The most common mental illnesses in old age
To be more precise, one would have to distinguish between mental and emotional illnesses when talking about illnesses that are not predominantly physical. Below you will find information on both in relation to gerontological psychiatry.
Basically, mental illnesses in old age are the same as in younger adulthood, with the exception of various dementias, which of course increase greatly with age. In old age, however, the body often already has certain diseases and this is then called multimorbidity (many diseases at the same time).
In addition, older people often have a certain frailty and immobility. On a mental level, you also have to see that older people have already experienced a lot and their personality has become very differentiated. In other words: sometimes they are very stubborn, sometimes obstinate, in any case they are not a blank slate and no longer as flexible as younger people. The knowledge that death is already approaching, so to speak, and could be at the door at any moment, also requires a confrontation with the "last questions" and the fact that one will soon no longer be around. As a young person, you don't really like to "get into" this topic and can hardly imagine what it does to you.
It is still far too common in our society to find old people who are lonely. Of course it is normal for friends and acquaintances to die off, but nevertheless - under the right conditions - there is really no need for older people to become lonely. We also hope that the Alterix portal will help society to address the problems of its ageing population. Especially since we will all grow old one day. And we are many...
Diseases that are treated as inpatient
In geriatric psychiatry and care, for the reasons mentioned above, some things are different from those for adults - both in diagnostic methods and therapies and in prevention and rehabilitation. Special attention must be paid to the very different physical, mental and social abilities of old people. One person may still be completely mentally fit but no longer able to walk, and another may have severe dementia but still be physically almost in top condition. In gerontological psychiatry, the following clinical pictures are most frequently treated as inpatients today:
- Dementia diseases
- Depression & affective disorders such as bipolar disease
- Delirium (acute confusion)
- Delusional or schizophrenic disorders (psychoses)
Furthermore, there are also quite a few addictive disorders in old age that are treated as inpatients. And then there are those stays that result from stress and crisis situations or from suicide attempts. Psychosomatic disorders (somatoform) and behavioural disorders also occur in the inpatient sector, but also in care at home and in nursing homes, of course. Depression & dementia are generally leading among mental illnesses in old age.
Old-age depression: New hope through new study
Depressed mood, no joy far and wide, no motivation and everything seems colourless and dreary. Many millions of people know these symptoms of depression. Often it is the sleep disturbances that make you feel really flat and done in. Then concentration problems are not far behind. And, when you are really depressed overall, you usually only hear negative self-talk and feel guilty to boot. The future seems grey in grey, like a never-ending disaster, and so it's understandable that some people start thinking about how he or she could put an end to it.
I think you now feel that depression is much more than just not being in a good mood, as it happens to everyone. Depression is a serious illness and should be taken seriously in old age, which unfortunately is not always the case when you look at how apathetic some old people are in a nursing home. Fortunately, from 2017 to 2020, a study called CBTlate is underway to remedy the inadequate treatment of old-age depression via a specially designed eight-week cognitive behavioural therapy programme. It is a costly, multi-centre study involving 248 depressed outpatients aged 60.
Suicide
Depression that is not recognised and treated in time is also a major cause of the approximately 10,000 suicides per year in Germany. That is more people than die annually from murder, AIDS, drugs and traffic accidents. However, it is usually not the elderly who die by suicide because they are often physically and/or mentally no longer capable of carrying it out.
But suicide due to depression does not have to be. Psychotropic drugs are generally very effective and no longer have as many side effects as is still wrongly assumed. They also work well for older people. Psychotherapy also helps as a supplement and/or light therapy and therapeutic sleep deprivation, which are sometimes offered during inpatient stays.
Dementia - the dreaded one-way street of no return
What actually causes dementia has not yet been conclusively clarified and there are different opinions. What can be observed in any case is that they often occur as a result of mental or physical illness and then reduce mental, emotional and social abilities. Alzheimer's dementia is the most common. It involves the gradual death of nerve cells and their connections, especially in the areas of the brain used for memory and thinking. Gradually, people become more and more forgetful. It often leads to physical symptoms such as bladder and bowel incontinence. Those affected often become bedridden and susceptible to infections.
The first phase is still very inconspicuous on the outside. In the middle stage, however, Alzheimer's dementia becomes clearly visible as speech, thinking and orientation decrease. In the late stage, the affected person often becomes a nursing case: physical limitations make care difficult, behavioural disorders with defensive or running away tendencies appear or the reversal of day and night.
Decide to self-test
So far, there is no ultimate safe prevention, but opting for the super-ager recommended lifestyle of healthy eating, smart exercise and mental activity with a sense of purpose reduce the risk. Currently, 1.2 million people in Germany are Alzheimer's patients.
Are you feeling forgetful and worried it could be the onset of dementia?
This questionnaire provides you with signs that can lead to the early detection of Alzheimer's disease, which can have a positive effect on it. Yes, we would prefer not to deal with dementia and depression at all and live as if at least it could never affect us. But isn't it better to be well informed and to recognise signs and changes as early as possible, so that you can act and still have many more decision-making options than if you close your eyes?
