Anxiety in Older Adults: Recognizing Symptoms and Finding Support

For some people, life can feel less predictable in older adulthood. Changes in health, major life transitions, or new responsibilities can bring worry or stress — even for people who haven’t experienced anxiety before. While research shows that older adults tend to have greater levels of emotional well-being on average than younger adults, anxiety can still show up later in life. 

The good news is that anxiety is treatable at any age. Understanding how it can emerge or resurface in older adulthood is an important step toward finding the support that feels right for you. 

Nilka McWilliams, a social worker at Hebrew Rehabilitation Center at NewBridge on the Charles, has worked closely with older adults experiencing anxiety. She shared symptoms of anxiety in older adults and how support can make a difference: 

Anxiety in older adulthood is often overlooked

Mental health disorders may manifest differently in younger and older adults. That may contribute to anxiety and depression being underrecognized in older people.

Older adults don’t always describe what they’re feeling as anxiety. “I’ve heard people say they worry more than they identify with having anxiety,” Nilka says. One study found that older adults describe their anxiety symptoms differently than younger adults, being more likely to describe anxiety as feeling “stressed” and “tense.” The researchers called for providers to assess symptoms broadly to better recognize anxiety in older adults.

Another challenge is that anxiety can appear as physical symptoms. Fatigue, appetite changes, difficulty sleeping or sleeping too much, and chronic pain can all be signs of anxiety, depression, medical conditions, or a combination of all three. Because physical and mental health symptoms can overlap, providers and patients may only focus on physical health, leaving anxiety untreated. 

Symptoms of anxiety in older adults 

Common signs of anxiety in older adults include: 

• Spiraling or repetitive thoughts 
• Trouble letting go of minor worries
• Physical symptoms like fatigue, sleep problems, appetite changes, or chronic pain 
• Irritability or social withdrawal 
• Excessive worry or monitoring of health (hypochondria)

Why anxiety can increase with age 

Many people find that they develop emotional resilience as they age. However, older adulthood can also bring new changes that feel overwhelming.  

These changes may include moving out of a home you’ve lived in for years, adjusting to changes in independence, managing new health concerns, taking on a caregiving role, or coping with loss or grief. You might be navigating more than one of these changes at the same time!

Moving into a senior living or long-term care setting can bring assumptions about a loss of independence. It can also come with new social situations, which not everyone adjusts to easily. “You’re in a communal setting with structured activities and regular social interaction, which can feel uncomfortable, especially if you weren’t very social to begin with,” Nilka explains. With the proper support, many introverts can feel at home in a senior living or long-term care setting with time. Read our blog post on how introverts can thrive in senior living.

Nilka has also seen health-related anxiety as a common concern among patients at Hebrew Rehabilitation Center. Fear about the progression of illness or uncertainty about the future can weigh heavily on a person. “Anxiety and fear around an illness can also manifest in not accepting a diagnosis. People may search for an alternative explanation to avoid accepting that an illness is progressing,” she says. She adds that, “this response is often rooted in self-protection.”

Some fears about health overlap with broader health anxiety. But anxiety about developing Alzheimer’s disease, a distinct form of worry tied to memory loss, is also common in older adulthood. 

When anxiety is about Alzheimer’s disease 

Losing your keys or struggling to find the right word happens to everyone from time to time. But for someone with dementia-related anxiety, those experiences can quickly escalate into more significant concerns about whether something more is wrong.

“Dementia-related anxiety has parallels to health anxiety, but it’s a type of anxiety of its own,” explains Tessa Lundquist, PhD, ABPP. Dr. Lundquist is a geropsychologist at the Deanna and Sidney Wolk Center for Memory Health who developed a quantitative measure of dementia-related anxiety in older adults.

A family history of Alzheimer’s disease can make you more likely to experience fear around memory loss. “Everyone has some connection to dementia,” says Dr. Lundquist. “It hits us very personally, and when there’s still so much we don’t know, that uncertainty can fuel anxiety.”

In Dr. Lundquist’s research, people who reported higher levels of anxiety about Alzheimer’s disease responded in different ways when it came to getting memory screenings. Some sought reassurance by having their memory checked, while others avoided screenings because the idea felt overwhelming. Researchers are still exploring why anxiety leads people to make different decisions.

“A lot of providers recognize the worry and fear around dementia, but it’s not always considered as much as it should be,” says Dr. Lundquist. Speaking with your doctor if you’re concerned about dementia or believe you may have dementia-related anxiety can be helpful. Additionally, the Wolk Center for Memory Health offers outpatient memory loss assessments for all memory concerns. 

Support that meets you where you are 

What matters most when it comes to finding support for your anxiety is finding an option that feels manageable and right for you.

That could mean speaking with your primary care physician about how you’ve been feeling. Alternatively, you may feel more comfortable reaching out to a social worker, psychologist, psychiatrist, chaplain, or trusted spiritual leader. Even opening up to a family member or close friend about how you’ve been feeling can be an essential first step.

Beneficial treatment may include therapy, medication, a support group, or a combination of approaches put together by your health care provider. That said, meaningful connections with others and knowing you aren’t navigating your anxiety alone can be valuable on top of clinical care.

For individuals experiencing cognitive decline, traditional talk therapy may not be the best fit. “Cognitive behavioral therapy is a goals-oriented therapy, so it may not be a viable option if someone won’t remember what they spoke about last time. What can be helpful is having the ability to talk to people, not necessarily in a therapy session, but in the moment, who check in with you and see how you’re doing,” says Nilka. 

Looking for support for yourself or a loved one? 

At Hebrew SeniorLife, emotional well-being is a crucial component of how we care for older adults. Our senior living communities offer coordinated care that supports both physical and mental health. We also provide outpatient services, including family and caregiver support through the Wolk Center for Memory Health, which offers individual and family counseling, memory support groups, and resource coordination.

Interested in learning more? Find a service or community online today to find the support that meets you where you are.