Symptoms of Depression Linked to Problems Performing Regular Daily Activities for Older Japanese Adults

JAGS graphicJournal of the American Geriatrics Society Research Summary

Recently, researchers investigated whether depressive symptoms might make it harder for older adults to perform their regular daily activities. The researchers also wanted to find out whether living circumstances or marital status had any impact on whether depressive symptoms affected older adults’ abilities to perform daily activities.

Symptoms of depression are common among older adults. Signs of depressive symptoms include:

  • Loss of interest in self-care and/or following medical advice
  • Little interest in social activities
  • Feeling “empty” inside
  • Trouble sleeping and/or feeling anxious
  • Trouble concentrating or remembering things
  • Unexplained aches and pains
  • Change in appetite and weight
  • Feelings of helplessness
  • Feeling that one is a burden

The researchers examined information from 769 older adults who participated in the Kurabuchi Study starting in 2005. The study was designed to look at how well adults 65-years-old and older could perform their daily functions. The researchers published their study in the Journal of the American Geriatrics Society. Continue reading

Older Adults May Need Better Follow-up After Emergency Room Screenings for Suicide

JAGS graphicJournal of the American Geriatrics Society Research Summary

According to the World Health Organization, suicide rates for men over the age of 70 are higher than in any other group of people. In 2015, almost 8,000 older adults committed suicide in the U.S., and the proportion of suicides is higher among older adults than younger people. When older adults try to commit suicide, they are more likely to be successful compared to younger adults.  This is why suicide prevention strategies are especially important for older men and women.

Hospital emergency departments (EDs) are caring for an increasing number of people with mental health concerns, including thoughts or actions related to suicide attempts. For example, nearly half of the older adults who committed suicide had visited an ED in the year before their death. However, when healthcare providers see older adults in the ED, some may be too quick to assume that the warning signs for suicide are just a natural part of aging. As a result, many older adults may not get the help they need to address suicidal thoughts. These facts prompted a team of researchers to study older adults seen in EDs and the related risks for committing suicide. Their study was published in the Journal of the American Geriatrics Society. Continue reading

PTSD, Certain Prescriptions for PTSD May Raise Risk for Dementia

JAGS graphicJournal of the American Geriatrics Society Research Summary

Researchers are discovering that post-traumatic stress disorder (PTSD) is a significant risk factor in developing dementia. Dementia is a memory problem that affects a person’s ability to carry out usual tasks. Dementia is a leading cause of serious illness, disability, and death.  It often requires care in a nursing home or other long-term care facility for people aged 65 and older.

Until now, researchers didn’t know whether the kinds of medications used for people with PTSD could increase risks for dementia. (These medications include including antidepressants, antipsychotics, sedatives, or tranquilizers.) A new study, published in the Journal of the American Geriatrics Society, examined this connection.

In their study, researchers examined information from 3,139,780 veterans aged 56 and older. At the beginning of the study, in 2003, the veterans were receiving health care from a Veterans Health Administration facility. Almost all the veterans were male and 82% were white.

Of the veterans in the study, 5.4% had been diagnosed with PTSD. As the researchers looked at the data over the study’s nine-year follow-up period, they also included veterans who were diagnosed with dementia.

Research has previously shown that veterans with PTSD are more likely to have health problems linked to a higher risk for dementia. These include traumatic brain injury, diabetes, chronic obstructive pulmonary disease (COPD), psychiatric disorders, substance abuse, and other health issues. Continue reading

Older Adults Are Being Overlooked When it Comes to Mental Heath Care

dr-sewellDaniel D. Sewell, MD
Director, Senior Behavioral Health, UC San Diego Medical Center
President, American Association for Geriatric Psychiatry

(This blog post originally appeared on CareForYourMind.org, a resource created by the Depression and Bipolar Support Alliance (DBSA) and Families for Depression Awareness (FFDA) to help society engage in critical discussions and decisions about mental health.)

For most individuals in the U.S., accessing mental health care is a struggle, but older adults may have it worst of all. Due to stigma, misinformation, and false beliefs about aging, they frequently go without adequate care for depression and other psychiatric illnesses and psychological problems. Too often, doctors offer prescription drugs as a cure-all solution, and fail to address the overall mental health and well-being of the older patient.

The truth is, addressing mental health issues in older populations requires paying more attention, not less. In aging adults, depressive symptoms can point to a physical illness, while physical pain or other physical complaints can often be a sign of mental health issues.

The good news is, when accurately diagnosed, mental health issues are just as treatable in older populations as in younger, but it takes commitment and understanding. In order to help aging Americans get healthier and happier, the system needs to properly address the physical and mental needs of these patients.

What gets in the way of patient-centered care?
Research shows that older adults are often less comfortable seeking care from a mental health professional than their younger counterparts. Due to historical shame and ignorance surrounding mental illnesses and psychological problems, stigma tends to be more powerful among those who came of age before the 1960s.

Depression is also experienced, witnessed, and treated differently in older adults. In this population, depression symptoms can present as physical complaints, irritability, and/or cognitive impairment rather than overt signs of sadness such as crying. Alternatively, psychiatric symptoms can often point to a physical ailment that’s been overlooked. Depression can also be an early sign of dementia.

Additionally, medical illnesses are too often misdiagnosed or wrongfully labeled as purely psychiatric illnesses. To test this theory, we did a six-month chart review in our geriatric psychiatric inpatient unit and discovered that 34% of patients referred to our unit had a previously unrecognized or documented but inadequately treated medical illness—and that illness was likely the source of the psychiatric symptoms. Based on that data, one out of three older patients may actually need medical care versus behavioral health care.

Insurance issues
Insurance companies also get in the way of good care. To cite one shocking example, a nurse employed by a continuing care community in my area was checking in on a patient. When she arrived, she saw the resident on the balcony, with one leg over the railing, clearly about to jump. Luckily, the nurse was able to pull the patient back. I was immediately contacted. When I tried to get pre-authorization for inpatient care from the patient’s insurance company, they told me she didn’t meet the criteria for care because she hadn’t actually jumped. Continue reading

Mental Health Awareness for Older Adults

Palmer MH high(8) res

Alice Pomidor, MD, MPH, AGSF
Professor
Florida State University School of Medicine

Mary Palmer, PhD, RN, FAAN, AGSF
Helen W. and Thomas L. Umphlet Distinguished Professor in Aging
UNC School of Nursing

Many of today’s older adults grew up during a time when mental health problems were not as well understood as they are today. People didn’t discuss problems like depression, for example, and many people considered mental health issues as “weaknesses” that could be cured by simply improving one’s attitude.

Now, of course, we understand that good mental health and good physical health are equally important to our well-being. Experts understand that mental health challenges are treatable. You can improve the quality of your life, or that of an older adult you care for, by making sure healthcare professionals address any potential mental health issues.

Mental Health Problems: Common Among Older Adults

Among adults aged 65 and older, about one in five have a mental disorder, including dementia.   Over 50% of people living in long-term care facilities have some form of cognitive impairment.

Other common mental health problems that affect older adults include anxiety and mood disorders, such as depression and bipolar disorder.

Even though older adults commonly have mental health issues, they are less likely than younger adults to receive treatment for them. When they do receive treatment, it’s also less likely for them to see a mental health specialist. More often, older adults seek mental health treatment from their primary care providers. Continue reading