Late-life anxiety disorders — structured clinical viva

Formulate as late-life anxiety, likely GAD, with a strong fear-of-falling / agoraphobic avoidance component after a fall, chronic benzodiazepine use, and mandatory depression/suicide screening. Comprehensive reviews emphasise that late-life anxiety is under-recognised, highly comorbid with medical illness, and treatable with adapted CBT and antidepressants rather than endless sedatives.^[1]

Offer late-life adapted CBT (Stanley primary-care RCT) and consider an SSRI such as escitalopram with start-low titration (Lenze RCT), monitoring sodium and falls.^[2][3][4] Treat temazepam as potentially inappropriate long-term therapy (Beers) and plan slow taper while active treatment is introduced.^[5] If residual GAD persists on an antidepressant, modular CBT augmentation has randomised support (Wetherell).^[7] Always assess suicide risk with high-lethality awareness in older adults.^[6]