Anxiety in later life

Anxiety is not just a young person's problem. Many older adults live with worry, fear or tension that makes daily life harder. In later life, anxiety often hides behind health problems, poor sleep or a quiet pulling back from activities.

The good news is that anxiety at any age can be treated. This page explains how anxiety can look different after 60, how it mixes with common health problems, and which treatments are safest for older bodies.

How anxiety can look different after 60

Older adults get the same kinds of anxiety as younger people. These include generalized anxiety, panic attacks, social anxiety and phobias. But later life adds some of its own patterns, such as fear of falling and anxiety linked to memory loss.¹

In later life, worry often centers on health, disability and money.¹ Many older people do not use the word "anxious." They may say they feel "nervous," "on edge," or "just worried." Anxiety may also show up as stomach trouble, pain, or sleep problems.²

Anxiety and depression often travel together in older adults. Both are often underdiagnosed.¹ Women, people with lower incomes, and people with long-term illness or disability face higher risk.¹

When anxiety starts late in life: check for medical causes

Panic disorder that starts for the first time in later life is rare.¹ So when a person over 60 suddenly feels anxious or has panic-like spells, doctors look for a physical cause first.

Common culprits include:¹

• Heart and lung disease, such as heart disease or COPD
• Thyroid problems and diabetes
• Medicines and substances, such as some inhalers (albuterol), steroid pills, and caffeine
• Early memory changes, which can make the world feel confusing and unsafe

New anxiety in later life is also a reason to get a memory check.¹ Bring a full list of your medicines, including over-the-counter pills and supplements. A "brown bag" review with your doctor or pharmacist can spot medicines that add to anxiety. See What causes anxiety and Medicines that can affect mood and memory.

Fear of falling

Falls are a real risk in later life. More than 1 in 4 adults age 65 and older fall each year, and fewer than half tell their doctor.⁶ After a fall, even one with no injury, many people become afraid of falling again.⁶

Some caution is healthy. But fear can grow until a person stops walking outside or visiting friends. Moving less weakens muscles and balance, which makes a fall more likely.⁶ It becomes a cycle.

Studies report fear of falling in anywhere from about 1 in 5 older adults to most of them, depending on the group and how it is measured. A past fall is a key risk factor.¹

What helps:

• Exercise that builds strength and balance. Tai chi has shown moderate benefits for fear of falling.¹ See Tai chi, the tai chi practice, and Strength and balance training.
• A Matter of Balance. This group class meets for 8 two-hour sessions with about 8 to 12 people. Trained volunteer leaders teach that falls are not a normal part of aging. The class covers home safety, exercise, and ways to cope with fear.⁷ In one state program, people felt more able to manage falls and walked a test course faster afterward. That study had no comparison group, so results are not certain.⁷
• Facing fear step by step. Gentle, gradual practice, like walking a little farther each week, works the same way exposure therapy does for other fears. See Phobias.

Ask your local Area Agency on Aging or senior center about classes near you. Read more in Fear of falling and Preventing falls.

Worry about health

Later life brings more doctor visits and test results, so some worry is natural. But for some people, fear of serious illness takes over. They check their body often or need reassurance that never lasts.

This pattern is called health anxiety. CBT (cognitive behavioral therapy) can help. See Health anxiety.

Anxiety with long-term illness

COPD and other breathing problems

Anxiety is common in COPD (chronic obstructive pulmonary disease, a long-term lung disease). Studies find it in roughly 13% to 46% of people with COPD. It is linked to worse daily functioning and more flare-ups.¹

Breathlessness and anxiety feed each other. Feeling short of breath sets off fear. Fear speeds up breathing, which makes breathlessness worse.⁹ People may then avoid activity, which weakens the body and makes breathing harder over time.⁹

The American Lung Association suggests talking with your care team about mood, counseling, staying active, and breathing and relaxation exercises.⁹ Support groups such as Better Breathers Clubs can help you connect with others. The Lung HelpLine is 1-800-586-4872.⁹ Slow breathing practices like box breathing may help some people, but ask your lung doctor which breathing methods suit you.

Heart disease

The American Heart Association lists anxiety among the mental health factors linked to heart health. Mental health problems are also tied to not taking medicines as prescribed.¹⁰ The AHA suggests doctors use short questionnaires, such as the GAD-2, to check for anxiety in people with or at risk for heart disease.¹⁰

Antidepressants called SSRIs are generally supported for anxiety in people with heart disease. Your doctor may check your heart rhythm, because some of these medicines can affect it.¹

Dementia and memory problems

Anxiety is common in dementia. Studies find it in about 17% to 52% of people living with dementia.¹ In people with mild cognitive impairment (memory or thinking changes that do not yet disrupt daily life), anxiety has been linked to a higher chance of developing Alzheimer's disease.¹

For a person living with dementia, anxiety often comes from a confusing world. Common triggers include a move, a hospital stay, travel, houseguests, a new caregiver, tiredness, or noise.⁸ Pain, hunger, thirst, constipation, a full bladder or an infection can also show up as restlessness or fear.⁸

The Alzheimer's Association recommends non-drug steps first:⁸

• Check for pain or other physical needs.
• Keep a calm, quiet space and a steady routine. Cut background noise like the TV.
• Speak calmly. Reassure the person they are safe and you will stay.
• Offer simple choices, music, a walk, or another soothing activity.
• Avoid arguing, raising your voice, or crowding the person.

Any new or sudden change in behavior needs a medical checkup.⁸ See Agitation and aggression, Sundowning, and Medicines for agitation and behavior.

What helps: safer treatment first

Hearing loss, loneliness and grief can make life feel harder and more uncertain. Getting help for them may ease worry too. See Loneliness in later life and Hearing loss, loneliness and the brain.

Medicines: what older adults should know

As we age, medicines can stay in the body longer and cause stronger side effects. The American Geriatrics Society keeps a list, called the Beers Criteria, of medicines that are often risky for people 65 and older.⁵

Here is what the 2023 Beers Criteria say about common anxiety medicines:⁵

SSRIs and SNRIs still have a place. They are favored over benzodiazepines for anxiety in later life.¹ Leaving anxiety untreated is not risk-free either. In COPD, for example, it is linked to worse daily functioning and more flare-ups.¹ The goal is to weigh the risks with your doctor, not to avoid all treatment.

Talk with your doctor or pharmacist before you start, stop or change any medicine. More detail is in Medicines for anxiety and Medicines that can worsen memory.

Benzodiazepines: why extra care is needed

Many older adults have taken a benzodiazepine for years. If that is you, you did nothing wrong, but it is worth reviewing with your doctor.

All benzodiazepines raise the risk of thinking problems, delirium, falls, fractures and car crashes in older adults.⁵ The Beers Criteria do list a few exceptions, such as seizure disorders, alcohol withdrawal and severe generalized anxiety disorder.⁵

In 2020, the FDA required its strongest warning, a boxed warning, on all benzodiazepines. It warns about misuse, addiction, physical dependence and withdrawal.⁴ Dependence can develop after days to weeks of regular use, even when the medicine is taken exactly as prescribed.⁴

Getting care and paying for it

Your primary care doctor is a good place to start. They can check for medical causes and refer you to a counselor or a geriatric psychiatrist (a psychiatrist who specializes in older adults).

Medicare Part B covers outpatient therapy and medicine visits. Covered providers include psychiatrists, psychologists, clinical social workers, nurse practitioners, and marriage and family therapists and mental health counselors. Telehealth visits are also covered. You usually pay 20% after the Part B deductible.¹¹ As of October 2026, check your own plan for details.

See What Medicare covers for mental health, Finding geriatric mental health care, and How to find a therapist.

For family members

You may notice anxiety before your loved one does. Watch for new reluctance to leave the house, frequent health worries, poor sleep, or dropping favorite activities. Ask gently what worries them, and offer to go with them to the doctor. See How to start a conversation about mental health and Supporting someone in treatment.

When to get help

See a doctor if anxiety or worry:

• Started recently, or came on suddenly
• Keeps you from going out, sleeping, or doing things you enjoy
• Comes with memory changes, weight loss, or low mood
• Has you relying on a sleeping pill or "nerve pill" every day

Is it normal to feel more anxious as I get older?

Some worry about health, money or loss is a normal part of life. But anxiety that is hard to control and gets in the way of daily life is not a normal part of aging. It can be treated at any age.¹

I've taken a "nerve pill" for years. Should I stop?

Do not stop on your own. Bring it up with your doctor. If you and your doctor decide to reduce it, a slow taper with support is the safe way.⁴

Could my anxiety be an early sign of dementia?

Sometimes. New anxiety in later life can come with early memory changes, so a memory check makes sense.¹ Most anxiety is not dementia, and a checkup can also find other treatable causes. See Treatable conditions that look like dementia.

Education only. This page is general information written from the sources listed. It is not medical, legal or financial advice and does not replace a doctor, therapist or lawyer who knows your situation. How we write and check pages.