Anxiety and other affective disorders in the elderly
https://doi.org/10.21518/ms2025-518
Abstract
The health of elderly is a priority issue of modern healthcare. Emotional disorders such as anxiety, depression, apathy, and anhedonia are very common in this age range. Emotional problems are quite common in the elderly people. On the one hand, this may be due to a large number of possible factors: loss of loved ones, leaving work and social isolation, loneliness, a large number of diseases, each of which can lead to the development of anxiety and depression. However, this is not the only explanation for the high prevalence of affective disorders in people over 60 years of age. Modern studies using neuroimaging techniques demonstrate a close relationship between anxiety and depression with late onset and the severity of both neurodegenerative and vascular changes in the brain. This suggests that the key cause of affective spectrum disorders in the elderly is organic brain damage. Given that the development of anxiety and depression in old age is often based on progressive diseases, late-onset affective disorders do not respond well to standard therapy, which forces doctors to constantly increase doses and combine different groups of drugs, which in the end not only does not help, but can also worsen the condition of patients. This review discusses the key mechanisms by which progressive neurological diseases can lead to the development of primary mood disorders and the formation of pathological anxiety. An algorithm for the differentiated assessment of elderly patients with anxiety disorders de nova will be proposed, which will optimize approaches to identifying the primary cause of these symptoms and form the right therapy strategy.
About the Author
E. E. Vasenina
Russian Medical Academy of Continuous Professional Education
Russian Federation
Russian Federation
Elena E. Vasenina, Dr. Sci. (Med.), Professor of the Department of Neurology with a Course in Reflexology and Manual Therapy
2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993
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Vasenina EE. Anxiety and other affective disorders in the elderly. Meditsinskiy sovet = Medical Council. 2025;(22):105-112. (In Russ.) https://doi.org/10.21518/ms2025-518
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