Mental Health and Illness in Older Adults

In a report, it is estimated that one in eight older adults has a mental illness. Older adult females were likely to have mental illness in comparison to male older adults, who are more likely to have substance abuse. It is reported that only 46% of older adults with mental health illnesses received behavioral health treatment. The number of older adults with mental illness or disorder is expected to double by the year 2030 due to the large aging population. 

The lack of mental health support for older adults can be attributed to stereotypes about aging, social stigma, and practical barriers. People create stereotypes that as people age, they become unhappy or lonelier. This is seen as something normal and is part of aging, which leads to undiagnosed and untreated mental illness. Aside from the stereotyping, the topic of mental health issues is treated as a social stigma with negative misconceptions about it. The lack of awareness about mental health creates discrimination, resulting in people being less likely to seek help. Living in a rural area or areas that lack transportation is one of the many practical barriers an older adult may encounter. This makes it difficult to get the treatment that they need. 

RISK FACTORS

The mental health of older adults is shaped by their physical and social environment, earlier life experiences, and specific stressors related to aging. The key risk factor of mental health conditions is social isolation and loneliness. In addition, abuse of older people and neglect have consequences that lead to anxiety and depression. One in six older adults experiences abuse, often from their carers. Abuse can be in the form of psychological, verbal, physical, sexual, or financial. Other older adults are at greater risk of anxiety and depression because of poor physical health, dire living conditions, or lack of access to quality support and services. 

COMMON MENTAL HEALTH CONDITIONS IN OLDER ADULTS

Among the mental health conditions experienced by older adults, the most common are depression, bipolar disorder, memory issues, dementia, including Alzheimer’s, and Parkinson’s disease. 

1. Depression

Depression is a serious mood disorder that affects the way a person thinks, feels, and acts. While depression is common among older adults, it is not a normal part of aging. It is reported that 4% of older adults aged 70 and over have depression. Many factors may increase the risk of depression in older adults, such as social isolation and loneliness, alcohol use disorder, medical conditions, personal or family history of depression, functional limitations, sleep problems, stress, and lack of physical activity. However, these risk factors do not necessarily cause depression.

Signs of depression can be difficult to recognize and may look different depending on an older adult’s cultural background. The common symptoms of depression are a lack of energy, feeling sad often or all the time, feeling worthless, weight gain or loss, thinking about hurting yourself, sleeping problems, feeling irritable, and trouble concentrating. Most cases of depression cannot be prevented, but having a healthy lifestyle is beneficial for your mental health. 

In older adults, getting help can be difficult. They may feel stigma or shame, think that it is part of getting older, lack of access to services, or it might not be adequately diagnosed. Depression can be treated, and the effective treatments available are psychotherapy, medication, repetitive transcranial magnetic stimulation (rTMS), and electroconvulsive therapy (ECT). Depression is commonly treated by psychotherapy, medication, or both. 

2. Bipolar Disorder

Patients aged 50 years and over with bipolar disorder are referred to as having older age bipolar disorder (OABD). It is a more complex subgroup of bipolar disorder with increased risk of dementia, frequent physical comorbidities, impaired psychosocial functioning, prevalent cognitive deficits, and premature death.

There is limited research and clinical trials for OABD, resulting in a lack of treatment guidelines. People with OABD may also be misdiagnosed or undiagnosed with other conditions. It can be difficult to differentiate it from a neurodegenerative condition such as frontotemporal dementia. Aside from this, patients overlook and dismiss their symptoms, leading to missed diagnoses. 

3. Memory Issues

Changes in memory and other thinking abilities are a normal part of aging. Age-related forgetfulness is different from dementia. It is normal to occasionally forget where you left things, having trouble remembering certain details, forgetting names of acquaintances, occasionally forgetting an appointment, and not being able to retrieve information that you have “on the tip of your tongue”. Other factors can also cause memory problems, such as medical conditions and major or traumatic life events. 

Mild cognitive impairment (MCI) is an intermediate stage between normal age-related forgetfulness and dementia. The symptoms of MCI are difficulty in following the flow of a conversation, frequently losing or misplacing things, difficulty in remembering names, and frequently forgetting appointments or conversations. It is difficult to predict if people with MCI later develop dementia. In general, there is a greater risk of dementia over time for people with a greater degree of memory impairment. 

If you are experiencing noticeable changes in your memory, it is best to talk with a doctor. They can perform tests and assessments to determine the source of the memory problem. 

5. Dementia and Alzheimer’s

According to the Alzheimer’s Association, 55 million people worldwide are living with Alzheimer’s and other dementias. Dementia is an overall term that describes a group of symptoms, such as a decline in memory, reasoning, or other thinking skills. On the other hand, Alzheimer’s is a degenerative brain disease that accounts for 60% to 80% of dementia cases. Simply put, Alzheimer’s is the most common disease that causes dementia. 

Dementia mainly affects older adults, and the risk of developing dementia is increased by various factors such as age, smoking, high blood pressure, high blood sugar, depression, being overweight, too much alcohol consumption, being physically inactive, and being socially isolated. Dementia can, over time, destroy nerve cells and damage the brain. It has physical, psychological, social, and economic impacts. There is no cure for dementia, but a healthy lifestyle and some medications can help manage its symptoms. 

Alzheimer’s is not a normal part of aging and worsens over time. Similar to dementia, Alzheimer’s has no cure. However, two treatments reduce the functional and cognitive decline of people with early Alzheimer’s. Many risk factors can increase the risk of Alzheimer’s, including genetics, habits, and behaviors. 

6. Parkinson’s Disease

Parkinson’s Disease is a brain disorder that causes uncontrollable or unintended movements. Most people develop this disease after 60, while 5% to 10% experience it before the age of 50. Some research studies show that Parkinson’s disease affects more men than women. There are also cases of Parkinson’s disease that are hereditary and can be traced to a specific genetic variant.

It has motor and non-motor symptoms that get worse over time. Motor symptoms include trouble walking, slow movement, imbalance, tremor, involuntary movement, and rigidity. For non-motor symptoms it includes cognitive impairment, sensory disturbances, sleep disorders, dementia, mental health disorders, and pain. 

Painful muscle contractions and involuntary movements can cause problems in moving and speaking. This leads to high rates of disability and need for care. There is no cure for this disease, but there are medicines, therapies, and surgical treatments that can relieve some symptoms. 

Mental health is important in every stage of a person’s life. It becomes more important as we age, which can severely affect our quality of life. Mental health does not only include psychological well-being but also emotional and social well-being. It should be our priority for healthy living and healthy aging. 

Visit Ca Care Association website to read more about health care for older adults.