In recognition of Mental Health Month, this issue of the newsletter is focusing on mental health and older adults age 55 and over. With women now living an average of 81.1 years and men living an average of 76.1 years, Americans are facing issues associated with growing old—loss of partner, loss of mobility and independence, and declining physical and mental health. According to the American Psychological Association, 20% of people over age 65 suffer from a mental disorder, and two-thirds of nursing home residents experience mental and behavioral problems. The most common conditions include anxiety, depression, and severe cognitive impairment; mental health issues are often contributors to suicide. Underutilization of mental health services is common, with less than 3% seeking professional services, due to inadequate integration of care by primary care, mental health, and aging service providers; stigma; access barriers; denial of problems; and paucity of trained geriatric mental health treatment providers (http://www.apa.org/about/policy/white-house-aging.aspx).
Of particular concern regarding aging and mental health are prevention, early diagnosis, recognition of major diseases, treatment, and quality of life interventions, at both the individual and community levels. A review of the literature indicates that much more research must be conducted about the needs of older adults, common clinical conditions, and behavioral health issues. With the increase in average life expectancy, primary care physicians and geriatricians are seeing the need for specific interventions to tackle chronic conditions that require medications (e.g., diabetes, hypertension, osteoarthritis) along with behavioral health challenges (e.g., dementia, mild cognitive impairment, depression, anxiety, sleeplessness, substance misuse). Mental health issues, particularly those affecting old age are frequently underestimated, adding to the suffering of a large number of people who could be treated and could benefit from diverse social and health care interventions to enhance their well-being. Below are a few statistics related to mental health challenges:
- Symptoms of depression and anxiety in older Americans over the age of 65 are often overlooked and untreated because they typically coincide with other medical illnesses or life events that commonly occur as people age (e.g., loss of loved ones).
- Dementia afflicts as many as 7% of Americans over the age of 65 and 30% over age 85. People with dementia often suffer from depression, paranoia, and anxiety.
- Alzheimer’s disease, the most common cause of dementia, affects between 2.6 to 4.5 million Americans age 65 and over. The number of Alzheimer’s disease cases doubles every five years from age 65 to 85.
- About 17% of older adults misuse and abuse alcohol and medications. Although 87% of older adults visit a physician regularly, about 40% of those who are at risk for substance abuse problems do not self-identify or seek services for their substance misuse and are unlikely to be identified by their physicians.
- An estimated 70% of all primary care visits were driven by psychological factors (e.g., panic, generalized anxiety, major depression, somatization, stress, adjustment disorders). Distressed patients utilize health care at a rate of two to three times higher than non-distressed patients.
Factors that may contribute to mental health issues and chronic illnesses include poor diet, inactivity, misuse of alcohol, lack of medication compliance, and loneliness. What may assist in the treatment and recovery of chronic illnesses and behavioral health issues is evidence-based psychotherapy (e.g., Cognitive Behavioral Therapy), a controlled diet, exercise program, increased socialization, and a strong support network