., 2003). GAD in older adults is also associated with greater physical disability (Astrom, 1996). Because older adults tend to somaticize psychiatric problems (Lenze et al., 2005) and because of the overlap between GAD, depression, and comorbid medical problems, GAD can be difficult to diagnose in older adults.

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Author information

Authors and Affiliations

  1. Wake Forest University School of Medicine, Winston-Salem, NC, USA

    Gretchen A. Brenes

  2. Baylor College of Medicine, Winston-Salem, NC, USA

    Paula Wagener & Melinda A. Stanley

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  1. Gretchen A. Brenes
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  2. Paula Wagener
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  3. Melinda A. Stanley
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Editors and Affiliations

  1. Stanford University, 94305-5717, Stanford, CA, USA

    Dolores Gallagher-Thompson Ph.D. ABPP

  2. University of Missouri-St. Louis, 63121, St. Louis, MO, USA

    Ann M. Steffen Ph.D

  3. Stanford University School of Medicine and Pacifi c Graduate School of Psychology, 94024, Los Atlos, CA, USA

    Larry W. Thompson Ph.D

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Brenes, G.A., Wagener, P., Stanley, M.A. (2008). Treatment of Late-Life Generalized Anxiety Disorder in Primary Care Settings. In: Gallagher-Thompson, D., Steffen, A.M., Thompson, L.W. (eds) Handbook of Behavioral and Cognitive Therapies with Older Adults. Springer, New York, NY. https://doi.org/10.1007/978-0-387-72007-4_3

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