99 An apt summary of these myriad findings would be that stress research and aging research are intersecting: accelerated aging and stress hyperreactivity (as seen in anxiety disorders) are overlapping concepts. Thus, for late-life anxiety disorders, agents that affect aging pathways (such as rapamycin or calorie restriction mime tics) may be among the novel treatments that benefit health and cognition. Unfortunately, despite the wealth of research in the stress, immunology, and aging fields that could be applied to elucidate these connections, no longitudinal

Inhibitors,research,lifescience,medical research, to our knowledge, has been done or is underway to elucidate the long-term consequences of chronic pathological anxiety in late life, their Inhibitors,research,lifescience,medical mechanisms, and/or novel treatments to reverse this “accelerated aging” process. Comorbidity of anxiety with depression in the elderly Depressed individuals at all ages, Barasertib including older adults, commonly have comorbid anxiety symptoms or disorders. Longitudinally, anxiety symptoms appear to lead to depressive symptoms, more likely than is the case vice versa.100 Anxiety disorders could therefore be a risk factor for late-life Inhibitors,research,lifescience,medical depression as well as a predictor of persistence and relapse, as in young adults.14,101,102-106 Some research disputes this assertion.107 On the whole, though, studies support the conceptualization of anxious depression as a severe, treatment-relevant subtype of depression

throughout Inhibitors,research,lifescience,medical the lifespan. It remains unknown whether anxious depression reflects diagnostic or dimensional phenotypic overlap, a common neurobiological, behavioral, and/or psychological underpinning, or some additional heterogeneity. Anxious depression might be particularly relevant in older adults, in whom it predicts more cognitive decline44 and greater suicide risk108 than nonanxious depression. Treatment Pharmacological

treatments for anxiety disorders do not always have the same benefits or risks across the lifespan. Inhibitors,research,lifescience,medical Additionally, in the case of psychotherapy, treatments typically need to be adapted for older adults.30,109 This section summarizes treatment literature in geriatric anxiety disorders, discusses new directions in treatment development for older adults, and then provides a set of management Florfenicol guidelines for clinicians. Psychotherapy Cognitive behavioral therapy (CBT) is the mainstay for anxiety disorder treatment. In younger adults, it is a treatment of choice, particularly when exposure-based, for most anxiety disorders (although it is by no means the only effective approach in these cases). It remains unclear whether CBT is superior to other psychotherapy approaches in late-life anxiety disorders; however, this is presently the dominant and most widely available formal psychotherapy for anxiety disorders. CBT might be particularly effective for anxiety disorders in cognitively intact, motivated older adults who are able to learn new skills in CBT and use them effectively.