Older adults

Projects investigating emotional health later in life

With an ageing population in Australia and internationally, the number of older adults with anxiety, depression and other emotional health conditions is set to multiply.

The Macquarie University Lifespan Health and Wellbeing Centre is conducting a range of projects to better understand and support the emotional health of older adults.

CONTACT-GAD: therapy for treatment resistant anxiety

Full title: A randomised controlled trial of tailored acceptance and commitment therapy for older people with treatment resistant generalised anxiety disorder (CONTACT-GAD)

Funded by: NHMRC-NIHR Collaborative Research Grant

This trial will provide the first clinical and cost-effectiveness evaluation of Acceptance and Commitment Therapy (ACT) for treatment-resistant Generalised Anxiety Disorder (GAD) in older adults.

The randomised control trial will examine ACT when routinely applied in older adult mental health services compared to treatment as usual.

The results from this trial will inform clinical guidelines and the routine management of GAD in older adults in both the United Kingdom and Australia.

With the ageing of Australia’s population, more older people will require evidence-based interventions for the management of chronic anxiety in the future.

Fear learning: can we reduce fear and prevent it from returning?

Full title: Fear learning in late-life anxiety disorders: can we reduce fear and prevent it from returning?

Funded by: Macquarie University

Around 1.5 million older Australians are predicted to have an anxiety disorder by 2050 – yet little is known about the learning mechanisms that underlie late-life anxiety.

This project will involve experimental research that examines:

• the impact of older age and anxiety disorders on fear learning and recovery
• biases in attention and memory toward threat-based stimuli.

This research will drive future treatment research that will use this knowledge of learning and cognitive mechanisms to improve the efficacy and durability of treatment for late-life anxiety.

Understanding and treating OCD in older adults

Funded by: International OCD Foundation

The global number of older people with obsessive compulsive disorder (OCD) is set to more than double over the next 30 years, yet this has been a largely neglected area of mental healthcare.

There is promising evidence that exposure with response prevention (ERP) treatment may be effective, however a range of age-related changes in physical, social and cognitive functioning may warrant the development of age-appropriate treatment protocols.

This project involves questionnaires and interviews with clients, supporters and clinicians to examine:

• the nature and impact of late-life OCD
• the phenomenology of accommodation by supporters (eg participation in OCD rituals, facilitation of avoidance).

This information will inform the development of age-appropriate treatment protocols for late-life OCD.

Learn more about this study.

Become a participant.

Reducing fear of falling in older adults

Full title: Using translational neuroscience to optimise treatment for older adults with anxiety disorders

Funded by: National Health and Medical Research Council (NHMRC)

Cognitive behavioural therapy (CBT) is the most effective psychological treatment for late-life anxiety, however specific treatment skills may be affected by age-related changes in cognition.

This project aims to examine whether we can translate advances in experimental neuroscience (optimising inhibitory learning mechanisms) to improve clinical outcomes for older adults with anxiety disorders, and how cognitive ability affects the efficacy and durability of treatment.

Older adults (65 years or older) with an excessive fear of falling will be randomised to one of three CBT treatments. This research will identify whether simple modifications to treatment can improve anxiety outcomes for older adults.

Long-term remission and relapse after CBT for anxiety and depression

Funded by: National Health and Medical Research Council (NHMRC)

Cognitive behaviour therapy (CBT) is an effective treatment for anxiety and depression in older adults, with improvements lasting between six months and a year after the end of treatment. However it is unclear how long past the first year these improvements last.

This project is a naturalistic follow-up to examine the long-term (10 year) impact of CBT on late-life anxiety and depression in a group of individuals who received treatment as part of a previous randomised control trial, and compare this to outcomes after an active discussion control group.

Stepped care effectiveness trial for ageing adults

Funded by: NHMRC and Beyond Blue

We are evaluating whether evidence-based treatment models for older adults (65 years and over) with anxiety and/or depression can be delivered through existing health services using a Stepped Care model.

• Step one comprises low intensity treatment. The adults receive treatment at home via a workbook or an internet program, supported by brief telephone calls from a clinician.
• Step two is a face-to-face higher intensity treatment option.

We compare this Stepped Care model to standard treatment for older adults with symptoms of anxiety and depression across five existing mental health services representing community (urban/regional) and private mental health care organisations.

Learn more about this study.

Improving mental health and social participation outcomes

Full title: Improving mental health and social participation outcomes in older adults with depression and anxiety

Funded by: NHMRC and Beyond Blue

In this NHMRC-Beyond Blue co-funded study we are examining whether there is a difference in the benefits of two psychological treatment programs aimed at reducing depression and anxiety in older adults. Adults aged 65 years and above who have anxiety and/or depression can participate in this free research trial.

Learn more about the Ageing Wisely study.

Evidence-based interventions for older adults in inpatient services

Full time: Developing evidence-based interventions for older adults with depression and anxiety in inpatient services: a pilot trial

Funded by: Macquarie University 2021 Research Acceleration Scheme

Acute anxiety and depression in older adults are managed in inpatient settings. Psychotropics are first-line management – including benzodiazepines, which place older adults at increased risk of falls and cognitive decline.

Despite the effectiveness of psychological interventions for older adults with anxiety and depression in older community samples, no evidence-based psychological interventions exist for inpatient settings. Due to alterations in orientation, variable attendance and admission durations, psychological interventions need to be purpose-built.

This project aims to develop an inpatient program, and evaluate its initial acceptability, feasibility and effectiveness leading to a manuscript and pilot data for grant applications for a clinical trial.