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Mental Health and Older Adults

| January 5, 2018

Older adults typically enjoy increasing emotional well being as they age. Emotional regulation skills tend to improve with life experience and application, leading to more satisfying activities and relationships, reflecting a more selective decision making process. As we age we tend to apply lessons learned, and make more thoughtful decisions about how we spend our time and who we spend it with.

Many older adults, however, have unique challenges that can lead to the development of mental health issues, resulting from a number of changes in their health and circumstances. The physical effects of aging can lead to mild or moderate disability. Normal changes in musculoskeletal efficacy, cardiac output, and sensory input can reduce an individual’s ability to perform tasks and operations that were once central to identity and financial wellness. The development of chronic health conditions is more likely as we age, again leading to a reduced ability to be as productive as in the past. Circumstantial changes can include retirement, downsizing, and the loss of loved ones, all of which can contribute to the risk of developing a behavioral health condition. The most common mental health conditions for older adults are Anxiety, Depression, Dementia, and Cognitive Disorders.

Anxiety

Anxiety in older adults is often under recognized. One reason for this is that symptoms are increasingly varied; each older adult exhibits signs of anxiety in a unique way. Another reason is that anxiety symptoms can be less pronounced for older adults, but they often have an increased impact on an individual’s ability to function as he or she ages. 10-15% of older adults exhibit symptoms that lead to a diagnosis of an anxiety disorder, but 15-50% of older adults have individual symptoms that do not add up to the level of a formal diagnosis. The result is lack of treatment for sub-syndromal symptoms, even though the impact on disability is significant, and increases with age.

The most frequently reported anxiety among older adults is a fear of falling. This may be based on the very real statistic that falls increase the risk of early death, and that they are the leading cause of fractures and disability among older adults. The anxiety symptoms linked to a fear of falling are typically avoidance behaviors that lead to a decrease in overall activity outside of the home. This reduction in physical activity actually increases the risk that an older adult will fall because of a loss of physical fitness, creating a vicious cycle of increasing disability and fear.

Depression

Depression in older adults often leads to greater levels of disability and exacerbated chronic health conditions. There appears to be a correlation between poor health and depression in older adults; the percentage of older adults reporting symptoms of depression increases as medical interventions increase. Symptoms of depression in older adults can be missed by healthcare providers due to their unique presentation, and they often have a greater impact on daily function than in younger people. Older adults with depression often do not appear sad, or report an increase in negative emotions. Instead we see a decrease in motivation and energy, unexplained aches and pains, neglect of personal care, feelings of hopelessness, and changes in sleep patterns. This constellation of symptoms can be misread as cognitive decline or dementia, making the use of screening tools for depression extremely important to effective treatment.

Dementia & Cognitive Disorders

Coming soon.

Social Isolation

loneliness among older adults (AARP)

Loneliness Among Older Adults (click to enlarge). Source: AARP / https://www.aarp.org/research/

 

Category: Older Adults

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