April 16, 2009
Talk therapy eases anxiety among elderly
Therapy, which teaches relaxation, cognitive and problem-solving skills, improves the mental health of old folks with anxiety and depression
Adding talk therapy to typical anxiety treatment that often includes drugs helps older adults cope better, improving their quality of life and lowering their risk of depression and other health problems, reported researchers in the United States last week.
An increasingly popular type of therapy called cognitive behaviour therapy (CBT) which includes specific problem-solving strategies, significantly decreased levels of worry and depression. It also improved their general mental health compared to those who received only anti-depressants and anti-anxiety drugs, they said.
'This study is the first to suggest that CBT can be useful for managing worry and associated symptoms among older patients in primary care,' said Professor Melinda Stanley of the Baylor College of Medicine in Houston, whose study was published in the Journal Of The American Medical Association.
The findings follow similar results in younger adults and suggest a new approach to treating anxiety in older adults. Many older adults see their primary care doctor for treatment of anxiety, which typically includes a variety of medication.
However, anti-anxiety drugs such as benzodiazepines, a type of tranquillizer, can worsen other problems common among the elderly such as increased risk of falls, hip fractures and memory problems.
'Often, older adults don't want to add another medication. They are worried about the side effects and interaction with other medicine,' Prof Stanley said.
She and her colleagues wanted to see if cognitive behaviour therapy might help. They studied 134 older adults with an average age of 67 who visited their primary care doctor for anxiety symptoms.
In addition to what their doctor prescribed, about half of the patients also got three months of talk therapy, which included relaxation training, cognitive therapy, problem-solving skills training and sleep management.
Prof Stanley described it as a tool kit that patients can use when they start to feel anxious.
The other half got enhanced routine care, which included their doctor's treatment plan plus regular telephone calls from therapists to check on how they were doing.
Prof Stanley said that about 42 per cent of the patients in both groups were taking anti-depressants or anti-anxiety drugs.
At the end of the year-long study, the people in the therapy group reported significantly improved symptoms on several common scales measuring anxiety.
In general, she said she was confident that patients showed a benefit which seemed to last over a period of several months.
'Often when people stop taking medication, the symptoms come back,' she said.
Generalised anxiety disorder is a disabling condition that can also cause muscle tension, insomnia and fatigue.