Mental Health
The age of anxiety: anti-anxiety medication use among older adults in the United States Maria Springall De Pablo* Maria Springall De Pablo Springall De Pablo Springall De Pablo Springall De Pablo Springall De Pablo The University of Chicago
National statistics indicate rising rates of anxiety symptoms (e.g., feeling afraid, unable to stop worrying) from 2019 to 2022. For older adults, a treatment challenge is that the most common class of anti-anxiety (AX) medication, benzodiazepines (e.g., Xanax, Valium), are not recommended due to risk of falls and cognitive impairment. Using an ongoing nationally representative cohort of older adults, the National Social Life, Health and Aging Project, we describe AX use among 4,615 older adults by generation (“builders” born 1927-45 vs. “boomers” born 1946-64), measured in 2015/16 (R3) and 2021/23 (R4), and examine sociodemographic correlates. R3 data were collected by interviewers documenting medications in the home, while R4 was multimodal due to the pandemic.
AX use increased by one-third, from 4.1% of participants in R3 to 5.5% in R4. AX use was more common for builders than boomers. In R3, 74.3% of AX use was benzodiazepines and 29.0% other AXs (i.e., buspirone, hydroxyzine); R4 distributions were similar. In both rounds, benzodiazepine use was ~12% more common among builders than boomers. Concomitant use of benzodiazepines plus other AXs increased from R3 to R4, going from 3.3% of users to 4.6%.
Logistic models assessed age, gender, race/ethnicity, education, and logged assets as correlates of cross-sectional AX use. In R3, ORs for Black and Hispanic compared to white participants were 0.18 (95% CI 0.04, 0.74) and 0.27 (95% CI 0.11, 0.69) respectively. Higher education was associated with lower odds of AX use (OR 0.69, 95% CI 0.52, 0.92). In both rounds, higher log assets were associated with lower odds (R3 OR 0.88, 95% CI 0.79, 0.99; R4 OR 0.87, 95% CI 0.80, 0.94), while the odds of AX use were 2.07 (95% CI 1.34, 3.18) and 2.46 (95% CI 1.45, 4.19) higher for females than males.
Despite clinical guidelines, benzodiazepine use remains common for older adults, particularly among builders. Women, those with fewer assets, and less education present higher AX use.