Anxiety in Older Adults: What It Looks Like and What Helps

For Patients & Families
Written By Sonia Mia Diaz, MD

Anxiety disorders affect an estimated 6% to 10% of older adults, and they are often missed because they look different later in life. Worry may show up as trouble sleeping, stomach or heart complaints, or pulling back from activities rather than as "feeling anxious." Anxiety in later life is treatable, and the best first treatments are not the sedatives many older adults are still prescribed.

How Anxiety Looks After 60

Most anxiety disorders start earlier in life, so families and doctors may see long-standing worry as "just how she is." Others notice new worry after a health scare, a loss, or a move. Signs to watch for:

  • Constant worry about health, money, family or safety that is hard to switch off

  • Trouble falling or staying asleep

  • Restlessness, irritability or muscle tension

  • Physical symptoms with no clear cause, such as a racing heart, shortness of breath, dizziness or stomach upset

  • Avoiding driving, going out, or social events that used to be easy

  • Frequent calls or visits to the doctor for reassurance

  • Fear of falling that limits walking or activity

Anxiety often comes with depression in later life. When both are present, each makes the other harder to treat, so it is worth checking for both.

What Can Look Like Anxiety

A good evaluation rules out other causes, because some are common after 60:

  • Medical conditions such as an overactive thyroid, heart rhythm problems, breathing problems or low blood sugar

  • Medications such as steroids, decongestants, some inhalers, or too much thyroid hormone

  • Caffeine and alcohol, including withdrawal from regular evening drinking

  • Early memory changes, which can make people anxious and unsure of themselves

  • Pain and poor sleep, which feed worry and are worsened by it

Bring a full list of medications and supplements to any visit.

What Helps

Cognitive behavioral therapy (CBT) works for anxiety in older adults. It teaches practical skills for worry, avoidance and sleep. In a primary care trial, older adults with generalized anxiety who had CBT had less worry and fewer depression symptoms than those with usual care. In a long-term follow-up, people who had CBT were more likely to be in remission 10 years later. CBT is available by video.

Antidepressants, mainly SSRIs such as sertraline and escitalopram, are the first-line medications for anxiety. In a trial of adults 60 and older with generalized anxiety, escitalopram helped, and continuing it prevented relapse. Combining medication with CBT reduced worry further. These medications are started at low doses in older adults and adjusted slowly.

Regular physical activity, steady sleep habits, cutting back on caffeine and alcohol, and staying socially connected support either treatment.

Why Sedatives Aren't the Answer

Benzodiazepines, such as lorazepam, alprazolam and clonazepam, calm anxiety quickly, which is why they are still widely prescribed. In older adults they raise the risk of falls, fractures, confusion and car accidents, and they can be hard to stop. The American Geriatrics Society's Beers Criteria recommends avoiding them in most older adults.

If your parent already takes one regularly, don't stop it suddenly. Stopping abruptly can cause rebound anxiety, insomnia and, in some cases, seizures. Any change should be a slow, planned taper with the prescriber. Our guide Sleeping Pills After 60 covers related medications.

How Families Can Help

  • Name what you've noticed, without labels: "You seem worried a lot lately, and you've stopped going to church."

  • Offer to come to an appointment or join a video visit, with your parent's permission.

  • Help put together a medication list, including over-the-counter sleep aids and supplements.

  • Encourage the activities that anxiety has pushed out, a little at a time.

What Medicare Covers

Original Medicare Part B covers outpatient mental health care, including psychiatric evaluations, medication management and visits by telehealth. After the Part B deductible ($283 in 2026), you generally pay 20% of the Medicare-approved amount when your provider accepts assignment. A supplemental (Medigap) plan may cover some or all of that 20%. For help comparing plans, Virginia residents can contact VICAP and Florida residents can contact SHINE.

How Welmivia Can Help

Welmivia is a participating Medicare practice. Dr. Diaz sees adults with Original Medicare located in Virginia or Florida by video. An evaluation looks at anxiety alongside mood, sleep, memory, medical conditions and every medication. Dr. Diaz can coordinate with the primary care physician and therapist. For Florida patients, Dr. Diaz does not prescribe controlled medications, including benzodiazepines. We are not able to see patients with Medicare Advantage or Medicaid. Private-pay patients are welcome too.

To check coverage or ask about a first visit, call 434-623-0003 or use our Medicare request form. For what to bring, see How to Find Psychiatric Care for a Parent With Medicare.

What to Take Away

  • Anxiety is common after 60 and often shows up as poor sleep, physical complaints or avoidance.

  • CBT and SSRIs work for older adults; benzodiazepines carry real risks at this age.

  • Never stop a benzodiazepine suddenly; plan any change with the prescriber.

Welmivia is not a crisis service. If someone is in danger, call 911. For a mental health crisis, call or text 988.

Sources

This guide is general information, not medical advice for your situation. Do not change any medication without talking with your prescriber.

Sonia Mia Diaz, MD

Sonia Mia Diaz, MD, is the founder and medical director of Welmivia, a physician-led psychiatric practice that cares for adults in Virginia and Florida by video, including patients with Original Medicare. Her work focuses on diagnostic clarity, careful medication management, and coordinated care with primary care physicians.

Next

Your Antidepressant Isn’t Working: What to Check Before Switching