Anxiety in older adults: Symptoms, causes, and treatment options

Anxiety is a common but often overlooked mental health issue in older adults. Many older adults feel anxious because of big life changes or health problems, but anxiety is not just something normal that happens with age.

Anxiety disorders are the most widespread mental health condition in seniors — about 15% of adults over 65 have a diagnosis. Anxiety disorders are underdiagnosed and often mistaken for physical health conditions, so the prevalence of anxiety disorders is likely higher.

Anxiety is a condition that can be treated, and learning how it shows up in later life is the first step toward feeling better.

How anxiety affects seniors

Anxiety is more than just worrying: it's a strong feeling of fear or nervousness that can affect your body, mood, and thinking. While it can be caused by stress, it often doesn’t go away even after the stress is gone. It can also be related to medical conditions or medications.

Feelings of anxiety can be triggered by outside stress—like illness, major life changes, or trauma—or come from long-term emotional struggles or changes in brain chemistry. Some health conditions can feel similar to anxiety, such as heart palpitations. Frequently, people who suffer from dementia also have symptoms of anxiety. In some cases, people who suffered from anxiety at younger ages may experience anxiety again if they suffer new losses or stressful events.

Anxiety is common at any age, but for older adults it can bring extra challenges. Anxiety in later life can increase the risk of disability, interfere with daily activities, and make some people less likely to follow medical advice. It’s also linked to more frequent doctor visits, hospital stays, and ongoing health problems. For many older adults, anxiety reduces independence and places added stress on family members. Overall, anxiety can negatively impact quality of life, physically, emotionally, and socially.

Anxiety symptoms in seniors include:

Emotional signs: Feeling nervous, fearful, worried, or restless.
Cognitive signs: Racing thoughts, intrusive thoughts, forgetfulness, trouble focusing, and difficulty stopping worries.
Physical signs: Trouble breathing, feeling dizzy, headache, chest tightness, heart palpitations or rapid heart rate, upset stomach, needing to pee often, and tight muscles.

If these symptoms last for weeks and make it hard to do everyday things, it’s important to talk to your healthcare provider. They can help with diagnosis and treatment. Some of these signs are similar to other health issues, such as heart problems or thyroid problems, so talk to a doctor to rule out other health conditions.

Why do older adults experience anxiety?

Anxiety can affect anyone at any age. A mix of factors come together to increase one’s risk for anxiety. Risk factors include:

Stressful life events
- Loss of a loved one
- Financial insecurity
- Retirement
Health problems or ongoing illness
Memory changes
Fear of falling or losing independence
Past trauma coming back later in life
Substance use
Certain personality traits such as shyness
Genetics (family history)

Some people may get anxiety for the first time in their 60s, 70s, or 80s. Others may have felt this way for years. Regardless of when anxiety starts, it’s manageable and treatable. By making healthy lifestyle choices, or attending to stress and treating medical conditions, you can take steps to lower your risk and protect your mental well-being.

Types of anxiety

Anxiety disorders can affect people of all ages and come in many forms. According to the DSM-5, anxiety is considered a disorder when excessive fear or worry occurs on most days for at least 6 months and interferes with daily functioning.

If you experience symptoms, your healthcare provider can help with a diagnosis. While there are many types of anxiety disorders, here are some of the most common:

Generalized anxiety disorder (GAD)

Ongoing, uncontrollable worrying that interferes with daily life.
- Compared to younger people, seniors tend to have a wider variety of topics to worry about, such as medical issues, memory loss, and fear of falling.
Common symptoms: Tight muscles, trouble sleeping, concentration problems, and feelings of restlessness.
GAD is the most common anxiety disorder in older adults. GAD is diagnosed in about 0.7% to 9% of seniors, however it is under-diagnosed and under-treated.

Panic disorder

Frequent, unexpected attacks or episodes of fear and dread.
Common symptoms: Chest pain, trembling, sweating, and racing heartbeat.
Most later-life panic attacks are associated with medical conditions such as chronic obstructive pulmonary disease (COPD) and psychiatric conditions. Panic attacks can also follow a stressful life event.

Obsessive-compulsive disorder (OCD)

The presence of obsessions (intrusive, unwanted thoughts, images, or urges) and compulsions (repetitive behaviors or mental acts performed to relieve the anxiety caused by obsessions).
- Often, people know that intrusive thoughts are unrealistic or unlikely to be true, but emotionally, they cannot stop worrying or believing. Intrusive thoughts can include violent themes, thoughts of death or that something bad will happen, feelings of responsibility, fear of contamination or having an illness.
Many people repeat specific actions to relieve fears. For instance, they may check whether a door is locked multiple times, since once is not enough for them to feel safe. These “rituals” may have started out as ways to distract or soothe the self from something traumatic that happened, but over time the thoughts become the surface problem while the underlying problem is not addressed.
The onset of OCD after age 60 is uncommon. Most seniors with OCD have had it since they were young, and symptoms tend to subside with age.

Hoarding

Acquiring and keeping an excessive number of items and feeling intense distress when trying to discard them. Related to OCD.
This is a health and safety issue, particularly for older adults, because homes become cluttered and lack wide pathways that increase the risk of falling and block rescue access by first responders.

Post-traumatic stress disorder (PTSD)

Caused by a traumatizing experience in the past, such as war, abuse, or violence.
Common symptoms: Nightmares, flashbacks or re-experiencing of the traumatic event, and avoiding reminders of trauma.
PTSD can be caused by stressful events suffered in late life. PTSD symptoms can be re-triggered with the onset of dementia or due to common aging experiences, such as death of a loved one, illness, or financial loss.

Phobias

Strong fear of certain places, things, or situations.
- Common phobias amongst seniors include germs or going outside. The most common fear in seniors is falling, which can lead to avoidance of certain activities which can negatively impact health, mobility and social isolation.
Phobias occur with low frequency in older adults.

The anxiety-depression connection

In older adults, anxiety and depression frequently happen at the same time.
This is associated with more severe symptoms, worse social functioning, and increased risk of suicide.

When should you seek help?

Talk to a healthcare provider if your anxiety:

Keeps you up at night several times a week
Makes you avoid people, places, or activities
Fills your mind with constant worry
Gets in the way of daily life

If these feelings happen most days for two weeks or longer, or feel hard to manage, it’s time to get help.

Ways to manage anxiety in older adults

There are many ways to manage older adult anxiety:

Try calming activities daily: Use deep breathing, mindfulness techniques like in Bold’s meditation classes, or gentle stretching to relax your body and quiet your thoughts.
Talk to others: Remember, you don’t have to go through it alone. Share your feelings with a friend, family member, or professional.
Break problems into smaller steps: Write down your worries. Focus on solving one thing at a time. Get help if you need it.
Take care of your body:
- Participate in physical activity through Bold’s online classes.
- Eat a balanced diet.
- Avoid alcohol or other substances to “take the edge off.”
Get professional help

Therapy: Talking with a trained counselor (in person or online) can help you manage anxious thoughts and create healthy coping habits. There are specific and highly effective treatments for anxiety disorders. Work with a professional who has specialty in treating anxiety disorders such as PTSD, panic, OCD and phobias.

Does Medicare cover counseling for anxiety? Yes. Medicare often helps pay for therapy, psychiatry, and other mental health services, depending on your plan.

Medication: Talk to your doctor about medications such as anxiolytics and some antidepressants to alleviate or manage symptoms. Several types of medication are effective in reducing anxiety symptoms. Anxiety responds well to therapy and behavioral techniques, so most of the time medication should be combined with therapy.

Anxiety and aging: What to remember

Anxiety is not a normal part of aging. It’s a health condition that can be treated.
You are not alone. Many older people feel this way—and many get better.
With the right tools, treatment, and habits, you can feel calmer and in control.

If you’re feeling anxious—or supporting someone who is—know that help is out there. You deserve to feel good and enjoy life, at every age.