Anxiety and depression in old age: challenges in recognition and diagnosis

Abstract

Recent years have seen much debate about both the prevalence and the nature of anxiety and depression in older adults. On the one hand, some authors have suggested that older populations are characterized by surprisingly high levels of well-being and resilience, despite increasing losses and functional impairment (Staudinger and Fleeson, 1996) and that the prevalence of mental illness, with the exception of dementia, decreases in late life (Jorm, 2000). Others have suggested that this is a spurious finding resulting from the methodological problems in obtaining accurate data for older adults (Beekman et al., 1998, Krasucki et al., 1999; O'Connor, 2006), with categorical diagnostic systems, such as the DSM-IV (American Psychiatric Association, 1994) and ICD-10 (World Health Organization, 1992) frequently cited as aggravating these difficulties (Palmer et al., 1997).