Research Progress on Anxiety Disorders in the Elderly and Their Relationship with Aging

Corresponding author: WU Xiangping, wxp029@126.com

DOI: 10.12201/bmr.202602.00100

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  Abstract: Anxiety disorders in older adults represent a prevalent mental health issue in late life; however, their true burden is likely underestimated due to inadequate clinical detection. These disorders are closely associated with accelerated cognitive decline, increased risk of comorbidities, and higher mortality rates, posing a significant public health challenge. Research indicates that their pathogenesis involves multifaceted changes related to aging. At the neurobiological level, this includes structural remodeling and neurodegeneration in key brain regions (e.g., the amygdala-prefrontal cortex circuit), as well as functional decline in neurotransmitter systems such as GABA, glutamate, and serotonin. In the endocrine-immune domain, factors like sex hormone fluctuations and a state of chronic low-grade inflammation (inflammaging) contribute to regulating anxiety susceptibility. Genetic and epigenetic studies also suggest that aging can modify the influence of genes on anxiety phenotypes and is accompanied by epigenetic age acceleration. Furthermore, psychosocial factors such as loneliness, negative perceptions of aging, and ageism play crucial mediating roles in the development and progression of anxiety. Treatment for elderly patients requires individualized adaptation: pharmacological therapy must carefully consider age-related pharmacokinetic changes and potential side effect risks, while psychotherapy (e.g., Cognitive Behavioral Therapy) should be optimized, potentially by integrating physical exercise or technological assistance, to enhance efficacy. Future research should integrate neurobiological and psychosocial perspectives to further elucidate aging-specific mechanisms and develop novel intervention strategies targeting core pathways such as inflammaging, aiming to achieve more effective prevention and treatment of anxiety disorders in the elderly.

  Key words: Anxiety disorders in the elderly; Aging; Neurobiological mechanisms; Psychosocial factorsTreatment; 

  Submit time: 28 February 2026

  Copyright: The copyright holder for this preprint is the author/funder, who has granted biomedRxiv a license to display the preprint in perpetuity.
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