Psychological Disorders in Late Life

7/25/2019 Psychological Disorders in Late Life

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Psychological Disorders inLate Life

By: Seemab Zahra


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Prevalence:

How common are Psychological Disorders in

Late Life?

Current estimates indicate that person oer !" hae the

lowest oerall prealence of mental disorders of all age

groups#

Prealence rate for alcohol abuse or dependence rates are

less than %

'en rates for depression and an(iety appear lower than in

younger population#

)ost people !" years of age and older are free from serious

psychopathology#


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Medical Issues in DiagnosingPsychological Disorders

)edical conditions are more common in elderly it is particular to rule

out the e(planations for diagnosis

)edical problems such as thyroid problems* +ddison,s disease*

Cushing,s disease* Par-inson,s disease* +l.heimer,s disease*

hypoglycemia* anemia* and itamin de/ciencies can produce

symptoms that mimic schi.ophrenia*depression* or an(iety 0)arengo

1 2estermeyer* 344!5#

+ngina* congestie heart failure*and e(cessie ca6eine consumption

may all cause a faster heart rate* which can be mista-en as a

symptom of an(iety 07isher 1 8oll* 344!5


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Contd9

+gerelated deterioration in the estibular

system0innerear control of one,s sense of balance5

can account for panic symptoms such as seere

di..iness0;a5#


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Major Depressive

Disorder:;esearchers initially

belieed that symptoms of

depression di6ered in late

life* but researchers hae

identi/ed only one

consistent di6erencecognitie symptoms 0such

as memory de/cits and

confusion5 appear more

pronounced when

depression emerges in late

life compared to earlier

adulthood#

+lthough depression is lesscommon among older adultsthan younger ones* it accountsfor a ery large proportion ofthe psychiatric hospitaladmissions among the aged#

0Daid @oung2ol6APhoto'dit#5


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Depression vs. Dementia

he freuent presence of cognitie symptoms in late life

depression can ma-e it hard to di6erentiate whether

memory problem is due to dementia or depression

ndeed* depression in older adults is often misdiagnosed

as dementia because of the seere cognitie

impairment#

Ef course* people can hae both dementia anddepression# Cognitie diFculties in late life do predict

increases in depression oer time 0Gin-ers et al#* %>>5#


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Is it Depression orDementia?

Symptoms ofDepression Symptoms ofDementia

)ental decline is relatiely rapid )ental decline happens slowly

Inows the correct time* date* andwhere he or she is

Confused and disorientedJbecomes lost in familiar locations

DiFculty concentrating DiFculty with shortterm memory

DiFculty concentrating 2riting* spea-ing* and motors-ills are impaired

8otices or worries about memoryproblems Doesn,t notice memory problems

or seem to care


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DSMI! DI"#$%S&ICC'I&('I"

" or more symptoms lasting K% w-* change from

preious functioning:

Depressed mood andAor loss of interest

+ltered sleep* loss of energy* appetite change or

weight loss* feelings of

worthlessnessAguilt*psychomotor changes* loss ofconcentration and focus* recurrent thoughts of

death


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(tiology of Depression in %lder "dults

+s you grow older* you face signi/cant life changes that can put

you at ris- for depression# Causes and ris- factors that contribute

to depression in older adults and the elderly include:

*ealth pro+lems llness and disabilityJ chronic or seere painJ

cognitie declineJ damage to body image due to surgery or

disease#

Loneliness and isolation Liing aloneJ a dwindling social circle

due to deaths or relocationJ decreased mobility due to illness or

loss of driing priileges#

'educed sense of purpose 7eelings of purposelessness or loss

of identity due to retirement or physical limitations on actiities#

,ears 7ear of death or dyingJ an(iety oer /nancial problems or


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&reatment of depression

here are seeral treatment options aailable for

depression#

hey include :

+ntidepressant medication

Psychotherapy

'lectroconulsie therapy

Sometimes* a combination of these treatments

may be


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"ntiDepressantMedication

7our groups of antidepressant medications hae been used to

e6ectiely treat depressie illness:

selectie serotonin reupta-e inhibitors 0SS;s5 and norepinephrineand serotonin reupta-e inhibitors 08S;s5*

and less commonly* tricyclics* monoamine o(idase inhibitors 0)+Es5*

)edication adherence is especially important* but can present

challenges among forgetful indiiduals# t is important to note that all

medicines hae side e6ects as well as bene/ts#* and the selection of

the best treatment is often made based on tolerability of the side

e6ects#


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Psychotherapy)ost depressed people /nd that support from family and friends*

inolement in selfhelp and support groups* and psychotherapy are

helpful#

Psychotherapy is especially bene/cial for those who prefer not to ta-e

medicine and who hae mild to moderate symptoms# t also is helpful for

people who cannot ta-e drugs because of side e6ects* interactions with

other medicines* or other medical illnesses#

Psychotherapy in older adults can address a broad range of functional and

social conseuences of depression# )any doctors recommend the use of

psychotherapy in combination with antidepressant medicines#


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(lectroconvulsive therapy-(C&

'C 0also -nown as shoc- treatment5 may

be ery useful in the treatment of seere

depression in older adults#

7or carefully selected people* 'C can be

a lifesaing interention# 7or e(ample* an

M> year old man who lies alone* has

been depressed for months* lost !>

pounds and has delusions about his body

as a -ind of presentation that may

improe uic-ly with 'C#

'C can impact memory so that is an

important consideration in comparing it to

other interentions#


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Suicide

Elder people are =( more li-ely to -ill themseles

than younger people

Depression is the ris- factor# Ether factors

include* physical illness* loss of loed ones* and dire /nancialcircumstances

Elder people are less li-ely to communicate their

intentions to commit suicide

Ene treatment program to reduce depression

and suicidal rate among the elderly draws on the /nding that

elderly people are more li-ely to isit primary care doctors than to

see specialty mental health proiders


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Psychological Disorders in Late Life