Mental Health in Older Adults

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The nation’s population is aging. According to U.S. Census Bureau (2022), there were 54.1 million people aged 65 years and older in the United States in 2019, and this number is projected to increase to 80.8 million in 2040 and 94.7 million in 2060. The overall population of older adults is growing, and the number of people over 85 is on rising. Aging brings significant biological changes, unique challenges, and particular upsets. As a society, we must be prepared to meet the physiological health needs and mental health needs of the elderly population. In the United States, National Older Adults Mental Health Awareness Month is celebrated each May, making it an excellent time to focus on the mental health needs of older Americans.

Although the rates of most mental health disorders decline during late adulthood, a variety of disorders are closely associated with this later stage of life. Older adults commonly deal with the stress of loss, including the loss of a spouse, friends, adult children, former activities and roles, as well as hearing and vision loss. Sadly, many older adults lose their sense of purpose after their retirement, and some also endure the loss of beloved pets and possessions. While not all elderly individuals experience psychological difficulties, studies reveal that more than 20% of older adults meet the criteria for a mental disorder. Half of all elderly people would benefit from some form of mental health services, but it is estimated that less than 20% of elderly people receive mental health care.

Neurocognitive disorders receive the most attention and are often the most feared psychological problems among elderly people. However, they are not the only psychological issues that older adults may experience. Like younger individuals, elderly people may suffer from depression, bipolar disorders, anxiety, alcohol and substance use disorders, and schizophrenia spectrum disorders.

Depression 

  • Depression is a common psychological problem among the elderly.
  • The symptoms of depression are the same for older adults as for younger people, including feelings of profound sadness and emptiness, low self-esteem, guilt, and pessimism, as well as loss of appetite and sleep disturbances.
  • As many as 20% of older adults become depressed at some point during their elderly years, with higher rates among elderly women.
  • The rate of depression is much higher among the elderly who live in nursing homes compared to those living in the community.
  • Like younger adults, depressed elderly people may benefit from psychotherapy, antidepressant medications, or a combination of these treatments.

Anxiety Disorders 

  • In the United States, it is estimated that as many as 11% of elderly people display at least one anxiety-related disorder.
  • Generalized anxiety disorder appears to be particularly prevalent among older adults.
  • Many aspects of aging may contribute to the heightened levels of anxiety among the elderly, such as worrying about declining physical health and functioning.
  • Older adults who experience significant medical ailments or injuries report more anxiety compared to their healthy counterparts.
  • Those struggling with anxiety-related disorders may benefit from psychotherapy and antianxiety medications or serotonin-enhancing antidepressant drugs.

Neurocognitive disorders

  • People with neurocognitive disorders experience a significant decline in at least one area of cognitive functioning, such as memory, attention, visual perception, planning and decision-making, language ability, or social awareness.
  • People may also undergo personality changes and exhibit behavioral issues.
  • Neurocognitive disorders are classified as either major or mild. Major neurocognitive disorder is associated with substantial cognitive decline, which interferes significantly with instrumental activities of daily living, whereas individuals with mild neurocognitive disorder exhibit modest impairments in cognitive abilities and can, with some accommodations, continue to function independently.

Mental Health Resources

There are several resources available to older adults who are struggling with mental health issues and their families:

  • Substance Abuse and Mental Health Services Administration (SAMHSA) offers information and materials to help understand the issues associated with substance misuse and mental illness in older adults.

https://www.samhsa.gov/

  • Mental Health America partnered with the National Council on Aging to feature materials on older adults.

https://mhanational.org/

(Co-Authors include Dr. Mercado’s Mental Health Lab at UTRGV Frances Morales, Andy Torres, Amanda Palomin)

 

Dr. Alfonso Mercado