Mental Health of Older Adults

Mental and physical health are two-way streets and closely related. As we age, our physical health can often decline. It means that as we age, we may face new health problems, live by adapting to a new environment, or have less independence. These events can affect the mental health of older adults. They start to think and look at things in different ways.

Mental health in older adults is often overlooked because it is unnoticed. Some people might mix it with the symptoms of depression and take it as a normal part of getting older. It can cause difficulty for older adults to access the mental health care they need. It also creates a stigma, which makes things worse.

Why Mental Health in Older Adults Is an Issue?

The world’s population is ageing fast. From 2015 to 2050, the number of people aged 60 and up is expected to double to reach 2.1 billion. In 2020, 1 billion people worldwide were aged 60 years or over. By 2030, this number will rise to 1.4 billion, showing one in six people worldwide. The number of persons aged 80 years or older will be expected to triple between 2020 and 2050 to reach 426 million.

About one in 4 older adults experiences mental health issues. The most common issues are dementia, anxiety, and depression. Dementia and depression are the most common mental health issues. World Health Organization (WHO) reports that about 5% to 7% of older adults over 60 are affected with dementia and depression. However, anxiety affects 3.8% of older adults.

Mental Health Issues Common in Older Adults

The mental health needs of older adults are unique. As you get older, you may pass through transitional periods and emotional events like the death of loved ones, bodily changes, and relocating. These things are common in adults over 60 years. It may cause mental health issues, such as dementia, depression, anxiety and substance abuse.

This is the biggest reason why the suicide rate is high in older adults when compared to other groups. People aged 85 and over have the highest suicide rate as compared to adults aged 75-84. Loneliness and social isolation are the main factors that cause the highest suicide rates.

It is also linked to these physical illnesses and health conditions, such as:

1. Obesity
2. High blood pressure
3. Heart disease
4. Cognitive decline
5. Weak immune system
6. Alzheimer’s disease

Loneliness and social isolation might sound similar, but they are different. You might live alone but have an active social life surrounded by family and friends. However, even surrounded by people, you can feel lonely. This is because humans are a social species. When people do not connect to others or lose a sense of community, it can change their understanding of the world around them and negatively impact their mental health.

Risk factors

Physical issues and social environments can shape mental health at older ages. Earlier life experiences and specific stressors related to ageing also increase the risk of mental health issues in older adults. A decline in functional ability and congenital health can result in psychological distress. Older adults are more likely to experience unfortunate events such as a drop in income, bereavement, or a reduced sense of purpose in retirement.

Older adults contribute to society as family and community members; many are volunteers and workers. However, they are subject to ageism, which can seriously affect people’s mental health. It is a form of discrimination where people are mistreated based on their age. They feel left out or less respected by their loved ones, family, or friends. It turned into loneliness and social isolation as they did not want to see anyone or their family and friends leave them or make them feel like they were invisible. This will be a key risk factor that affects about a quarter of older people’s mental health.

It also includes the abuse of older people, which may be verbal, physical, sexual, psychological, or financial abuse or neglect. A study shows that about one in six older adults experience abuse, often by their own carers. Any kind of abuse can produce serious consequences and can lead to depression and anxiety in older adults. Many older people take care of their spouses living with chronic health conditions, such as dementia. They are overwhelmed by the responsibilities of such care, which can affect the mental health of the carer.

Some older adults are at greater risk of depression and anxiety. Mostly, older adults have poor physical health, lack of access to quality support and services or miserable living conditions. Older adults living with chronic diseases (such as heart disease, stroke or cancer), neurological conditions (such as dementia), or substance use problems and those living in humanitarian settings are at high risk of mental health issues.

Promotion and Prevention

Promotion and prevention strategies for mental health in older adults focus on supporting healthy ageing. It means creating physical and social environments that support well-being and help people to do what is important to them despite losses in capacity. Promotion and prevention strategies for healthy ageing may include:

1. Find ways to reduce financial insecurity and income inequality and make them financially stable and secure.
2. Make programmes to ensure their safety at houses, public buildings and transport.
3. Provide social support for older adults and their carers to reduce the risk of loneliness and social isolation.
4. Support for healthy behaviours, especially eating a balanced diet, getting physically active, reducing alcohol use and refraining from tobacco.
5. Health and social programmes targeted at vulnerable groups such as those who live alone or in remote areas and those living with chronic health issues.

Social connection is important for older adults to reduce risk factors such as loneliness and social isolation. Meaningful social activities can significantly improve life satisfaction, mental health, and quality of life and reduce depressive symptoms at this stage of life. Some examples of interventions include community and support groups, befriending initiatives, creative arts groups, social skills training, education and leisure services, and volunteering programmes.

Protection from ageism and abuse is also critical. It includes anti-discrimination policies and laws as well as educational and intergenerational activities. It also includes various carer interventions such as respite care, education, advice, financial support and psychological interventions. It can support carers in maintaining a good and healthy caring relationship that prevents abuse of older adults.

Treatment and Care

Early identification is crucial for treating mental health conditions in older adults. This should follow community-based standards for integrated care for older people. It focused on the long-term care of older adults living with mental health conditions and declines in intrinsic capacity, as well as the training, education, and support of carers. Usually, a mix of mental health interventions is recommended with other supports to address the personal care, health issues, and social needs of older adults.

Dementia is one of the common and often mental health issues in older adults. It causes depression and symptoms of psychosis, which is life-threatening and requires access to quality mental health care. Responding to the abuse of older adults is also critical. Promising interventions include mandatory reporting of abuse, helplines and emergency shelters, self-help groups, training of health care providers, psychological programmes for abusers, and other caregiver support interventions.

Warning Signs of Mental Health Issues

Depression and other mental health issues can make bodily diseases worse and slow down recovery time. These issues can cause complications and roadblocks to recovery, making it hard to do simple things like eating, self-care, and clothe oneself. Struggling with basic tasks is not always a sign of getting older or the life changes related to ageing. Watch for these signs if you are concerned about the mental health of your loved ones, such as:

1. Change in sleeping patterns, not getting enough sleep or oversleeping.
2. Anger and irritability.
3. Having high-stress levels or constant worrying.
4. Constant headaches and pain.
5. Showing unusual ideas or behaviours.
6. Feeling hopeless or giving up.
7. Trouble feeling positive emotions.
8. A need or dependence on drugs and alcohol.
9. Doing high-risk activities.
10. Suicidal thoughts

What You Can Do?

As you get older, moving at a slower pace is normal. A noticeable change in mood or memory could signal something more serious. If you see the signs mentioned in your loved ones, take these steps to determine if they need help.

Ask questions: Sit with your loved ones and talk openly and clearly. Ask them how they are feeling. Be supportive and listen attentively. Ask if they are feeling especially tired or stressed. Ask if there is anything they are feeling anxious or sad about. People often need someone who listens to them, which is more needed as we age.

Ask their pharmacist: If your friend or family member takes medication and shows signs of fatigue, ask their pharmacist if their medication could be the cause. Because certain medication combinations can cause low energy levels and fatigue. A geriatric pharmacist has information that can help as they specialize in medication for people over 60.

Ask their doctor: Bring your concerns to your loved one’s doctor. Discuss their medical history and the medications they are on with the doctor. The doctor will recommend tests and refer to specialists to determine the problem.

Get an evaluation: Take your loved one to a geriatric psychiatrist. Geriatric psychiatrists are trained to recognize and treat age-related mental health issues.