Older adults are able to adapt to multiple changes and lead very productive and happy lives. However, as we age, there are likely to be more challenges, life experiences and changing circumstances that raise our risk of experiencing a mental health problem. Even if we never experienced a mental health disorder, we must be aware of risks and symptoms of problems as we get older. Older adults are considered a “special population” because assessment and treatment may be different. The mental well being of an older adult is tied to multiple variables. The more people know about these variables and associated risk factors, the better they can identify potential problems and mental health needs that might arise. Following are areas to monitor:
All human beings experience changes in their bodies as they age. Aging changes are influenced by the effects of heredity, environment, cultural practices, diet, exercise, leisure choices, past illnesses and many other factors.
Certain medications, illnesses, significant life changes and increased demands on the body are stressors that make the body work harder. These factors contribute to the changing health status of an older body.
The brain, as an organ of the body, is vulnerable to the influences listed above and susceptible to change and illness in later life. These changes and illnesses might become a mental health disorder.
As people consider age related health changes, they need to be aware of their own mental health and seek professional help if they have any symptoms of a mental health disorder.
Common physical changes in late life include:
- Decrease in the number and mass of nerve cells, resulting in slight slowing of memory and thought processes (continued, moderate physical and mental exercise is helpful in maintaining cognitive abilities)
- Nerve changes that can reduce the reflexes and affect the senses, making them less acute and requiring higher sensory input to trigger sensory awareness (hearing and vision being the most dramatic.)
- Cellular and tissue changes result in organ rigidity, decreased organ capacity and functioning
- Decreased organ reserve makes it harder for the body to restore equilibrium, therefore drugs are detoxified at t slower rate and medication side effects become more common
Many older people are not aware of the age related changes that make their bodies more vulnerable to the effects of alcohol, drugs and medications. Here’s more information on what to look for. Learn more about substance use here.
Sensory changes, particularly hearing loss and low vision, contribute to social withdrawal, isolation, paranoia, anxiety and depression in many older adults who are impaired.
Hearing loss is widespread in the over 75 age group with a reported 48% of men and 37% of women experiencing hearing difficulties. Yet, approximately 3/5 of these individuals do not use hearing aids believing that their hearing is “not bad enough.”
Many older adults fail to recognize or accommodate changes in vision. People with low vision tend to cut back on regular activities like driving, reading or playing games instead of getting treatment to improve their sight.
Unfortunately, too many people do not recognize subtle sensory changes or accept sensory deficits as an “inevitable” part of aging. Treatment or sensory aides could restore their quality of life, sense of independence and participation in relationships and activities.
Older individuals with activity restrictions and inhibitions due to hearing or vision loss are a risk for depression, anxiety and paranoia. Such mental health problems exacerbate other chronic illnesses, dramatically strain relationships and negatively impact all aspects of daily living.
Older persons and their caregiver should be encouraged to check for and address sensory deficits. They should know the mental health risks that accompany an untreated sensory deficit and they should be supported in accessing treatment.
As people age, it is common for some brain functions to slow down i.e. recall of names or events. Memory loss that disrupts everyday life is not part of the normal aging process. It could be a sign of something more. Click here to learn about cognitive impairment and dementia.
There is a strong correlation between physical health and mental health. Though depression or anxiety may affect anyone, people suffering from chronic illness or pain are often at greater risk.
Chronic illnesses occur more frequently in later years. More than 80% of Americans over age 65 experience one or more chronic health problems.
A skilled health professional should educate older people regarding the relationship between their physical health issues and their risk for mental health problems. Older adults should know if any of the medications they take could have a mental health side-effect there are many medications that cause depressive symptoms.
A mental health disorder can worsen the symptoms and limitations of a chronic condition and vise versa. It is important to treat all illnesses at the same time, as medications and other treatment therapies permit.
The following are some examples of common later life ailments and their association with mental illness.
- Diabetes: Diabetes may double the risk of depression. The chances of becoming depresses increase as diabetes worsens. The stress and metabolic effects of diabetes on the brain are primary causes of associated depression.
- Stroke: Between 10-27% of those who suffer a stroke experience major depression. An additional 15-40% experience some symptoms of depression within two months following a stroke. Causes may include: location of the brain lesion, previous or family history of depression and pre-stroke social functioning. Common characteristics of stroke survivors suffering from depression include less compliance with rehabilitation, irritability, and/or personality change.
- Cancer: An estimated 25% of those with cancer also suffer from depression. A co-occurring depression can seriously impact a cancer patient’s ability to participate in the treatment and ultimately impact of the course of the disease.
- Heart Disease: 1/3 people who have survived a heart attack experience major depression. Depression may result in chronically elevated levels of stress hormones, such as cortisol and adrenaline. This causes the body’s metabolism to not make the type of tissue repairs needed in heart disease.