Mental health and an aging population

As the baby boom generation sneaks into retirement age, medical knowledge advances and population growth slows in many countries, it isn’t too surprising to hear the world is getting older.

Today there are almost 500 million people in the world who are over the age of 65 and by 2050 that number is expected to triple. During the same period, the number of people aged 80 or older is also expected to climb dramatically – from 87 million today to almost 400 million.

In our own country the situation is no different. Less than a century ago only five per cent of Canadians were aged 65 or older and now it is expected that by 2031 nearly a quarter of the population will be in this age group.

Of course an aging population has significant implications for health care systems around the world. Not surprisingly, seniors seek out medical care more frequently than younger people and also put more demand on acute care beds and other medical resources.

As we get older, we are more susceptible to a wide range of medical problems and some of the most common include cancers, heart disease and joint problems.

Aging is also linked to higher rates of two common mental disorders – dementia and depression.

Many people believe the prevalence of depression decreases after the age of 65, but this is not actually true. Depression rates do drop off somewhat in the 10 years immediately after retirement, but increases dramatically between the ages of 70 and 85.

Among those 85 and older who are not suffering from dementia, a full 20 per cent experience depression.

Sometimes depression is continuing as part of a chronic condition experienced throughout adult life, but many times it also begins for the first time in elderly individuals. It can begin at the same time or as a result of serious illnesses such as Parkinson’s disease, Alzheimer’s, cancer or other age-related conditions, but depression can also occur independently of physical ailments.

Regardless, depression in the elderly can have serious physical consequences. Obviously, depression is a key risk factor for suicide among the elderly. It is also implicated in the worsening of several other physical ailments and increases the risk of problems like heart attack and stroke.

Depressed people over the age of 85 are twice as likely to suffer a stroke as their non-depressed peers – in fact depression is a stronger risk factor in this group than high blood pressure.

When an elderly person claims to have lost interest in life it is important to look for undiagnosed depression. Almost half of elderly women who felt life was not worth living died within three years compared to 14 per cent who did not have that feeling.

Losing the will to live has proven more fatal than 20 other analyzed disorders including cardiovascular disease and cancer.

Still, mental illness is not well recognized in seniors and is under-treated. Many people including health care providers tend to dismiss symptoms as a normal part of aging when this is not the case.

While some feelings of loneliness or lack of energy might be more common among the elderly, true depression is more than this. Feeling very bad almost all of the time for extended periods or when there are no obvious reasons for sadness is not normal and should not be ignored.

Depression can be effectively treated in the elderly just as it is in the younger population.


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