Mental Health Issues of the Aging

Elderly Face Greater Risk of Mental Disorders

Having good mental health throughout life does not ensure immunity from severe depression, Alzheimer’s disease, anxiety disorders and other disorders in the senior years of life. Elderly people are at greater risk of mental disorders and their complications than are younger people. However, many of these illnesses can be accurately diagnosed and effectively treated, and it is erroneous to conclude that they are part of the process of “normal aging:”

  • From 15 to 25 percent of elderly people in the United States suffer from significant symptoms of mental illness.
  • The highest suicide rate in America is among those aged 65 and older. In 1985, this age group represented 12 percent of the total U.S. population, but  accounted for 20 percent of suicides nationwide. That means close to 6,000 older Americans kill themselves each year.
  • Severe organic mental disorders afflict one million elderly people in this country and another two million suffer from moderate organic brain disorders.

Don’t ignore noticeable changes in an older person’s behavior or moods. These changes could be symptoms of depression, “reversible” dementia, Alzheimer’s disease, or other conditions for which you can get them help. Seek medical and psychiatric evaluations which can lead to treatments that can return an older person to a productive and happy life.


Depression, the most common emotional disorder, afflicts about 5% of the elderly. Symptoms include:

  • Feelings of worthlessness, hopelessness, helplessness, inappropriate guilt,
  • Prolonged sadness or unexplained crying spells, jumpiness or irritability,
  • Loss of interest in and withdrawal from formerly enjoyable activities, family, friends, work or sex.
  • Intellectual problems such as loss of memory, inability to concentrate, confusion or disorientation
  • Thoughts of death or suicide
  • Loss of appetite, or drastic increase in appetite
  • Persistent fatigue and lethargy, insomnia or drastic increase in sleep
  • Aches and pains, constipation, or any unexplainable physical problems


Dementia is characterized by confusion, memory loss, and disorientation. In America, only 15% of elderly people suffer from dementias. Dementia can be caused by:

  • Complications of chronic high blood pressure, blood vessel disease or strokes
  • Parkinson’s disease, when severe and advanced
  • Huntington’s disease, a genetic disorder, with signs of mental decline, changed personality, psychosis, and movement disturbance.
  • Creutzfeldt-Jakob disease, a viral infection that leads to rapid and progressive dementia.

Pseudodementias or “Reversible” Dementias

It is possible that elderly people will become forgetful, disoriented and confused due to a rapidly reversible condition that is totally unrelated to irreversible causes of dementia. Depression can resemble dementia, while medications or malnutrition can trigger the symptoms of dementia. Factors that could cause a condition that mimics dementia include:

  • Medications: With the increasing number of medications being taken by the elderly combined with their slowed metabolism, the medications may reach toxic levels quickly. Certain drugs acting alone, or through interactions with other drugs can  cause confusion, mood changes and other symptoms of dementia.
  • Malnutrition caused by poor eating habits: Poor eating habits can upset the way the brain functions. Without proper nutrients, pernicious anemia, a blood disorder caused by the poor absorption of vitamin B-12, can cause irritability, depression or dementia.
  • Diseases of the heart or lungs: The brain requires a great deal of oxygen to function properly. When diseased lungs do not draw enough oxygen into the blood, or when a diseased heart fails to pump enough blood to the brain, the lack of oxygen can affect the brain’s functions.
  • Diseases of the adrenal, thyroid, pituitary or other glands: These glands regulate emotions, perceptions, memory and thought processes. When they do not function properly, various mental processes are negatively affected.

Alzheimer’s Disease

Alzheimer’s disease (AD) is the most common form of dementia among older people. Dementia is a brain disorder that seriously affects a person’s ability to carry out daily activities.

AD begins slowly. It first involves the parts of the brain that control thought, memory and language. People with AD may have trouble remembering things that happened recently or the names and identities of people they previously recognized.

Symptoms of Alzheimer’s disease begin slowly and progress in stages to include the following:

  • Loss of recent, short-term memory
  • Mild personality changes, such as increased apathy, or social withdrawal
  • Decrease in ability to think abstractly, handle money, work with numbers when paying bills,
  • Difficulty in understanding what they read, or organizing their day
  • Irritability, agitation, loss of neatness in appearance
  • Confusion, disorientation, (for example, clients often forget the time and date, where they live, or recent events)

Ultimately, clients become erratic in mood, uncooperative, incontinent, stop conversing, and become unable to care for themselves. As of yet, there is still no proven cause of Alzheimer’s disease. There is still no cure for Alzheimer’s disease, but medication and therapy can help forestall the progress of the disease and provide much-needed support to care-givers.

At Potomac Psychiatry our psychiatrists and therapists specialize in treating mental health issues in the elderly. Contact us to discuss your needs or to schedule an appointment.