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Nonpharmaceutical Treatment of Anxiety in Institutionalized Older Adults

 


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Am Fam Physician. 2016 Apr 1;93(7):592-593.

Clinical Question

What is the best nonpharmaceutical treatment for anxiety in institutionalized older adults?

Evidence-Based Answer

Cognitive behavior therapy (CBT) or relaxation training, alone or in combination, can be used to treat anxiety in older adults. (Strength of Recommendation [SOR]: A, based on a systematic review.) Music therapy can also be used to reduce anxiety in older adults. (SOR: B, based on extrapolations from meta-analyses of randomized controlled trials [RCTs] in the ambulatory setting.) Appropriate training of institutional caregivers is also helpful in reducing anxiety in older adults. (SOR: B, based on a single RCT.)

A systematic review of 19 RCTs (N = 522) analyzed treatment of anxiety and depression in noninstitutionalized patients whose mean age was older than 65 years.1 The authors studied the effect of CBT alone, relaxation training plus CBT, and relaxation training alone compared with no treatment and an active control (e.g., supportive counseling, psychotherapy, informal CBT training, informal relaxation training, group discussion, reflection, medication management, psychoed

Address correspondence to Connie Kraus, PharmD, at connie.kraus@wisc.edu. Reprints are not available from the authors.

Author disclosure: No relevant financial affiliations.

REFERENCES

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1. Thorp SR, Ayers CR, Nuevo R, Stoddard JA, Sorrell JT, Wetherell JL. Meta-analysis comparing different behavioral treatments for late-life anxiety. Am J Geriatr Psychiatry. 2009;17(2):105–115....

2. Hendriks GJ, Oude Voshaar RC, Keijsers GP, Hoogduin CA, van Balkom AJ. Cognitive-behavioural therapy for late-life anxiety disorders: a systematic review and meta-analysis. Acta Psychiatr Scand. 2008;117(6):403–411.

3. Ueda T, Suzukamo Y, Sato M, Izumi S. Effects of music therapy on behavioral and psychological symptoms of dementia: a systematic review and meta-analysis. Ageing Res Rev. 2013;12(2):628–641.

4. Teri L, Huda P, Gibbons L, Young H, van Leynseele J. STAR: a dementia-specific training program for staff in assisted living residences. Gerontologist. 2005;45(5):686–693.

Help Desk Answers provides answers to questions submitted by practicing family physicians to the Family Physicians Inquiries Network (FPIN). Members of the network select questions based on their relevance to family medicine. Answers are drawn from an approved set of evidence-based resources and undergo peer review.

The complete database of evidence-based questions and answers is copyrighted by FPIN. If interested in submitting questions or writing answers for this series, go to http://www.fpin.org or e-mail: questions@fpin.org.

This series is coordinated by John E. Delzell, Jr., MD, MSPH, Assistant Medical Editor.



 

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