Mental Health in Older Adults
摘要
As the population is aging rapidly and the life expectancy increasing, the probability of psychological morbidity in older adults is expected to increase. Depression and dementia are among the most common conditions contributing to years lived with disability in those aged 60 years or above. Late-life depression is associated with cognitive impairment and increases the risk of suicide in older adults. Behavioral and psychological symptoms of dementia are the most common causes for increased care giver burden and institutionalization of the elderly. Other common psychiatric disorders in this population include anxiety disorders, bipolar disorders, psychoses, substance use disorders, and sleep disorders. Late onset of psychiatric disorders is often secondary to other medical conditions, medications, or substance use disorders. Nonpharmacological management strategies have to be tried before pharmacotherapy. Generally, the use of medications, which are started at a low dose and titrated slowly, should be time-limited. Adverse effects of medications and drug interactions have to be watched out for. Psychosocial issues like social isolation, loneliness, bereavement, adjustment problems in the family, financial dependence, elder abuse, etc. contribute to psychological morbidity in older adults. Suicide rates are the highest in this population. Their mental health is also affected frequently during pandemics like the COVID-19, which leads to social isolation, lack of access to medical and other essential services, and high risk of infection and its consequences; all these predispose them to anxiety, sleeplessness, and other psychiatric morbidity.