Mental Health in Seniors

American Psychiatric Association
www.psychiatry.org

Seniors

Studies show that seniors are at greater risk of some mental disorders and their complications than younger people, and many of these illnesses can be accurately diagnosed and treated. However, many seniors are reluctant to seek psychiatric treatment that could alleviate or cure their symptoms and return them to their previous lifestyle.

Many people don’t understand mental illness or even acknowledge its existence. Some seniors are ashamed or frightened by their symptoms or believe that they are an inevitable part of aging. Often, seniors, their loved ones and friends, and even their doctors fail to recognize the symptoms of treatable mental illness.

Types of Mental Disorders

Depression
Depression is considered the most common mental disorder of people aged 65 and older. Many researchers think this estimate is low because the symptoms of depression often appear in people who have other conditions, or can mimic the symptoms of dementia—its victims withdraw, cannot concentrate, and appear confused. Some experts estimate that as many as 10 percent of those diagnosed with dementia actually suffer from depression that, if treated, is reversible.

Dementia
Dementia (characterized by confusion, memory loss, and disorientation) is not an inevitable part of growing old. In fact, only about 10 percent of Americans aged 65 and older suffer from this condition. Of that number, an estimated 60 percent suffer from Alzheimer’s disease, a type of dementia for which no cause or cure has been found.

Alzheimer’s Disease
Alzheimer’s disease, which causes some of the brain’s cells to die, involves a part of the brain that controls memory. As it spreads to other parts of the brain, the illness affects a greater number of intellectual, emotional, and behavioral abilities. An adult’s chances of developing the illness are one in 100, but the incidence increases with age. One million people older than 65 are severely afflicted with Alzheimer’s disease and another two million are in the moderate stages of the disease.

Because this disease is so widespread, many associations have organized support groups, educational materials, and insurance information for Alzheimer’s sufferers and their families. Many support groups offer daycare activities for patients and counseling for family members who are often faced with years of care for their loved one.

The other 40 percent of all dementias can be caused by:

• Complications of chronic high blood pressure, blood vessel disease, or a previous stroke. Deterioration comes in steps, as opposed to a steady progression. This type of dementia is often referred to as vascular or multi-infarct dementia.

• Parkinson’s disease generally begins with involuntary and small tremors or problems with voluntary movements. Dementia may occur when the disease is severe or very advanced.

• Huntington’s disease is a genetic disorder that begins in middle age and has symptoms of changed personality, mental decline, psychosis, and movement disturbance.

• Lewy body dementia (LBD) is the second leading cause of degenerative dementia, and it can occur by itself or in combination with other conditions, including Alzheimer’s disease and Parkinson’s disease.

• Often dementia is caused by more than one condition, such as combinations of stroke, depression, Alzheimer’s disease, and Parkinson’s disease.

Reversible Dementias
Seniors may become forgetful, disoriented, or confused because they have developed reversible conditions that imitate dementia. Side effects from prescription drugs, drug interactions or overdoses, poor diet, and other physical or mental problems may cause this. These types of dementia can often be reversed after their causes are diagnosed and treated. It is important that a psychiatrist first complete a thorough medical evaluation, which can differentiate true dementia from the other factors that could mimic the condition.

Medications. Seniors take many more medications than other age groups. Coupled with a slower metabolism, these substances can stay in the body longer and quickly reach toxic levels. Moreover, because many older people take more than one medication and may drink alcoholic beverages, there is a high risk that drugs will interact, causing confusion, mood changes, and other symptoms of dementia.

Malnutrition caused by poor eating habits. The brain requires a steady supply of proper nutrients, and poor eating habits or problems with digestion can upset the way the brain functions. For example, pernicious anemia, a blood disorder caused by a problem with B12 absorption, causes irritability, depression, and dementia. Too little sugar in the bloodstream also causes confusion and personality change. Changed eating habits may result from dental problems, where difficulty chewing can cause seniors to omit certain important foods from their diet.

Diseases of the heart or lungs. The brain also requires a great deal of oxygen to work properly. If diseased lungs cannot draw enough oxygen into the blood or a diseased heart fails to pump enough blood to the brain, lack of oxygen can affect the brain and behavior.

Diseases of the adrenal, thyroid, pituitary, or other glands. These glands help regulate emotion, perception, memory, and thought processes. When they don’t function well, these mental processes are affected.

In older people, some psychiatric conditions, particularly depression, can cause symptoms of dementia. For many, treating depression will improve the symptoms of dementia; however, it also is possible that depression is an early symptom of Alzheimer’s disease or vascular dementia.

Conclusion
Having good mental health throughout life does not ensure immunity from severe depression, Alzheimer’s disease, anxiety disorders, and other mental disorders in the senior years of life. Take note of noticeable changes in an older person’s behavior or moods. These changes could be symptoms of conditions for which help is available. Seniors should not be afraid to seek medical and psychiatric evaluations and treatments that can return them to a productive and happy life. There is help, and there is hope.