Perioperative Anxiety and Depression in Older Adults: Epidemiology and Treatment
Issued Date
2023-01-01
Resource Type
ISSN
10647481
eISSN
15457214
Scopus ID
2-s2.0-85165678167
Pubmed ID
37482501
Journal Title
American Journal of Geriatric Psychiatry
Rights Holder(s)
SCOPUS
Bibliographic Citation
American Journal of Geriatric Psychiatry (2023)
Suggested Citation
Srifuengfung M., Abraham J., Avidan M.S., Lenze E.J. Perioperative Anxiety and Depression in Older Adults: Epidemiology and Treatment. American Journal of Geriatric Psychiatry (2023). doi:10.1016/j.jagp.2023.07.002 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/88195
Title
Perioperative Anxiety and Depression in Older Adults: Epidemiology and Treatment
Author(s)
Author's Affiliation
Other Contributor(s)
Abstract
The intervals before and after major surgery is a high-risk period for older adults; in this setting, anxiety and depression are common and serious problems. We comprehensively reviewed current evidence on perioperative anxiety and depression in older adults, focusing on epidemiology, impact, correlates, medication risks, and treatment. Principles of perioperative mental healthcare are proposed based on the findings. Prevalence estimates of clinically significant anxiety and depression range from 5% to 45% for anxiety and 6% to 52% for depression, depending on surgical populations and measurement tools. Anxiety and depression may increase risk for surgical complications and reduce patient participation during rehabilitation. Medical comorbidities, pain, insomnia, cognitive impairment, and delirium are common co-occurring problems. Concomitant uses of central nervous system acting medications (benzodiazepines, anticholinergics, and opioids) amplify the risks of delirium and falls. Based on these findings, we propose that anxiety and depression care should be part of perioperative management in older adults; components include education, psychological support, opioid-sparing pain management, sleep management, deprescribing central nervous system active medications, and continuation and optimization of existing antidepressants. More research is needed to test and improve these care strategies.