Mental health problems with the elderly

Majority of the elderly do not have mental problems but a minority of them have problems regarding depression and dementia.

Introduction

Approximately 18% of the population in UK are at pensionable age and this could increase to 20% by the year 2025. Society nowadays tends to think that mental health problems are a normal aspect of ageing. Majority of the elderly do not have mental health illnesses but a minority of them does:

• 25% of the elderly over the age of 85 will develop dementia
• 10-25% of the elderly over the age of 65 will experience depression
• 4-23% of the elderly would have alcohol problems.

Aside from experiencing dementia, the elderly can also experience emotional and psychological stress closely related to loneliness, isolation or loss of a loved one. These dilemmas are not taken into account by the medical or health care system.

Problems of the elderly

Dementia

Dementia is the decline in a person's mental ability. This disorder affects thinking, memory, concentration, solving, behaviour and perception. Most of the types of dementia, like Alzheimer's disease, tend to get worse as time goes by or they are degenerative. There are other types of dementia, like vascular dementia, which are non-degenerative or do not get worse as time goes by.

For the people affected with dementia, they become easily confused, restless and perform repetitive actions. The patients can become irritable, agitated and tearful. This scenario is stressing for both the patient and his family. Because of the frustration patients feel about their condition, they can also develop depression, aggressive and improper sexual behaviour, disturbed sleep and incontinence.

There are one out of twenty people over the age of sixty-five who can develop dementia. When the elderly is over the age of eighty-five, there is a higher risk of developing dementia: one out of four elderly can develop the disorder. People who have been diagnosed with dementia before the age of sixty-five are very rare cases. This type of dementia is called pre-senile or early onset dementia.

Causes of dementia

Dementia is caused by the death of the neurons or if there are damaged areas in the brain that is responsible for functioning and thought processes. Alzheimer's disease is the most common form of dementia. How Alzheimer's disease is triggered is not exactly known but scientists have suggested that ageing could be a risk factor. The multi-infarct or the vascular dementia is the next common type of dementia. This type caused by a series of strokes that are responsible in constricting the blood and oxygen flow to the brain.

Cure and preventive measures for dementia

Majority of the types of dementia do not have cures but there a lot of psychological therapies and anti-dementia medications that are effective in minimizing the symptoms in the early stage of dementia. It is essential that the patient should get proper evaluation of his cognitive function as early as necessary.

There are no known preventive measures for dementia but there are possible ways to try and lead healthy lifestyle to prevent the onset of dementia. Pursuing a healthy diet, regular exercise and taking in dietary supplements like Ginkgo biloba can ensure an ample supply of blood going to the brain. But before trying any medication always consult a doctor first. Fun activities like doing puzzles and crosswords can help stimulate the cognitive function of the brain as well.

Depression

People with depression display a variety of moods which can interfere with their everyday lives and normal activities. For those who have severe depression, they can experience symptoms like feeling down, losing interest in the activities they once liked, feeling guilty or being worthless.

Depression affects everyone regardless of age and culture but the elderly has a higher risk of developing it than anyone else. Approximately 10-15% of the elderly have depression symptoms and 40% of this figure lives in care homes. It should be noted elderly people do not become depressed just because they are getting older.

Causes of depression

The following are known risk factors for the elderly:

• Divorced, widowed, or retired
• Taking in of medications for other ailments
• neurobiological changes related to ageing
• physical impairment and having other diseases
• isolation and loneliness
• genetic susceptibility that agrees with the patient's age.

Prevention and cure for depression

Depression in the elderly is not often recognized and is thus an under treated condition. Until recently, some of the health experts including mental health professionals and doctors have failed to give treatments to other age group. Other types of depression are treatable by taking in medication and undergoing talk therapies and other similar treatments.

It is hard to properly diagnose depression in the elder because it occurs with other physical and mental illnesses like dementia, cancer, stroke and diabetes. Apart from that, the elderly do not seek medical advice unless they are experiencing multiple symptoms of the disorder. The patient should seek medical help as early as possible is the best possible preventive treatment for this condition.

There are self-help plans to reduce having depression:

• seek support from friends and family about losing a loved one
• perform regular exercise routine
• plan for critical life transitions like retirement
• ensure that the patient pursues a variety of interests later life.

Depression and dementia

The connection between depression and dementia is hard to explain but they share similar symptoms like having the patient withdraw from social activities and feeling apathy. An elderly with severe depression can be misdiagnosed with dementia and vice versa.

Alcohol abuse

Approximately 4-23% of the elderly have alcohol problems and statistical figures show that the elderly male is at a higher risk of having alcohol problems than women. Alcohol abuse affects people in all ages and is mainly caused by emotional stress like dealing with loss or feeling lonely for some reason. There is an estimated 10-30% of the elderly who have alcohol problems and subsequently become depressed. These people are at a much higher risk of committing suicide.

Medication

Prescribed medicines and drugs can result to mental health problems especially among the elderly. A survey of the Health Department back in 2001 showed that 79% of the elderly take in prescribed medicines. The elderly were shown to take in four medicines or more at the same time. Confusion can also result from taking in multiple medications.

Other mental health complications

Delirium, late-onset of schizophrenia and anxiety are rare mental health illnesses which can affect the elderly. The nature, prevalence and course of the disorders are different for the elderly as well as for their treatment.

Capacity of the elderly with mental health illness

The elderly with depression and severe dementia will have problems in communicating and making decisions. Some patients may be able to partially make decisions as they may have erratic mental capacity. There are several approaches which would help engage someone with dementia. Patients with dementia need longer time to make proper decisions and they may require someone to speak for them. Their mental capacity and functioning can also vary within the day. The family members or the guardians of the patient are the ones who could help make decisions for them but they should also consider what the patient wants as well as what is best for him.

Advice for caregivers

Taking care of the elderly with mental health problems is often time consuming, stressful and physically and emotionally challenging. Taking care of someone with dementia can cause severe stress and almost a third of the caregivers would also suffer from depression.