Geriatric Issues in Mental Health

The elderly suffer from a multitude of neuro-psychiatric disorders that go unrecognised. The most common mental health issue among the elderly is cognitive impairment or dementia. Depression and mood disorders are also fairly widespread among older adults. Anxiety is also one of the more prevalent mental health problems among the elderly.

As well as the typical life stressors common to all people, many older adults lose their ability to live independently because of limited mobility, chronic pain, frailty or other mental or physical problems, and require some form of long-term care. In addition, older people are more likely to experience events such as bereavement, a drop in socioeconomic status with retirement, or a disability. All of these factors can result in isolation, loss of independence, loneliness and psychological distress in older people, and depression. Mental health has an impact on physical health and vice versa. For example, older adults with physical health conditions such as heart disease have higher rates of depression than those who are medically well. Conversely, untreated depression in an older person with heart disease can negatively affect the outcome of the physical disease.

Although some psychological decline is inevitable during senescence, it is becoming clear that a lot of it is due to disease that may be ameliorated or cured.  Some of the symptoms in older adults that require attention are sadness of mood lasting longer than two weeks; social withdrawal and loss of interest in things that used to be enjoyable; unexplained changes in appetite, weight and sleep pattern; feelings of worthlessness, inappropriate guilt, helplessness; thoughts of death, dying or suicide; confusion, disorientation, problems with concentration or decision-making; memory loss, especially recent or short-term memory problems; changes in appearance or dress, or problems maintaining the home not explained by physical illness or limitations; new trouble handling finances or working with numbers.

The relationship between mental and physical health is particularly close in old age, and the identification and effective treatment of the aged person with depression, dementia and other neuro-psychiatric disorder demands special skills and expertise.