4. CANADIAN GUIDELINES FOR THE ASSESSMENT AND TREATMENT OF ANXIETY IN OLDER ADULTS

Abstract

Introduction

Anxiety is not a normal part of aging, and misconceptions about anxiety in older adults lead to it being underrecognized and undertreated. Anxiety has a negative impact on quality of life, increases disability and caregiver burden, and is a risk factor for depression and dementia. To address the need for up-to-date, comprehensive clinical guidelines aimed at the assessment, treatment, and prevention of anxiety in older adults, the Canadian Coalition for Seniors Mental Health (CCSMH) has led a guideline project which has engaged with older adults and caregivers, healthcare providers, and community organizations across Canada to produce guidelines and tools that establish best practices for the care of older people with anxiety.

Methods

The guideline development followed a rigorous process set out by the Guidelines International Network (GIN)-McMaster Guideline Development checklist, including systematic reviews and meta-analyses across priority areas, with certainty of evidence evaluated using the GRADE methodology, and Evidence to Decision Frameworks used to consolidate evidence on the interventions to establish the recommendations.

Results

The guideline contains a total of 32 recommendations across case-finding, assessment, and treatment. This presentation will provide an overview of the guidelines, with a focus on the treatment recommendations including non-pharmacological (CBT, Mindfulness, Exercise) and pharmacological interventions (antidepressants, buspirone, benzodiazepines, antipsychotics and gabapentinoids). The presentation will also include sharing of knowledge translation tools and other resources to support care.

Conclusions

Anxiety in older adults is a treatable mental health condition and there are many evidence-based interventions that are helpful. These guidelines are an important step in setting out best practices in the assessment and treatment of anxiety in older adults.