Self-managing late-life anxiety: a narrative review of older adults’ use of approach, avoidance, and proactive strategies

Objective To identify and organise anxiety self-management strategies employed by older adults, using a framework with approach, avoidance, and proactive coping as organising principles.Methods Relevant papers were identified from Ovid MEDLINE and psychology databases using search terms such as “anxiety”, “self-manage”, “self-management strategies”, “mental health”, “late life”, and variations of “old”.Results Older adults’ self-management approaches drew on a mix of approach, avoidance, and proactive strategies. Approach strategies involving reflection, meaning-making and acceptance, including those grounded in religious faith, were prominent. Mental health professionals were often not consulted unless anxiety was severe, although prior positive experiences may serve as a catalyst for formal help-seeking. Distraction may be relied on over strategies that required thinking about anxiety experiences or adopted because older adults lacked coping options when new and unfamiliar sources of anxiety emerged. Proactive strategies reflected the core behaviours promoted in healthy ageing research, suggesting health-promoting strategies may form part of the anxiety self-management repertoire. Fear of falling safety behaviours encompass elements of vigilance (proactive) and anxiety-maintenance risk (avoidance), reflecting a hybrid orientation.Conclusions The mixed use of strategies highlights a clear need to examine whether different strategy combinations exert varying influences on anxiety outcomes and overall wellbeing.