OBJECTIVE: Anxiety disorders have been reported to decrease with age, while anxiety feelings have been reported to be as common as in younger age groups. In order to further explore this relationship and variables associated with anxiety, a population of very elderly persons was examined. METHODS: 966 persons, aged 78 years and over, underwent an examination by a physician including a structured psychiatric interview. RESULTS: Anxiety feelings are strongly associated with psychiatric disturbances (anxiety disorders and depressive disorders). Moreover, the feelings were associated with dementia, a history of psychiatric disorders (most often depression), being female and being dissatisfied with social network. Few of those with a psychiatric disorder were adequately treated, in spite of the fact that most of them had seen a physician during the past month. CONCLUSIONS: After excluding an anxiety disorder, one of the most important things to consider in a very old person with anxiety is whether depression is present or not. Generally, there is a need for more education of physicians concerning the common mental disorders in the elderly in order to improve their management.