Mental Health and Aging: Challenges, Family, and Interventions

Introduction

This paper explores concerns about aging in the modern day. It also examines the psychological problems that older people face and sheds light on the social networks and families within which aging people operate. There is a sustained effort to explore the therapies and programs that can effectively address the psychological challenges related to aging. Finally, this paper investigates what further research is needed to provide clearer direction on handling aging-related problems more effectively.

There is no doubt that elderly people — especially those aged 60 and above — make significant contributions to society. They work as volunteers and as active members of the workforce. Although most elderly people retain steady faculties, others suffer from mental health disorders such as substance abuse issues and neurological complications. They are also widely prone to conditions such as diabetes, osteoarthritis, and hearing loss. Another important fact is that people tend to experience simultaneous ailments as they grow older (WHO, 2017).

The well-being of a human being tends to be compromised as they advance in age, owing to physiological changes triggered by the aging process itself. Therefore, older adults are likely to encounter many challenges related to aging. The role of maintaining good physical health cannot be overemphasized for the elderly. Engaging in physical activity enhances the mobility and functioning of older adults (Halaweh, Dahlin-Ivanoff, Svantesson, & Willen, 2018).

Aging and Psychological Challenges Faced by Older Adults

It has been noted that the world's population is aging rapidly. It has been estimated that the proportion of aged people will double from 12% of the global population in 2015 to 22% by 2050. In absolute terms, this represents an increase from approximately 900 million older adults to 2 billion. Older adults encounter special physical and mental challenges that deserve recognition. It has also been established that over 20% of adults aged above 60 years suffer from either a mental or psychological disorder, or both — excluding headaches.

It has further been established that 6.6% of all disabilities among people over 60 years of age are linked to neurological and mental disorders. These disorders account for 17% of the years lived with disability (YLDs) among older populations. The most prevalent neurological and mental disorders affecting elderly people are depression and dementia, which affect approximately 7% and 5% of the older population, respectively.

Anxiety affects approximately 3.8% of elderly people, while substance abuse accounts for around 1%. It has also been found that approximately a quarter of all deaths from self-harm involve people aged 60 and above. Additionally, substance abuse issues among the elderly are frequently overlooked or misdiagnosed (WHO, 2017).

A rapid increase in the numbers of elderly people will occur primarily in middle- and low-income countries, with far-reaching effects on these already vulnerable economies. Many people live long and remain happy with no notable mental health complications, despite the common assumption that elderly people lead sad lives. Sadness, cognitive slowing, and dementia are not inevitable consequences of aging.

However, one possible negative outcome of global population aging is a rise in the number of elderly people with mental disorders. Such a scenario would place enormous pressure on health facilities in countries experiencing a sudden increase in their aging population. Over 20% of people aged 55 and above may be carrying some form of mental health complication (Lima & Ivbijaro, 2013).

Biological shortcomings can disrupt brain functioning. Feelings of worthlessness and isolation can lead to somatic diseases. Mental challenges may also worsen the symptoms and functional disabilities that elderly people already exhibit. Inevitably, this increases the use of healthcare resources, including the length of hospitalization and associated costs. Mental health problems can have profoundly negative effects on elderly persons experiencing disability. They may lose the ability to carry out routine activities of daily life, leading to increased dependency, reduced autonomy, and diminished quality of life. It is essential to pursue early diagnosis if these problems are to be reduced and managed effectively. Unfortunately, mental health problems are commonly misdiagnosed and therefore remain untreated (Lima & Ivbijaro, 2013).

As people grow older, chronic illnesses become more common. These simultaneous occurrences strain available resources, including health systems that are often ill-equipped to meet the increased demand. Well-being plays a protective role in maintaining health among the elderly. Good nutrition, for example, has been shown to help prevent frailty. Frailty refers to the continuous process of losing social resources, functional abilities, and the general capacity to fulfill one's primary social needs throughout the lifespan. Frailty has also been found to result from one or a combination of factors such as functional impairments, poor self-rated health, depression, and lifestyle factors. In one study, depression was strongly associated with frailty in older women (Gronning et al., 2018).

Risk Factors among Older Adults for Mental Health Problems

Risk factors for mental health problems exist at all stages of life, but the elderly may be subjected to a wider range of life stressors than younger people. Some stressors are unique to later life. These include declining physical capacity and reduced functional ability. Older adults may also experience greater frailty and chronic pain, among other concerns requiring long-term care. Furthermore, the elderly are more likely to face experiences such as bereavement and socioeconomic decline following retirement. Such stressors can lead to isolation, psychological distress, and loneliness (WHO, 2017).

Mental health affects physical health, and vice versa. For instance, older adults with physical conditions such as heart disease are more likely to experience depression than those who are healthy. Untreated depression among already ill elderly people can produce further negative health outcomes (WHO, 2017).

Older adults are also vulnerable to abuse — including physical, psychological, financial, and sexual abuse — as well as loss of dignity, respect, and outright abandonment. Such mistreatment can cause physical injury and lasting psychological effects, including anxiety and depression (WHO, 2017).

It is currently estimated that 50 million people worldwide are living with dementia, 60% of whom live in low- or middle-income countries. By 2030, the number of people with dementia is projected to reach 82 million, rising further to 152 million by 2050. Significant social and economic concerns accompany these projections, relating to direct medical care costs, social care, and informal caregiving associated with dementia (WHO, 2017).

Physical, economic, and emotional pressures also cause great distress to families and caregivers. Support is urgently needed for people living with dementia and for those who care for them, spanning health, legal, financial, and social dimensions. Depression, meanwhile, causes profound suffering and impaired daily functioning. It affects approximately 7% of the general older population and accounts for an estimated 5.7% of YLDs among adults aged 60 and above (WHO, 2017).

Depression is underdiagnosed and underserved in primary care settings. Its signs are commonly overlooked because they coincide with symptoms of other illnesses prevalent among older adults. Elderly people suffering from depression demonstrate poorer functioning than age-matched peers with chronic physical conditions such as lung disease, diabetes, and hypertension. Depression also tends to worsen the perception of poor health, increase healthcare utilization, and raise associated costs (WHO, 2017).

Conclusion and Suggestions for Future Research

Healthy aging is an aspect of life that all societies must promote. It is equally important to diagnose health problems early and to treat conditions — including mental disorders — that are common among the elderly. Care for older adults calls for tact, sensitivity, and keen observational skill. It is also essential to protect and support the caregivers who attend to elderly individuals. Such interventions can be effectively delivered in primary care settings.

It has been established that family caregivers can generate ambivalence and disagreement among the elderly people they care for, and that such conflicts negatively affect those receiving care. The composition of family structures influences the likelihood of conflict arising. It is therefore important to examine these negative relational dynamics in order to develop approaches that promote peaceful coexistence and a positive self-appraisal for older adults, including appropriate understanding of their health concerns (Widmer et al., 2017).

It is also critical to consider mobility, independence, cognitive functioning, and resilience in designing preventive measures. New research focusing on the preferences of elderly people regarding their mental and psychological well-being could be highly valuable. To promote participation, it would be helpful to involve physicians working in primary care settings as well as social service workers who regularly interact with older adults experiencing depression or anxiety. Consideration should also be given to how services can reach older adults in rural settings and those who cannot afford care. The individualization of prevention measures — potentially enabled by biomarkers — could make programs more cost-effective and efficient. This last proposal holds considerable promise for the future of aging research (Leggett & Zarit, 2014).