老年躯体疾病伴发焦虑抑郁的临床诊治进展

doi:10.3969/j.issn.1003-9198.2026.08.003

Abstract

Abstract: Elderly patients with somatic diseases exhibit a higher probability of concurrent anxiety and depression; Conversely, depressive and anxious symptoms can exacerbate the progression of somatic diseases. The management of anxiety and depression in elderly patients is particularly crucial, understanding their pathogenesis and selecting appropriate assessment tools are key to effective treatment. This article reviews relevant studies on the pathological mechanisms and diagnostic/therapeutic advancements of anxiety and depression co-occurring in elderly patients with somatic diseases, aiming to provide clinical reference for the management of these comorbid conditions.

Key words: aged, somatic diseases, anxiety, depression

CLC Number:

R 749.7

DENG Jibao, TAN Li, WANG Yanrong. Advances in the clinical diagnosis and treatment of anxiety and depression in elderly patients with somatic diseases[J]. Practical Geriatrics, 2026, 40(8): 764-769.

References

[1] BEARD J R, OFFICER A, DE CARVALHO I A, et al. The world report on ageing and health: a policy framework for healthy ageing[J]. Lancet, 2016, 387(10033): 2145-2154.
[2] CHENG C, DU Y, BAI J. Physical multimorbidity and psychological distress among Chinese older adults: findings from Chinese Longitudinal Healthy Longevity Survey[J]. Asian J Psychiatr, 2022, 70: 103022.
[3] CHENG Y, FANG Y, ZHENG J, et al. The burden of depression, anxiety and schizophrenia among the older population in ageing and aged countries: an analysis of the Global Burden of Disease Study 2019[J]. Gen Psychiatr, 2024, 37(1): e101078.
[4] HALLAB A. Mediating effect of pro-inflammatory cytokines in the association between depression, anxiety, and cardiometabolic disorders in an ethnically diverse community-dwelling middle-aged and older US population[J]. medRxiv, 2025.[Preprint]. doi: 10.1101/2025.04.14.25325836.
[5] DERRY H M, JOHNSTON C D, BURCHETT C O, et al. Links between inflammation, mood, and physical function among older adults with HIV[J]. J Gerontol B Psychol Sci Soc Sci, 2022, 77(1): 50-60.
[6] JANTSCH J, DA SILVA RODRIGUES F, WICKERT F, et al. Cannabidiol attenuates diet-induced metabolic endotoxemia, neuroinflammation, and anxiety-like behaviors in male aged rats[J]. Brain Behav Immun, 2025, 130: 106121.
[7] ABBOTT R, WHEAR R, NIKOLAOU V, et al. Tumour necrosis factor-α inhibitor therapy in chronic physical illness: a systematic review and meta-analysis of the effect on depression and anxiety[J]. J Psychosom Res, 2015, 79(3): 175-184.
[8] KEMALA SARI N, BURHAN E, ISBANIAH F, et al. Emotional freedom techniques for elderly patients with COVID-19: a case series on clinical recovery, frailty, and inflammatory biomarkers[J]. Front Psychol, 2025, 16: 1627592.
[9] KRAUSE-SORIO B, SIDDARTH P, MILILLO M M, et al. Regional gray matter volume correlates with anxiety, apathy, and resilience in geriatric depression[J]. Int Psychogeriatr, 2023, 35(12): 698-706.
[10] CELLE S, BOUTET C, ANNWEILER C, et al. Leukoaraiosis and gray matter volume alteration in older adults: the PROOF Study[J]. Front Neurosci, 2021, 15: 747569.
[11] LI H, ZHAO J, LAI L, et al. Loss of SST and PV positive interneurons in the ventral hippocampus results in anxiety-like behavior in 5xFAD mice[J]. Neurobiol Aging, 2022, 117: 165-178.
[12] SEAH C W T, HO M, CHU C, et al. Immunosenescence and its impact on ischemic stroke risk and outcomes in older adults: a systematic review[J]. Front Aging Neurosci, 2026, 18: 1776458.
[13] ZHUBI E, LEHOCZKI A, TOTH P, et al. Intracerebral hemorrhage in aging: pathophysiology, clinical challenges, and future directions[J]. Life: Basel, 2025, 15(10).
[14] MéTIVIER L, VIVIEN D, GOY R, et al. Plasminogen activator inhibitor-1 in the pathophysiology of late life depression[J]. Int J Geriatr Psychiatry, 2024, 39(11): e70015.
[15] WEN H, MAO Q, JIANG Z, et al. The relationship between disability, anxiety and depression in older adults with chronic disease comorbidities: the mediating role of frailty[J]. BMC Geriatr, 2025, 25(1): 972.
[16] LI B, GUAN S, HUANG C, et al. Depression severity and chronic disease risk: interactive effects on cognitive function and life satisfaction in Chinese middle-aged and older adults[J]. Front Public Health, 2025, 13: 1530513.
[17] LIU Y, TONG J, CHEN L, et al. Nutritional frailty and the incidence of depression and anxiety among middle-aged and older adults: a prospective cohort study[J]. Clin Nutr, 2025, 50: 10-19.
[18] SHI Y Q, YANG H C, HE C, et al. Inflammatory links between epilepsy and depression: a review of mechanisms and therapeutic strategies[J]. Front Neurosci, 2025, 19: 1614297.
[19] LICINIO J, LICINIO A W, BUSNELLO J V, et al. The emergence of chronic diseases of adulthood and middle age in the young: the COIDS (chronic inflammation, obesity, insulin resistance/type 2 diabetes, and depressive syndromes) noxious quartet of pro-inflammatory stress outcomes[J]. Mol Psychiatry, 2025, 30(7): 3348-3356.
[20] MISHRA S P, JAIN S, WANG B, et al. Abnormalities in microbiota/butyrate/FFAR3 signaling in aging gut impair brain function[J]. JCI Insight, 2024, 9(3) :e168443.
[21] HUANG H, LU M, ZHANG P, et al. Association between malnutrition, depression, anxiety and fatigue after stroke in older adults: a cross-lagged panel analysis[J]. Aging Clin Exp Res, 2024, 37(1): 4.
[22] WANG N, TU Q. Analysis of factors influencing anxiety and depression disorders among hospitalized patients[J]. Front Psychiatry, 2026, 17: 1757945.
[23] JOKELAINEN J, TIMONEN M, KEINÄNEN-KIUKAANNIEMI S, et al. Validation of the Zung self-rating depression scale (SDS) in older adults[J]. Scand J Prim Health Care, 2019, 37(3): 353-357.
[24] PENG L, PENG Y, HUANG W. Social participation and insomnia in Chinese older adults with multimorbidity: mediating roles of frailty, anxiety, and depression[J]. BMC Geriatr, 2025, 25(1): 605.
[25] BYRNE G J, PACHANA N A. Development and validation of a short form of the Geriatric Anxiety Inventory-the GAI-SF[J]. Int Psychogeriatr, 2011, 23(1): 125-131.
[26] SNELLMAN S, HöRNSTEN C, OLOFSSON B, et al. Validity and test-retest reliability of the Swedish version of the geriatric depression scale among very old adults[J]. BMC Geriatr, 2024, 24(1): 261.
[27] PACHANA N A, BYRNE G J, SIDDLE H, et al. Development and validation of the geriatric anxiety inventory[J]. Int Psychogeriatr, 2007, 19(1): 103-114.
[28] CHEN J, YAN Y, YUAN F, et al. Brain grey matter volume reduction and anxiety-like behavior in lipopolysaccharide-induced chronic pulmonary inflammation rats: a structural MRI study with histological validation[J]. Brain Behav Immun, 2019, 76: 182-197.
[29] YE S, DAVE A, SALAMI A, et al. Frontoparietal functional dedifferentiation during naturalistic movie watching among older adults at risk of emotional vulnerability[J]. Neurobiol Aging, 2025, 156: 150-162.
[30] WINTER N R, LEENINGS R, ERNSTING J, et al. Quantifying deviations of brain structure and function in major depressive disorder across neuroimaging modalities[J]. JAMA Psychiatry, 2022, 79(9): 879-888.
[31] WANG H, REN Y, ZHOU S, et al. Depression, pain, and seven chronic diseases in middle-aged and older adults: findings from five prospective cohort studies[J]. J Affect Disord, 2026, 401: 121251.
[32] LUTZ J, MACKIN R S, OTERO M C, et al. Improvements in functional disability after psychotherapy for depression are associated with reduced suicide ideation among older adults[J]. Am J Geriatr Psychiatry, 2021, 29(6): 557-561.
[33] BABA H, KITO S, NUKARIYA K, et al. Guidelines for diagnosis and treatment of depression in older adults: a report from the Japanese society of mood disorders[J]. Psychiatry Clin Neurosci, 2022, 76(6): 222-234.
[34] ESKANDARI B, NOURIZADEH R, MEHRABI E, et al. Evaluating the impact of home supportive counseling and telephone supportive counseling on postpartum depression and anxiety: a randomized controlled trial[J]. BMC Psychiatry, 2025, 25(1): 510.
[35] HAUSMAN H K, ALEXANDER G E, COHEN R, et al. tDCS reduces depression and state anxiety symptoms in older adults from the augmenting cognitive training in older adults study (ACT)[J]. Brain Stimul, 2024, 17(2): 283-311.
[36] MANOR B, ZHOU J, HARRISON R, et al. Transcranial direct current stimulation may improve cognitive-motor function in functionally limited older adults[J]. Neurorehabil Neural Repair, 2018, 32(9): 788-798.
[37] MOLEÓN-RUIZ Á, ÁLVAREZ DE TOLEDO P, NARBONA-ANTÁNEZ J, et al. Rapid relief of suicidal ideation via repetitive transcranial magnetic stimulation (rTMS) in depressed patients[J]. Clin Neurophysiol, 2025, 178: 2110941.
[38] 李上达, 胡少华, 周和统, 等. 《重复经颅磁刺激技术在精神障碍临床应用中的操作规范》团体标准解读[J]. 中华精神科杂志, 2024, 57(3): 133-137.
[39] LENZE E J, KARP J F, GEBARA M A, et al. Pharmacotherapy of major depressive disorder in older adults: from an evidence-informed stepwise algorithm to precision medicine[J]. Neuropsychopharmacology, 2026. doi: 10.1038/s41386-026-02338-w. Online ahead of print.
[40] SRIFUENGFUNG M, PENNINGTON B R T, LENZE E J. Optimizing treatment for older adults with depression[J]. Ther Adv Psychopharmacol, 2023. doi: 10.1177/20451253231212327.
[41] CHOI N G, CHOI B Y, MARTI C N, et al. Depression/anxiety symptoms and self-reported difficulty managing medication regimen among community-dwelling older adults[J]. Gen Hosp Psychiatry, 2022, 78: 50-57.
[42] NG T K S, LIM Z H, TODD M, et al. Effects of choral singing on depression and anxiety in older adults: a randomized controlled trial[J]. J Psychiatr Res, 2025, 188: 162-168.
[43] REMISZEWSKI M, RAJTAR G, KOMAREK Z, et al. Long-term aerobic exercise enhances interoception and reduces symptoms of depression and anxiety in physically inactive young adults: a randomized controlled trial[J]. Psychol Sport Exerc, 2025, 81: 102939.
[44] ROSSON S, BRESOLIN N, D’AMICO A, et al. Long-term efficacy and safety of vagus nerve stimulation in treatment-resistant depression: a systematic review[J]. J Affect Disord, 2026, 394(Pt A): 120483.
[45] YU L, CHEN C. Symptom patterns of comorbid depression and anxiety among older adults in China and their predictors[J]. Psych J, 2024, 13(3): 494-511.

Advances in the clinical diagnosis and treatment of anxiety and depression in elderly patients with somatic diseases

PDF (PC)

Knowledge

Abstract

Cite this article

share this article

References

Related Articles 15

Metrics

Recommended 10

[1]	YUAN Yucheng, CHEN Gang. Principles of psychotropic medication use in elderly [J]. Practical Geriatrics, 2026, 40(8): 759-763.
[2]	WANG Lanlan, JI Yunxin. Diagnosis and treatment progress of delirium in elderly patients with somatic diseases [J]. Practical Geriatrics, 2026, 40(8): 770-774.
[3]	WU Heng, YUAN Yonggui. Advances in the clinical diagnosis and treatment of geriatric somatic distress disorder [J]. Practical Geriatrics, 2026, 40(8): 775-780.
[4]	YANG Liu, LIANG Zhifang, WANG Yan, WEI Jing, CHENG Xiaomei, LI Ni, JING Yujie, LI Hao. Risk factor analysis and prediction model construction for multiple organ dysfunction syndrome in elderly patients with upper gastrointestinal bleeding [J]. Practical Geriatrics, 2026, 40(8): 781-786.
[5]	WANG Xuefei, KANG Shengqin, WANG Wei, WANG Jie, CAI Cuichun. Meta-analysis of incidence and influencing factors of falls in elderly patients with atrial fibrillation [J]. Practical Geriatrics, 2026, 40(8): 787-792.
[6]	FANG Yuanyuan, CHEN Xinxin, CAI Chunyu, KONG Lili. Predictive value of serum copeptin, sST2, and NGAL for heart failure in elderly patients with acute myocardial infarction after PCI [J]. Practical Geriatrics, 2026, 40(8): 793-797.
[7]	LI Yangbo, ZHAO Zhengkun. Predictive value of residual cholesterol inflammation index for the prognosis in elderly patients with unstable angina pectoris [J]. Practical Geriatrics, 2026, 40(8): 811-815.
[8]	BI Jing, WANG Yinuo, YU Dongmei. Study on the correlation of social support and depression with oral frailty in elderly stroke patients based on ICFM model [J]. Practical Geriatrics, 2026, 40(8): 826-830.
[9]	GAO Xinyu, KONG Xiaoming, GENG Hao, LYU Siwen. Effect of sarcopenia on episodic memory function in patients with late-life depression [J]. Practical Geriatrics, 2026, 40(8): 831-836.
[10]	DENG Ting, YANG Wei, WANG Weihua, XIN Yuanyuan. Research progress on digital exclusion among older adults [J]. Practical Geriatrics, 2026, 40(8): 850-854.
[11]	ZHOU Chunxia, TIAN Meng, LI Qian, CHEN Ying. Fall risk stratification profiles and associated factors in elderly inpatients experienced falls: a retrospective analysis [J]. Practical Geriatrics, 2026, 40(8): 860-864.
[12]	ZENG Miao, LEI Jiawei, WANG Sheng. Research progress in the diagnosis and treatment of common chronic renal fibrosis diseases in the elderly [J]. Practical Geriatrics, 2026, 40(7): 651-657.
[13]	WANG Siya, YIN Shi. Advances in the diagnosis and management of liver fibrosis in the elderly [J]. Practical Geriatrics, 2026, 40(7): 662-666.
[14]	DENG Jiwang, GUO Ying. Progress in the diagnosis and treatment of common chronic pulmonary fibrotic diseases in the elderly [J]. Practical Geriatrics, 2026, 40(7): 667-673.
[15]	OU Xiya, DIAO Yao. Advances in radiomics for the assessment of myocardial fibrosis in the elderly [J]. Practical Geriatrics, 2026, 40(7): 674-677.