Bringing the bedside to the bench, and then to the community: a prospectus for intervention research in late-life anxiety disorders

被引:41
作者
Lenze, Eric J. [1 ]
Wetherell, Julie Loebach [2 ,3 ]
机构
[1] Washington Univ, Sch Med, Dept Psychiat, Washington, DC USA
[2] Univ Calif San Diego, Dept Psychiat, San Diego, CA 92103 USA
[3] VA San Diego Healthcare Syst, Psychol Serv, San Diego, CA USA
基金
美国国家卫生研究院;
关键词
anxiety; generalized anxiety disorder; elderly; neurobiology; prevention; intervention; personalized medicine; stress; aging; fMRI; POSTTRAUMATIC-STRESS-DISORDER; ECOLOGICAL MOMENTARY ASSESSMENT; GENERALIZED ANXIETY; OLDER-ADULTS; MENTAL-HEALTH; BEHAVIOR-THERAPY; ANTIDEPRESSANT THERAPY; ACTIVITY RESTRICTION; BENZODIAZEPINE USE; PUBLIC-ATTITUDES;
D O I
10.1002/gps.2074
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
Background Anxiety disorders are highly prevalent in elderly persons, and they are associated with functional impairment, poorer quality of life, and adverse long-term consequences such as cognitive decline. Intervention research in late-life anxiety disorders (LLAD) lags behind where it ought to be. Research in cognitive neuroscience, aging, and stress intersects in LLAD and provides the opportunity to develop innovative interventions to prevent chronic anxiety and its consequences in this age group. Methods This paper evaluates gaps in the evidence base for treatment of LLAD and synthesizes recent research ill cognitive neuroscience, basic behavioral science, stress, and aging. Results We examine three intervention issues in LLAD: (1) prevention; (2) acute treatment and (3) pre-empting adverse consequences. We propose combining randomized controlled trials (RCTs) with mechanistic biobehavioral methodologies as an optimal approach for developing novel, optimized, and personalized treatments. Additionally, we examine three barriers in the field of LLAD research: (1) How do we measure anxiety?; (2) How do we raise awareness? (3) How will we ensure our research is applicable to underserved Populations (particularly minority groups)? Conclusions This prospectus outlines approaches for intervention research that call reduce the morbidity of LLAD. Copyright (C) 2008 John Wiley & Sons, Ltd.
引用
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页码:1 / 14
页数:14
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