Mental illness in older adults

The combination of the post-World War II baby boom and breakthroughs in medical research is causing the aging population in the United States to surge. This population boom over the next few decades will result in more older adults facing special physical and mental health challenges that need to be recognized—especially when among older adults in the U.S., fewer than 25 percent receive treatment for mental health issues.

The most common mental and neurological disorders in the 55+ age group are dementia and depression. As we age, it’s natural for some changes to occur. Regular forgetfulness, for example, can occur more frequently, but persistent cognitive or memory loss can be potentially serious. An estimated five million adults 65 and older currently have Alzheimer’s disease— about 11% of seniors, according to the Alzheimer’s Association.

Depression and mood disorders are also fairly widespread among older adults, and disturbingly, often go undiagnosed, due to the fact that older adults tend to report physical symptoms rather than psychiatric complaints. This reluctance to seek psychiatric help is mainly due to the stigma surrounding mental illness.

Mental health professionals in New York State have taken on the challenge of reaching older adults who need their services; the key is continuing to improve those services and making them more readily available to older adults. The Geriatric Mental Health Alliance has existed in the state since 2004, in order to address the elder boom. Along with advocacy and policy, the alliance helped to pass the state’s Geriatric Mental Health Act. Programs throughout the state, run by private companies such as TCD Medical in Amherst, offer specialists who work with older patients struggling with depression, anxiety, Alzheimer’s, or dementia and more, in between primary care visits. Other programs, such as Senior Partnership Services, tailor their services to seniors with physical, transportation, or financial limitations. The services exist in the state, but so does the stigma.

The Geriatric Mental Health Foundation lists a number of potential triggers for mental illness in the elderly:

• Alcohol or substance abuse

• Change of environment, like moving into assisted living

• Dementia-causing illness

(e.g. Alzheimer’s disease)

• Illness or loss of a loved one

• Long-term illness

(e.g., cancer or heart disease)

• Medication interactions

• Physical disability

• Poor diet or malnutrition

Many older people experience stress factors as they age, such as a significant decline in functional ability. For example, reduced mobility, chronic pain, frailty, or other health-age related problems may require some form of long-term care. Older adults are also vulnerable to elder abuse, which not only includes physical injuries, but also serious long-lasting psychological consequences. All of these factors can result in psychological distress, including depression and severe anxiety, causing impaired functioning in daily life.     

Depression is often overlooked and untreated in older adults and can be masked by physical health conditions such as heart disease. It has been shown that heart patients have higher rates of depression than those who are healthy.

The assumption that mental health problems are a “normal” aspect of aging in most older people is not necessarily true. Many seniors don’t develop mental health problems, and those that do can be helped. Mental health of older adults can be improved by creating adequate living conditions, healthy diets and environments that support well-being. To help promote mental health in seniors, it is important to have the necessary resources to meet their needs, for example: health and social programs that work with vulnerable groups such as those who live alone and/or in rural populations, or those who suffer from mental or physical illness.

Aging can also be a busy phase of life if there are activities and support groups that are accessible. With more time on their hands older retired or semi-retired adults can take the opportunity to try a new activity or learn new skills. Seniors have life experience that you can’t acquire in school. Its time to ditch the stigma of old age and embrace the opportunity to benefit from an aging population.

 

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