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Centre for Emotional Health Ageing Research Viviana Wuthrich Centre for Emotional Health (CEH) • Centre for research excellence • Focused on the understanding, treatment and prevention of anxiety, depression and related mental health problems • The Centre for Emotional Health also encompasses the Emotional Health Clinic and the eCentreClinic Current members & Output • 11 Academic staff • 6 Post-doctoral research fellows • Around 65 doctoral students • Total research funding > $8.5M. (2010 – 2014) • Scientific publications > 115 (2010 – 2011) Emotional Health Clinic • Highly respected clinical treatment service that provides the latest help for people suffering emotional difficulties. • Provides treatment and assessment services to around 500+ clients per year • Strong reputation among public and professionals • Around 30 students & 10 professional visitors each year Agenda • Prevalence of anxiety and depression • Common signs of anxiety and depression in older adults • Consequence of these problems being left untreated • Latest findings regarding treatment of these problems in older adults Ageing Population • ABS estimations for over 65 year olds: – 2004 = 13% (or 2.6 million) – 2051 = 26% • Estimation for over 85 year olds: – 2007 = 1.6% – 2051 = 5-7% Mental Health Research is Neglected in Older Adults • Apart from Dementia • Little research exists into the understanding and treatment of anxiety and depression in older adults • There is more research for depression, very few studies focus on anxiety in older adults Prevalence of Anxiety & Depression in Adults over 60 • Prevalence of clinical anxiety disorders is up to 10.2% • 24% for clinical depression in adults • Rates of clinical disorders for anxiety and depression decrease in older adulthood 12 month prevalence of anxiety and depression by age group (NSMHW, 2007) Lower Prevalence Rates • Prevalence may be underestimated: – Tools used to measure are unsuitable – Older adults less willing to admit symptoms – Symptoms change as people age • Better coping skills -wisdom and life experience Prevalence of Mild Anxiety & Depression • Rates of subclinical depression are as high as 25% in primary health care settings, 50% in nursing homes • Rates of subclinical anxiety up to 5-30% Consequences of Untreated Symptoms • • • • • • • Life dissatisfaction Disability Mortality Medication Health care services Suicide Dementia Completed Suicide (ABS, 2010) Symptoms of Depression • Sadness, tearfulness – but this is less prominent than in younger samples • Loss of interest • Low motivation • Hopelessness • Excessive fatigue • Difficulty sleeping Reduced Levels of Sadness • Unclear why this is. Hypotheses include: – Less willing to admit low mood – Less able to recognise it – Depression characterised by hopelessness and helplessness rather than sadness – Biological changes or vascular lesions might result in differences in symptoms presentation Symptoms of Anxiety • Anxiety most characterised by worry – Worry about relationships, health, finances, family – Restlessness or agitation – Difficulty sleeping • Other anxiety is less common (post traumatic stress, social anxiety, obsessive compulsive disorder) Common Themes of Distress • • • • • • • • Life long anxiety and/or depression Relationship conflict Worry about family, children and grandchildren Burden of caring for frail parents or spouse Worry: ageing, illness, dementia, fitness, finances Difficulty adjusting to retirement, loss of purpose Bereavement Isolation, loss of social networks Help Seeking- NSMHW (2007) • Of those people who identified as having anxiety or depression, service use was lowest among the young people (23%) and older adults aged 75-85years (23%) • Males were particularly unlikely to seek help across all age groups Treatment for Anxiety & Depression • Most common treatments are medications – Possible side-effects, drug-to-drug interactions • Psychological treatments are also effective – International research indicates that psychological techniques can greatly benefit older adults – Problem solving skills, relaxation, changing negative thinking, socialising and discussion groups are all helpful Treatment continued • Research normally is targeted at anxiety OR depression • Anxiety and depression commonly co-occur throughout the lifespan – Community sample in Netherlands aged 55-85 yrs comorbid prevalence of major depression and any anxiety disorder was 47.5% • Some research indicates that having both reduces the effectiveness of treating the other disorder Our Research • • • • • • • Assessment of anxiety and depression in older adults Symptom profiles Emotion regulation Coping skills Barriers to treatment seeking Psychological Treatments Impact of cognitive changes on effectiveness of psychological treatments Recent Trial (2007-2010) • Developed and examined the effectiveness of a group psychological treatment for comorbid anxiety and depression in adults over 60 • Compared to doing nothing, we found that psychological treatment provided benefits for both anxiety and depression symptoms and improved quality of life • These improvements were lasting (evident 3 months later) Changes in Depression Score Latest Research • Comparing two different psychological treatments to determine which is the most effective (randomised controlled trial) • Comorbid anxiety and depression in older adults aged 60 and over • Examining changes in symptom severity, quality of life, and cognitive performance • 3 year trial funded by National Health & Medical Research Council (2011-2013) Contact Details • Further information about the free group treatment program for treating anxiety and depression in adults over 60 is available by contacting the Emotional Health Clinic on 9850 -8711 • Information on the Centre for Emotional Health is available at www.centreforemotionalhealth.com.au