Mental disorders in the elderly are often different than in younger patients. Depression in seniors may be associated primarily with irritability, psychotic disorders - with suspicion and isolation from close people. Dementia is one of the more common mental disorders in elderly patients. What other mental disorders are distinguished in the elderly and how do they manifest themselves? When should you go to the doctor with the senior?

Contents :

  1. Mental disorders in the elderly: causes
  2. Mental disorders in the elderly: depression
  3. Mental disorders in the elderly: dementia
  4. Mental disorders in the elderly: psychotic disorders
  5. Mental disorders in the elderly: anxiety disorders
  6. Mental disorders in the elderly: sleep disorders
  7. Mental disorders typical of the elderly
  8. Mental disorders in the elderly: treatment

Mental disorders in the elderly are a growing problem in psychiatry. According to the World He alth Organization (WHO), as the current percentage of people over 60 years of age is around 12%, already in 2050 - according to estimates - it may even be as high as 22%. It is related to the improvement of medical care standards.

Therefore, more and more emphasis is placed on the development of geriatrics, but also its more detailed areas. One of the distinguished is psychogeriatry, the subject of which is diseases and mental disorders in the elderly.

Seniors, as well as people of any other age, suffer from various psychiatric disorders. However, psychogeriatry is distinguished because certain problems are specific to the older age group. Some individuals in the elderly lead to symptoms that are slightly different than those seen in younger people.

In many seniors - due to a separate clinical picture - mental disorders in old age are not properly diagnosed and properly treated, therefore it is fully justified to disseminate information about the nature and course of these individuals. It should be added here that mental disorders in the elderly are simply common - it is estimated that they are differenteven more than 15% of patients aged 60 and over suffer.

Mental disorders in the elderly: causes

Old age is unfortunately a period in which most people have many risk factors for mental disorders. It is in the late years of life that patients often become lonely - it happens that their overworked relatives do not have time for them and the senior spends most of the time entirely alone. Often, an elderly person also experiences the loss of a loved one - e.g. a spouse - and this may also contribute to the development of some mental disorders.

Other risk factors for mental disorders in the elderly include:

  • chronic diseases (such as, for example, ischemic heart disease, diabetes or chronic obstructive pulmonary disease)
  • serious life changes (e.g. retirement or change of place of residence - moving even to your own children and to a nursing home for seniors can lead to psychiatric problems)
  • financial difficulties (e.g. due to receiving a low pension)
  • loss of contact with other people

Mental disorders in the elderly: depression

Depression is typically associated with low mood, loss of interest or a feeling of constant fatigue, but in the case of depressive disorders in old age their symptoms may be slightly different.

Yes, depression of old age may also be associated with the depressed mood of an elderly patient, but much more often in this case, significant irritability or nervousness comes to the fore. A senior may even explode in case of minor misunderstandings or be rude in contact even with his beloved grandchildren.

In addition to the symptoms listed above, there may also be sleep disturbances (usually in the form of difficulty falling asleep and waking up early), a significantly reduced appetite or a constant feeling of guilt.

Quite characteristic of this type of depression are patients' complaints about cognitive disorders (consisting in deterioration of memory, concentration and attention), as well as various somatic symptoms, e.g. the pain complaints still felt by the patient may not be caused by a somatic disease at all, but result simply from depression.

One more aspect needs to be emphasized here: depression in seniors can also lead to suicidal thoughts and thus an increased risk of committing suicide, therefore this problem should never be underestimated.

Mental disorders in the elderly: dementia

Most often associated with old agedementia are mental disorders. It is commonly believed that their primary symptom is memory impairment, and indeed, in the case of the most common dementia - Alzheimer's disease - memory difficulties come to the fore in patients.

This is not always the case - there are dementia disorders, the course of which may be dominated by, for example, significant changes in the behavior of seniors or impaired thinking and difficulties in carrying out everyday activities.

The group of dementias includes the above-mentioned Alzheimer's disease, but also such entities as:

  • vascular dementia
  • frontotemporal dementia
  • post-stroke dementia
  • dementia with Lewy bodies

Mental disorders in the elderly: psychotic disorders

The group of psychotic disorders includes, inter alia, schizophrenia. This disease rarely begins only in old age - much more often is the situation where the elderly suffer from it, in whom the first symptoms of schizophrenia appeared at a young age.

As in other age groups, schizophrenia may be associated with the occurrence of productive symptoms - which may be delusions and hallucinations - but much more often in patients in advanced age, the so-called negative symptoms of this unit. They include, among others problems such as emotional pallor, isolation from people, complete loss of interest in the surrounding world or apathy.

Mental disorders in the elderly: anxiety disorders

One of the most common mental disorders in the elderly are neurotic disorders. Sleep disorders, a feeling of constant fatigue, irritability or a constant feeling of anxiety can be manifestations of a variety of anxiety disorders.

Apart from them, in seniors they can also be accompanied by somatic symptoms of anxiety, which may include palpitations, a feeling of increased muscle tension or various types of pain (e.g. headaches).

Older people may have generalized anxiety disorder, as well as panic disorder, social phobia or post-traumatic stress disorder (PTSD). These types of mental disorders in the elderly are more common in women than in men.

Mental disorders in the elderly: sleep disorders

With age, it is completely natural that the amount of night rest necessary for the body decreases - seniors simply sleep shorter than young people.

Difficulties with falling asleep or waking up very early can not always be explained aloneage - if such problems appear in an elderly person basically during every night, they can be treated as one of the mental disorders in older people.

You should always try to look for factors that are responsible for the occurrence of this problem - such can be, for example, depressive disorders or anxiety disorders. A proper diagnosis of the underlying problem is necessary, because it is the source of the interactions aimed at reducing the difficulty of sleeping in an elderly person.

Mental disorders typical of the elderly

There are many more psychiatric problems that are encountered in the elderly. However, it is worth paying attention to some irregularities that are found in this particular age group - we are talking here, inter alia, with units such as:

  • Diogenes syndrome: significant changes in the behavior of a senior are associated with it, where the most important is usually significant hygiene negligence and the collection - by the general public considered completely unnecessary - items
  • sunset syndrome: people struggling with this problem experience significant changes in behavior in the evening hours, where they become, among others, agitated (sometimes even aggressive), experience disorientation or visual hallucinations

Mental disorders in the elderly: treatment

Properly conducted therapy of mental disorders is important at any age, however, seniors are one of those groups in which the treatment of psychiatric problems is extremely important. First of all, the abandonment of treatment may result in an exacerbation of chronic somatic diseases - occurring in most elderly people.

A senior with mental disorders may eventually neglect taking medications or completely ignore the diet recommended by doctors (especially important, for example, in people with hypertension or diabetes). In addition, the longer the time elapses from the onset of mental disorders in the elderly to the commencement of their treatment, the greater the risk that the necessary therapy will achieve the expected results much later than if it was started early after becoming ill.

Treatment of mental disorders in the elderly is certainly not easy - it is necessary in seniors to use lower doses of drugs than in young people (which results, among others, from changes in liver and kidney function that occur with the aging of the body ), and quite often difficulties arise when telling the patient exactly whatthe preparation should be used (due to the fact that seniors usually take many different medications, including some new drugs, special attention should be paid to potential interactions).

One thing should definitely be emphasized: mental disorders in seniors should be treated as much as possible, because properly selected therapy allows for longer maintenance of fitness and a good level of functioning.

About the authorBow. Tomasz NęckiA graduate of the medical faculty at the Medical University of Poznań. An admirer of the Polish sea (most willingly strolling along its shores with headphones in his ears), cats and books. In working with patients, he focuses on always listening to them and spending as much time as they need.

Category:

Geriatrics