Association of age and gender with anxiety disorders in older adults: A systematic review and meta-analysis

Int J Geriatr Psychiatry. 2019 Mar;34(3):397-407. doi: 10.1002/gps.5035. Epub 2018 Dec 10.


Objectives: To provide an estimate of 12-month and lifetime prevalence of Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) anxiety disorders in older adults based on published studies on this topic and to identify the impact of gender and age.

Methods/design: A systematic review and meta-analysis was performed. Six databases were searched, and manual searches through reference lists of selected articles and reviews were performed. When the information was available, summary effects were calculated for the prevalence of each anxiety disorder and for every age and gender subgroups. Summary odd ratios (OR) were calculated to compare the prevalence of an anxiety disorder according to age and gender.

Results: A total of 6464 studies were identified, and 16 studies were included in the meta-analyses. Prevalence was significantly higher in women than men for generalized anxiety disorder (12 month OR = 6.10, P = 0.001; lifetime OR = 1.96, P = 0.001), 12-month social anxiety disorder (OR = 2.07, P = 0.01), and lifetime post-traumatic stress disorder (OR = 1.93, P = 0.002). The prevalence of specific phobia was significantly lower in both the 75 to 84 and 85 years and above age groups when compared with the 65 to 74 years age group (OR = 0.70, P = 0.004 and OR = 0.63, P = 0.01, respectively).

Conclusions: Our results suggest that the tendency for women to experience a greater prevalence of anxiety disorders remains present in older adults. Specific phobia was the only disorder to be less frequent with advancing age. This is likely to change with the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria because this new DSM version now indicates that fear of falling is a possible type of specific phobia and fear of falling is generally more frequent in the oldest age groups.

Keywords: anxiety disorders; meta-analysis; systematic review.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Systematic Review

MeSH terms

  • Age Factors
  • Aged
  • Anxiety Disorders / epidemiology*
  • Diagnostic and Statistical Manual of Mental Disorders
  • Female
  • Humans
  • Male
  • Odds Ratio
  • Phobic Disorders / epidemiology
  • Prevalence
  • Sex Factors
  • Stress Disorders, Post-Traumatic / epidemiology

Supplementary concepts

  • Phobia, Specific