Abstract
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.
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References
Andreas, S., Schulz, H., Volkert, J., Dehoust, M., Sehner, S., Suling, A., et al. (2017). Prevalence of mental disorders in elderly people: The European MentDis_ICF65+ study. British Journal of Psychiatry, 210, 125–131. https://doi.org/10.1192/bjp.bp.115.180463
Andreescu, C., & Varon, D. (2015). New research on anxiety disorders in the elderly and an update on evidence-based treatments. Current Psychiatry Reports, 17, 53. https://doi.org/10.1007/s11920-015-0595-8
Azermai, M., Petrovic, M., Elseviers, M. M., Bourgeois, J., Van Bortel, L. M., & Stichele, R. H. V. (2012). Systematic appraisal of dementia guidelines for the management of behavioural and psychological symptoms. Ageing Research Reviews, 11(1), 78–86. https://doi.org/10.1016/j.arr.2011.07.002
Babazadeh, T., Sarkhoshi, R., Bahadori, F., Moradi, F., Shariat, F., & Sherizadeh, Y. (2016). Prevalence of depression, anxiety and stress disorders in elderly people residing in Khoy, Iran (2014–2015). Journal of Analytical Research in Clinical Medicine, 4(2), 122–128. https://doi.org/10.15171/jarcm.2016.020
Barua, A., Ghosh, M. K., Kar, N., & Basilio, M. A. (2011). Prevalence of depressive disorder in the elderly. Annals of Saudi Medicine, 31(6), 620–624. https://doi.org/10.4103/0256-4947.87100
Beard, J. R., Officer, A., de Carvalho, I. A., Sadana, R., Pot, A. M., Michael, J., et al. (2016). The world report on ageing and health: A policy framework for healthy ageing. Lancet, 387(10033), 2145–2154.
Bessey, L. J., & Walaszek, A. (2019). Management of behavioral and psychological symptoms of dementia. Current Psychiatry Reports, 21,66. https://doi.org/10.1007/s11920-019-1049-5
Brendel, R. W., & Stern, T. A. (2005). Psychotic symptoms in the elderly. Primary Care Companion to The Journal of Clinical Psychiatry, 7(5), 238–241.
Cerejeira, J., Lagarto, L., & Mukaetova-Ladinska, E. B. (2012). Behavioral and psychological symptoms of dementia. Frontiers in Neurology, 3(73), 1–21. https://doi.org/10.3389/fneur.2012.00073
Conejero, I., Olie, E., Courtet, P., & Calati, R. (2018). Suicide in older adults: Current perspectives. Clinical Interventions in Aging, 13, 691–699.
Conwell, Y., Van Orden, K., & Caine, E. D. (2011). Suicide in older adults. Psychiatric Clinics of North America, 34(2), 451–468.
Finkel, S. I., e Silva, J. C., Cohen, G., Miller, S., & Sartorius, N. (1996). Behavioral and psychological signs and symptoms of dementia: A consensus statement on current knowledge and implications for research and treatment. International Psychogeriatrics, 8(3), 497–500.
Fiske, A., Wetherell, J. L., & Gatz, M. (2009). Depression in older adults. Annual Review of Clinical Psychology, 5, 363–389.
Flint, A. J. (2005). Generalised anxiety disorder in elderly patients. Drugs & Aging, 22, 101–114. https://doi.org/10.2165/00002512-200522020-00002
Gulia, K. K., & Kumar, V. M. (2018). Sleep disorders in elderly: A growing challenge. Psychogeriatrics, 18, 155–166.
Hersch, E., & Falzgraf, S. (2007). Management of the behavioral and psychological symptoms of dementia. Clinical Interventions in Aging, 2(4), 611–621.
Indu, P. V., Remadevi, S., Philip, S., & Mathew, T. (2018). A qualitative study on the mental health needs of elderly in Kerala, South India. Journal of Geriatric Mental Health, 5, 143–151.
Kales, H. C., Gitlin, L. N., & Lyketsos, C. G. (2015). Assessment and management of behavioural and psychological symptoms of dementia. BMJ, 350, h369. https://doi.org/10.1136/bmj.h369
Kalish, V. B., Gillham, J. E., & Unwin, B. K. (2014). Delirium in older persons: Evaluation and management. American Family Physician, 90(3), 150–158.
Kang, H., Zhao, F., You, L., Giorgetta, C., Venkatesh, D., Sarkhel, S., et al. (2014). Pseudo-dementia: A neuropsychological review. Annals of Indian Academy of Neurology, 17(2), 147–154.
Kyomen, H. H., & Whitfield, T. H. (2009). Psychosis in the elderly. American Journal of Psychiatry, 166(2), 146–150.
Lee, M.-S., & Kang, S.-G. (2007). Geriatric depression. Psychiatry Investigation, 4, 2–5.
Ljubic, N., Ueberberg, B., Grunze, H., & Assion, H.-J. (2021). Treatment of bipolar disorders in older adults: A review. Annal of General Psychiatry, 20, 45. https://doi.org/10.1186/s12991-021-00367-x
Mane, A. B. (2016). Ageing in India: Some social challenges to elderly care. Journal of Gerontology and Geriatric Research, 5, 2. https://doi.org/10.4172/2167-7182.1000e136
Masopust, J., Protopopova, D., Valis, M., Pavelek, Z., & Klimova, B. (2018). Treatment of behavioral and psychological symptoms of dementias with psychopharmaceuticals: A review. Neuropsychiatric Disease and Treatment, 12, 1211–1220.
Math, S. B., & Srinivasaraju, R. (2010). Indian psychiatric epidemiological studies: Learning from the past. Indian Journal of Psychiatry, 52, S95–S103.
Ministry of Social Justice and Empowerment. (1999). National policy for older persons year 1999. Govt. of India.
Ministry of Statistics and Programme Implementation, National Statistics Office –Social Statistics Division. (2021). Elderly in India 2021. Government of India. Available from: https://ruralindiaonline.org/hi/library/resource/elderly-in-india-2021/#section02
Ngo, J., & Holroyd-Leduc, J. M. (2015). Systematic review of recent dementia practice guidelines. Age and Ageing, 44, 25–33.
Oh, E. S., Fong, T. G., Hshieh, T. T., & Inouye, S. K. (2017). Delirium in older persons: Advances in diagnosis and management. JAMA, 318(12), 1161–1174. https://doi.org/10.1001/jama.2017.12067
Parker, S. T., Quinlan-Colwell, A., Lattimore, T., Shattell, M., & Kennedy-Malone, L. (2010). Older adults with bipolar disorder: Guidelines for primary care providers. Journal of Gerontological Nursing, 36(5), 20–29.
Roepke, S. K., & Ancoli-Israel, S. (2010). Sleep disorders in the elderly. Indian Journal of Medical Research, 131, 302–310.
Sajatovic, M., Strejilevich, S. A., Gildengers, A. G., Dols, A., Al Jurdi, R. K., Forester, B. P., et al. (2015). A report on older-age bipolar disorder from the International Society for Bipolar Disorders Task Force. Bipolar Disorders, 17(7), 689–704. https://doi.org/10.1111/bdi.12331
Sarkar, S., Parmar, A., & Chatterjee, B. (2015). Substance use disorders in the elderly: A review. Journal of Geriatric Mental Health, 2(2), 74–82.
Shaji, K. S., George, R. K., Prince, M. J., & Jacob, K. S. (2009). Behavioral symptoms and caregiver burden in dementia. Indian Journal of Psychiatry, 51, 145–149.
Shaji, K. S., Raju, D., Sathesh, V., Krishnakumar, P., Punnoose, V. P., Kiran, P. S., et al. (2017). Psychiatric morbidity in the community: A population based-study from Kerala. Indian Journal of Psychiatry, 59, 149–156.
Shaji, K. S., Sivakumar, P. T., Rao, G. P., & Paul, N. (2018). Clinical practice guidelines for management of dementia. Indian Journal of Psychiatry, 60(3), S312–S328.
Sigstrom, G., Skoog, I., Sacuiu, S., Karlsson, B., Klenfeldt, I. F., Waern, M., et al. (2009). The prevalence of psychotic symptoms and paranoid ideation in non-demented population samples aged 70–82 years. International Journal of Geriatric Psychiatry, 24, 1413–1419.
Sivakumar, P. T., Reddy, M. S. S., Sinha, P., & Varghese, M. (2021). COVID-19 and mental health in older adults. In Y. C. J. Reddy & T. S. Jaisoorya (Eds.), COVID-19 pandemic update – February 2021: Guidelines for general medical and specialized mental health care settings (pp. 67–71). NIMHANS.
Steinberg, M., Shao, H., Zandi, P., Lyketsos, C. G., Welsh-Bohmer, K. A., Norton, M. C., et al. (2008). Point and 5-year period prevalence of neuropsychiatric symptoms in dementia: The Cache County study. International Journal of Geriatric Psychiatry, 23(2), 170–177.
Subramanyam, A. A., Kedare, J., Singh, O. P., & Pinto, C. (2018). Clinical practice guidelines for geriatric anxiety disorders. Indian Journal of Psychiatry, 60(3), S371–S382.
Suresh Kumar, P. N., Anish, P. K., & George, B. (2015). Risk factors for suicide in elderly in comparison to younger age groups. Indian Journal of Psychiatry, 57, 249–254.
Suzuki, K., Miyamoto, M., & Hirata, K. (2017). Sleep disorders in the elderly: Diagnosis and management. Journal of General and Family Medicine, 18, 61–71.
Tampi, R. R., & Tampi, D. J. (2020). Managing behavioral and psychological symptoms of dementia. Psychiatric Times, 36(3), 18–19.
Thomas, A. M., Kuruvilla, B. M., Kalliath, J. D., Cherian, V., Rose, B. M., Kizhatil, A., et al. (2021). Prevalence and correlates of geriatric depression in a rural community in Kerala, India. Journal of Ideas in Health, 4(special 2), 395–401.
Valiengo, L. L., Stella, F., & Forlenza, O. V. (2016). Mood disorders in the elderly: Prevalence, functional impact and management challenges. Neuropsychiatric Disease and Treatment, 12, 2105–2115.
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Indu, P.V. (2022). Mental Health in Older Adults. In: Handbook of Aging, Health and Public Policy. Springer, Singapore. https://doi.org/10.1007/978-981-16-1914-4_109-1
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DOI: https://doi.org/10.1007/978-981-16-1914-4_109-1
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