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Cognitive Therapy May Ease Seniors' Anxiety

Cognitive Therapy Improves Symptoms of Anxiety Disorder Common in Older Adults, Study Shows
By Caroline Wilbert
WebMD Health News
Reviewed by Louise Chang, MD

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April 8, 2009 -- Cognitive behavior therapy may help older adults deal with anxiety.

Generalized anxiety disorder is common among seniors. Cognitive behavioral therapy focuses on changing a person's way of thinking in order to change their behavior or emotions.

In a new study with 134 older adults, some participants received cognitive behavior therapy for three months. Treatment included education and awareness, motivational interviewing, relaxation training, cognitive therapy, problem-solving skills training, and sleep management training. Other participants received enhanced usual care, which consisted of biweekly phone calls from a therapist to offer support and ensure patient safety.

The participants had an average age of 67. They were evaluated at the start of the study, after the three months of therapy, and several times during the next year. The participants with the cognitive behavioral therapy improved significantly at three months, compared with the other group, on several measures, including worry severity, depressive symptoms, and general mental health. However, in another key measure, severity of anxiety, there was no difference between the two groups. 

The differences in treatment response rates at three months were not apparent at 15 months, suggesting that the enhanced usual care group had some improvement and that "booster sessions" of cognitive behavioral therapy might be helpful. There were no significant differences in use of anti-anxiety or anti-depressant medication between the two groups.

The study, conducted by researchers at the Baylor College of Medicine, was published in the Journal of the American Medical Association.

Generalized anxiety disorder is common late in life, affecting up to 7.3% in the community and 11.2% in primary care, according to the study. Anxiety in older adults is associated with physical disability, memory difficulties, decreased quality of life, increased use of services, mortality, and depression.

“This study is the first to suggest that CBT can be useful for managing worry and associated symptoms among older patients in primary care,” the authors write. “This study paves the way for future research to test sustainable models of care in more demographically heterogeneous groups.”

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