Getting older may be unsettling to some, what with greying hair, wrinkles and forgetting where you parked the car! But seriously, ageing can bring on a variety of health issues.
The World Health Organisation (WHO) reports that globally, the population is ageing rapidly and predicts that between 2015 and 2050, the proportion of people over 60 years will nearly double, from 12% to 22%.
Many seniors maintain good health and are fully able to function both physically and mentally well into their later years and they make important contributions to society as family members, volunteers and as active participants in the workforce. However, the biological effects of ageing will naturally lead to more physical and mental health problems among the older population than in younger age groups. They risk developing mental disorders, neurological disorders or substance use problems as well as other health conditions such as diabetes, hearing loss, and osteoarthritis. Furthermore, as people age, they are more likely to experience several conditions at the same time.
WHO figures show over 15 percent of adults over the age of 60 suffer from a mental disorder. The most common mental and neurological disorders in this age group are dementia and depression, which affect approximately 5% and 7% of the world’s older population, respectively. Anxiety disorders affect 3.8% of the older population, substance use problems affect almost 1% and around a quarter of deaths from self-harm are among people aged 60 or above.
Risk factors for mental health problems among older adults
Older people may experience life stressors common to all people, but also stressors that are more common in later life, like a significant ongoing loss in capacities and a decline in functional ability. For example, older adults may experience reduced mobility, chronic pain, frailty or other health problems, for which they require some form of long-term care. In addition, older people are more likely to experience events such as bereavement, or a drop in socioeconomic status with retirement. All of these stressors can result in isolation, loneliness or psychological distress in older people, for which they may require long-term care.
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 healthy. Additionally, untreated depression in an older person with heart disease can negatively affect its outcome.
Older adults are also vulnerable to elder abuse – including physical, verbal, psychological, financial and sexual abuse; abandonment; neglect; and serious losses of dignity and respect. Current evidence suggests that 1 in 6 older people experience elder abuse. Elder abuse can lead not only to physical injuries, but also to serious, sometimes long-lasting psychological consequences, including depression and anxiety.
Cognitive health is focused on a person’s ability to think, learn and remember. Independence in later life is as much determined by cognitive ability as by physical ability. Among older adults a broad spectrum of cognitive capability exists with dementia at one extreme and normal cognitive function at the other. Adequate cognitive functioning is required
to perform simple activities of daily living such as dressing and bathing and more complex tasks such as managing money, paying bills and taking medications.
The most common cognitive health issue facing the elderly is dementia, the loss of those cognitive functions. Approximately 47.5 million people worldwide have dementia—a number that is predicted to nearly triple in size by 2050. The most common form of dementia is Alzheimer’s disease with as many as five million people over the age of 65 suffering from the disease in the United States alone. According to the National Institute on Aging, other chronic health conditions and diseases increase the risk of developing dementia, such as substance abuse, diabetes, hypertension, depression, HIV and smoking. While there are no cures for dementia, physicians can prescribe a treatment plan and medications to manage the disease.
Mental & Emotional Health
Depression is believed to occur in 7% of the elderly population, but unfortunately, it is often under-diagnosed and under-treated. Older adults account for over 18 percent of suicides deaths in the United States. Because depression can be a side effect of chronic health conditions, managing those conditions help.
People in the following categories generally showed a higher rate of depression & anxiety:
- A strong association has been found between loss of vision and depression, with less consistent or weaker relationships between hearing loss and depression
- Physical inactivity
- Disturbed sleep
- Taking five or more drugs daily, including prescribed, over-the-counter, and complementary medicines
The WHO guidelines urge health providers and societies to be prepared to meet the specific needs of older populations with training, prevention & management of age-associated chronic diseases, designing suitable policies on long-term & palliative care and developing age-friendly services & settings.
Additionally, promoting a lifestyle of healthy living such as betterment of living conditions, programs to prevent & deal with elder abuse and social support from family, friends and support groups in the community.