Why Does Mental Illness Occur in Aging?
Silver Chats talks about change often. This is due in part to unavoidable changes that come with aging. Our bodies change, our lifestyles change, and we are faced with loss. Along with these changes come mental challenges like depression, anxiety, dementia, substance abuse, and Alzheimer's disease. Our aging population is expected to grow dramatically over the next couple of decades, making recognition of mental illness associated with aging a priority. We need to discuss this issue with family, friends, the medical community, and social groups. Recognizing the signs, knowing where to go for help, and being aware are key to treatment.
WHO has staggering statistics about our aging population in terms of the number of people: "The world's population is aging fast. In 2020, 1 billion people in the world were aged 60 years or over. That figure will rise to 1.4 billion by 2030, representing one in six people globally. By 2050, the number of people aged 60 years and over will have doubled to reach 2.1 billion. The number of persons aged 80 years or older is expected to triple between 2020 and 2050 to reach 426 million." These statistics make it even more important to address mental illness in aging. It can affect both daily life and quality of life.
Let's talk about depression and anxiety. These are mood disorders common with the aging population. It is common to feel anxious, have a down day, feel sad, or have the blues. This is different; what we are talking about is a clinical diagnosis associated with more profound, more acute symptoms. Some symptoms of depression are:
- Persistent sad, anxious, or "empty" mood
- Feelings of hopelessness, guilt, worthlessness, or helplessness
- Irritability, restlessness, or having trouble sitting still
- Loss of interest in once pleasurable activities, including sex
- Decreased energy or fatigue
- Moving or talking more slowly
- Difficulty concentrating, remembering, or making decisions
- Difficulty sleeping, waking up too early in the morning, or oversleeping
- Eating more or less than usual, usually with unplanned weight gain or loss
- Thoughts of death or suicide, or suicide attempts
Cedar-Sinai.org identifies some symptoms of anxiety as avoiding activities that cause joy, such as socializing, but others are:
- Insomnia
- Eating less
- Restlessness and trouble focusing
- Easily alarmed
- Intrusive thoughts
- Trembling
- Sweating
- Racing heart
- Muscle tension
- Irritability
- Stomach aches
- Headaches
Why are depression and anxiety common in aging? It's because of the many changes we experience during this time of life. We experience health issues, like chronic diseases, increased frequency of loss, like family and friends, and social isolation, like loneliness. There are even common medications that can contribute to depression, like blood pressure meds, painkillers, antacids, and anti-seizure medication, to name a few. If you find yourself with several of these symptoms and they persist for longer than a couple of weeks, it's recommended to see a doctor. Depression and anxiety are treatable.
Help guide.org says: "It's a myth to think that after a certain age, older adults can't learn new skills, try new activities, or make fresh lifestyle changes. The truth is that the human brain never stops changing, so as an older adult, you're just as capable as a young person of learning new things and adapting to new ideas that can help you recover from depression. Overcoming depression involves finding new things you enjoy, learning to adapt to change, staying physically and socially active, and feeling connected to your community and loved ones." There are also clinical ways to treat depression and anxiety. Counseling, psychotherapy, medications, exercise, acupuncture, massage, hypnosis, and biofeedback, to name a few. No one has to live with depression or anxiety. It affects the quality of life, relationships, thinking, and behavior and promotes health problems. If you or someone you know exhibits any of the signs discussed, reach out for help; it's not a sign of weakness but strength. Help guide.org says: "It's a myth to think that after a certain age, older adults can't learn new skills, try new activities, or make fresh lifestyle changes. The truth is that the human brain never stops changing, so as an older adult, you're just as capable as a young person of learning new things and adapting to new ideas that can help you recover from depression. Overcoming depression involves finding new things you enjoy, learning to adapt to change, staying physically and socially active, and feeling connected to your community and loved ones." There are also clinical ways to treat depression and anxiety. Counseling, psychotherapy, medications, exercise, acupuncture, massage, hypnosis, and biofeedback, to name a few. No one has to live with depression or anxiety. It affects the quality of life, relationships, thinking, and behavior and promotes health problems. If you or someone you know exhibits any of the signs discussed, reach out for help; it's not a sign of weakness but strength.
We experience mild cognitive decline as a natural aging process, but dementia and Alzheimer's are not. Both cause severe mental impairment and decline that interfere with daily living. With normal aging, we experience forgetfulness, slower thinking, reduced attention, changes in sleep patterns, less energy, loss of muscle and physical strength, appetite changes, and sight and hearing decline. But with dementia and Alzheimer's, we experience:
- Severe memory loss, especially for recent events
- Increasing confusion
- Reduced concentration
- Difficulty learning new things
- Difficulty completing familiar tasks
- Personality or behavior changes, such as apathy, withdrawal, or depression
- Difficulty speaking, understanding, and expressing thoughts
- Difficulty reading and writing
According to the National Institute on Aging: "There is growing evidence of a heart/brain connection. Research findings suggest that some factors related to heart disease may also be linked to cognitive health. For example, one study showed that higher levels of cardiovascular risk factors such as body mass index, blood sugar, and systolic blood pressure were associated with worse cognitive health later in life. Other data suggest that obesity — a known risk factor for heart disease — may also be associated with an increased risk of developing dementia. Taking better care of your overall cardiovascular health can help protect your brain and your heart." Silver Chats often discusses how our lifestyles affect our physical health, but there is evidence that it affects our mental health as well. A sedentary lifestyle is directly linked to an increased risk of dementia and Alzheimer's disease. Activities that involve sitting for long periods of time, like watching TV, spending time in front of the computer, and scrolling on social media for hours, reduce blood flow to the brain, increase inflammation, and negatively impact brain cell health.
There is growing evidence that suggests that diet can affect the risk of dementia. A healthy diet may help reduce the risk of dementia by lowering the risk of other conditions that increase the likelihood of dementia. Foods that may increase the risk of dementia:
- Highly processed foods
- These include fast foods, chips, fried chicken, pizza, and sugary sodas. They are high in added sugars, refined carbohydrates, salt, and fats.
- Refined foods
- These include pasta, cakes, white sugar, white rice, and white bread. They cause spikes in insulin production and contribute to the formation of toxic proteins associated with Alzheimer's.
- Processed red meat
- Eating at least 1/4 serving of bacon, bologna, or other processed red meat daily may increase the risk of dementia.
- Saturated fats and high serum cholesterol: These are associated with an increased risk of Alzheimer's disease.
- Lean meats, seafood, and whole fruits and vegetables: A protein-rich, high-fiber diet may lower the risk of dementia.
- Heart-healthy fats: These include olive oil and long-chain polyunsaturated omega-3 fatty acids (particularly DHA).
Yes, dementia and Alzheimer's disease can be influenced by genetics, but lifestyle and environmental factors play a huge part as well. Why not control what we can then and make healthier choices to mitigate our chances of living as cognitively fit as possible? Silver Chat believes that making positive, healthy choices as we age is the key to practicing holistic aging.Lastly, let's look at substance abuse as a mental illness of aging. The International Psychogeriatric Association states, "Evidence suggests that the current "Baby Boom" cohort of aging adults, born from the mid-1940s to mid-1960s, abuses alcohol and psychoactive prescription medications at a higher rate than previous generations did." This is a growing concern among healthcare providers as "Substance abuse in the elderly has many negative consequences including physical and mental health problems, social and family strain, legal problems, and death from alcohol or drug overdose." Alcohol use and mental illness are linked. Alcohol misuse by older adults is associated with faster cognitive decline, such as problems with memory, thinking, and judgment. Health problems in people older than age 65 and the medicines used to treat them can get worse with alcohol's effects. These include diabetes, high blood pressure, and ulcers. Heavy alcohol use can also lead to other health problems, such as cancer and liver disease. It's also linked to depression and suicide. The statistics are concerning, "alcohol abuse and alcoholism are common but under recognized problems among older adults. One-third of older alcoholic persons develop a problem with alcohol in later life, while the other two-thirds grow older with the medical and psychosocial sequelae of early-onset alcoholism." Drinking is socially acceptable and rarely addressed as an aging issue. Yet, alcohol has been identified medically as one of the most damaging substances we can put in our bodies. It is linked to rapid mental decline and is directly associated with heart disease and cancer. Rethinking attitudes and habits around drinking alcohol should be a significant health consideration for healthy aging. This has been an informative and serious discussion on mental illnesses in aging. Silver Chats has addressed mental health concerns with aging, what factors are related to them, and suggestions on how to mitigate them through lifestyle changes. Looking at our daily habits, committing to change, and adhering to positive, healthy, holistic aging practices can improve our chances of discovering the endless possibilities of aging.