Am Fam Physician. 2016 Apr 1;93(7):592-593.
What is the best nonpharmaceutical treatment for anxiety in institutionalized older adults?
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
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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.
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