THE CLINICAL CHARACTERISTICS OF PANIC DISORDER IN THE ELDERLY - A RETROSPECTIVE STUDY

Background: Community-based studies of the elderly have observed patho logic levels of anxiety to be common but find low rates of DSM-III-R a nxiety disorders. Our clinical experience was that panic disorder may be more common than previously acknowledged. Our goals were to determi ne the prevalence, clinical characteristics, and possible factors that may facilitate a late-onset of panic disorder. Method. The clinical r ecords of 540 patients aged 60 years or more were reviewed. DSM-III-R panic disorder was identified in 51 subjects. Demographic information, current medical illness, and family history were extracted from their records. Rating scale measures of anxiety, depression, phobias, and c ognition were available. For comparison, subjects were divided into an early group who experienced onset of panic disorder at age 59 years o r earlier and a late group who experienced onset at age 60 years or la ter. Results: The overall prevalence of panic disorder was 9.4% and la te-onset panic was 5.7%. The late-onset group experienced more shortne ss of breath (p = .05) during panic attacks and were more likely to ha ve medical disorders like chronic obstructive pulmonary disease. verti go, and Parkinson's disease. The early-onset subjects were more social ly phobic (p = .008) and more depressed. Conclusion: Panic disorder ca n have onset in late life. Its phenomenology is similar in most respec ts to that described in young adults. Factors contributing to onset in clude stress, medical illness, and central nervous system disease.