Mental health in the elderly
Key Facts by “World Health Organization”
According to WHO ( World Health Organization) Mental health and emotional wellness are as important in older adults as they are in any other period of life.
Neuropsychiatric disorders in the elderly account for 6.6% of all total disability cases (disability-adjusted life years) in this age group.
About 15% of adults aged 60 and above suffer from a mental disorder.
Seniors – those 60 years of age or older – make important contributions to society as family members, volunteers, and active participants in the workforce. Although most elderly people are in good mental health, many are at risk of developing mental disorders, neurological disorders, or substance abuse problems, as well as other health ailments such as diabetes, hearing impairment and osteoarthritis. Moreover, the more people get aged, the more likely they are exposed to different health symptoms at the same time.
The issue
The world’s population is rapidly aging; It is estimated that the proportion of the elderly in the world will double from about 12% to 22% between 2015 and 2050. This means – in absolute numbers – an expected increase from 900 million to two billion people over the age of 60. Older people face special health challenges – both physical and psychological – that should be recognized.
More than 20% of adults aged 60 years and over suffer from a mental or neurological disorder (excluding headache disorders) and 6.6% of all disability cases (disability-adjusted life years) among those over 60 are attributable to neurological and psychiatric disorders. These disorders in the old population group lead to 17.4% of the years of life spent with disability. The most common neuropsychiatric disorders in this age group are dementia and depression. Anxiety disorders affect 3.8% of the elderly population, substance abuse problems affect nearly 1%, and about a quarter of self-harm deaths are among those aged 60 and over. Substance abuse problems among the elderly are often overlooked or misdiagnosed.
There is a lack of recognition of mental health problems by health care professionals and older adults themselves, and the stigma surrounding mental illness makes people reluctant to seek help.
Risk factors for mental health problems among the elderly
There are multiple social, psychological, and biological factors that determine the level of a person’s mental health at any point in time. In addition to the stereotypical stressors of life common to all people, many older adults lose their ability to live independently, due to limited mobility, chronic pain, weakness, or other psychological or physical problems, and require some form of long-term care. In addition, older adults are more likely to experience incidents such as feelings of sadness and mourning, lower socioeconomic status in retirement, or disability. All these factors can lead to isolation, loss of independence, loneliness, and psychological distress in the elderly.
Mental health has an impact on physical health and vice versa; For example, older adults with physical health conditions — such as heart disease — have higher rates of depression than those who are otherwise well. Conversely, not treating depression in an elderly person with heart disease can negatively affect the outcome of the physical illness.
Older people are also vulnerable to elder abuse, which includes physical, sexual, psychological, emotional, financial and material abuse, abandonment and significant loss of dignity and respect. Evidence indicates that 1 in 10 elderly people are abused. Elder abuse can lead not only to physical injury, but also to serious, sometimes long-term psychological consequences, including depression and anxiety.
Dementia and depression in the elderly as public health issues
dementia
Dementia is a syndrome in which there is deterioration in memory, thinking, behavior and the ability to perform daily activities. It mainly affects elderly people, although it is not a normal part of aging.
It is estimated that 7.5 million people worldwide have dementia. The number is expected to increase to 75.6 million in 2030 and 135.5 million in 2050, with most of those affected living in low- and middle-income countries.
There are significant social and economic issues associated with dementia, in terms of the direct costs of medical, social and informal care. Moreover, physical, emotional and economic stresses can cause great distress to families. Support must be provided by the health, social, financial and legal systems for both people with dementia and their caregivers.
Depression
Depression can cause great suffering and lead to poor performance in daily life. Unipolar depression occurs in 7% of the general elderly, and is responsible for 5.7% of YLDs among those over the age of 60. There is a lack of both diagnosis and treatment of depression in health care settings. Symptoms of depression in the elderly are often overlooked and not treated because they coincide with other problems faced by the elderly.
Older adults with depressive symptoms perform poorer than those with chronic medical conditions. Such as lung disease, high blood pressure or diabetes. Depression also increases the perception of poor health, the use of medical services, and the costs of health care.
Treatment and care strategies
It is important to prepare health service providers and communities to meet the specific needs of older persons; This includes:
training of health professionals in the care of the elderly.
prevention and treatment of age-related chronic diseases; including psychiatric, neurological and substance use disorders.
developing sustainable policies for long-term care and palliative care.
Develop services and favorable conditions for the elderly.
health promotion
The mental health of the elderly can be improved by establishing active and healthy aging. Mental health promotion for the elderly involves creating living conditions and environments that support well-being and allow people to lead healthy, integrated lifestyles. To a large extent, mental health promotion depends on strategies that ensure that older people have the resources to meet their basic needs; Such as:
provide security and freedom.
Adequate housing through supportive housing policies.
Social support for the elderly population and their caregivers,
Health and social programs targeting vulnerable groups; such as those who live alone, those in rural areas, or those with a chronic or relapsing mental or physical illness,
community development programmes.
Interventions
It is necessary to immediately acknowledge the existence of mental, neurological and substance use disorders in the elderly and treat them immediately. Both psychosocial interventions and medication are recommended.
There is no medication currently available to treat dementia, but there is much that can be done to support and improve the lives of people with dementia and their caregivers and families. Such as:
Undertake Early diagnosis, in order to promote early and optimal management of treatment.
Improve physical and psychological health to the greatest extent possible.
Detect and treat challenging behavioral and psychological symptoms.
Provide information and long-term support to caregivers.
Mental health care in the community
Good general health and social care is important for promoting the health of older people, preventing them from disease, and treating their chronic ailments, so training all health providers to deal with issues and disorders related to aging is important. Primary mental health care at the community level for the elderly is critical. Equally important is a focus on the long-term care of older people with mental disorders, as is providing caregivers with education, training, and support.
An appropriate and supportive legislative environment, based on internationally accepted human rights standards, is needed to ensure that the highest quality of services is provided to people with mental illness and their caregivers.
WHO response
The WHO programs on the health and activity of older persons have created a global framework for action at the country level.
The World Health Organization supports governments in the goal of strengthening and promoting the mental health of the elderly and integrating effective strategies into policies and plans.
WHO recognizes that dementia is a public health challenge and has released its report “Dementia: a public health priority” to call for action in the national and international spheres.
Dementia is included – along with depression and other priority mental disorders – in the WHO Mental Health Gap Action Program. This program aims to improve care for mental, neurological and substance use disorders, by providing guidance and tools to develop health services in resource-poor areas.