Mental Disorders In Older Adults Research Articles

Age-related eye diseases and subsequent risk of mental disorders in older adults: A real-world multicenter study.

The relationship between age-related eye diseases and the subsequent risk of dementia and depressive disorders remains inconsistent. Furthermore, the effects on anxiety disorders and sleep disorders have been underexplored. This study aims to comprehensively examine the impact of age-related eye diseases on common mental disorders in older adults, thereby enhancing our understanding of the mental health implications in these conditions. The electronic health records of 1,522,036 patients aged over 60 from ten institutions in South Korea were analyzed. Patients with and without age-related eye diseases were identified, and 1:4 propensity score matching (PSM) was implemented. A 10-year longitudinal analysis was conducted using the Cox proportional hazards model to calculate the hazard ratios (HR). A meta-analysis was performed to combine the results from different institutions. Subgroup analyses were conducted to explore the impact of specific age-related eye diseases (cataract, glaucoma, age-related macular degeneration) on mental disorders. A total of 41,637 patients with age-related eye disease were matched with 134,908 patients without such conditions. Patients with age-related eye disease showed a significantly higher risk of mental disorders (dementia, HR: 1.21 [95% CI: 1.14-1.27]; depressive disorders, HR: 1.28 [95% CI: 1.20-1.36]; anxiety disorders, HR: 1.31 [95% CI: 1.22-1.41]; sleep disorders, HR: 1.29 [95% CI: 1.22-1.37]). In subgroup analyses, each of the three age-related eye diseases was significantly associated with an increased risk of mental disorders. (cataract, HR: 1.25-1.33; glaucoma, HR: 1.15-1.49; age-related macular degeneration, HR: 1.18-1.37). Age-related eye diseases increase the risk of developing mental disorders in older adults, highlighting the need for a multidisciplinary approach to patient care in these conditions.

Screening for Anxiety, Depression and Panic in older adults in a Family Medicine Unit in Sinaloa, Mexico

Introduction: The most prevalent mental disorders in Primary Care are Anxiety, Depression and Panic. These are one of the main causes of health demand in hospital stay services. Objective: to determine the frequency of mental disorders in older adults at the Family Medicine Unit No. 35, Culiacán, Sinaloa, México in the period from March to November 2024. Methods: Descriptive cross-sectional study. Older adults aged 60 to 75 years without a diagnosis of any mental disorder or syndrome were included. Sample of 379 participants. Simple random probabilistic sampling. A socio-demographic data sheet and the PHQ-4 + PHQ-TP scale were used. Descriptive and inferential statistics (Chi square) p ≤0,05 were used, it adhered to ethical and legal criteria. Results: The average age was 65,59 years. 53,3 % were men, 52 % were married, 50,7 % were currently working, 35,1 % had primary education and 76 % lived in urban areas. 34 % had anxiety, 28,2 % depression and 30,6 % panic. A significant relationship was found between anxiety and marital status (χ²=5,814, p=0,05) and schooling (χ²=12,845, p=0,00). Depression was related to schooling (χ²=18,479, p=0,00) and current job (χ²=8,528, p=0,003). Panic was related to sex (χ²=17,688, p=0,00), marital status (χ²=10,935, p=0,004), current job (χ²=6,273, p=0,001) and education (χ²=13,092, p=0,004). Conclusions: Anxiety was the most common mental disorder among older adults, highlighting the need to promote accessible and effective mental health programs that address the particular needs of this age group.

Mental healthcare for older adults among countries in World Psychiatric Association Zone 10.

This study aimed to compare mental healthcare services for older adults aged ≥65 years among countries in World Psychiatric Association (WPA) Zone 10. A culturally sensitive questionnaire was developed and sent to the presidents of national psychiatric associations of the eight countries in WPA Zone 10 (Armenia, Azerbaijan, Belarus, Kazakhstan, Kyrgyzstan, Moldova, Russia, and Uzbekistan). Psychiatric associations of six countries responded to the questionnaire (Armenia and Moldova did not respond). The prevalence of mental disorders among older adults (aged ≥65 years) varied from 2.6% in Russia (among those aged ≥60 years) to 3.5% in Azerbaijan, 4% in Uzbekistan, 12.1% in Kazakhstan, and 13.8% in Kyrgyzstan (no data were available for Belarus). Specialised gerontopsychiatric care is provided in all six countries, except for Kazakhstan. The prevalence of mental disorders in older adults differed among countries in WPA Zone 10. Improving gerontopsychiatric care is a target for healthcare planners in WPA Zone 10.

Falls increase the risk for incident anxiety and depressive symptoms among adults aged ≥50 years: An analysis of the Irish longitudinal study on ageing

BackgroundLittle is known about the potential impact of falls on the onset of common mental disorders in older adults. Thus, we aimed to investigate the longitudinal association between falls and incident anxiety and depressive symptoms in adults aged ≥50 years living in Ireland. MethodsData from the Irish Longitudinal Study on Ageing were analyzed (Wave 1: 2009–2011; and Wave 2: 2012–2013). The presence of falls and injurious falls in the past 12 months was assessed at Wave 1. Anxiety and depressive symptoms were assessed at Wave 1 and Wave 2 using the anxiety subscale of the Hospital Anxiety and Depression Scale (HADS-A) and the 20-item Center for Epidemiologic Studies Depression (CES-D), respectively. Covariates included sex, age, education, marital status, disability, and the number of chronic physical conditions. The association of falls at baseline with incident anxiety and depressive symptoms at follow-up was estimated by multivariable logistic regression. ResultsThis study included 6,862 individuals (51.5% women; mean [SD] age 63.1 [8.9] years). After adjusting for covariates, falls were significantly associated with anxiety (OR = 1.58, 95%CI = 1.06–2.35) and depressive symptoms (OR = 1.43, 95%CI = 1.06–1.92). These associations were no longer significant after including fear of falling in the models. Similar findings were obtained for injurious falls, although the relationship with anxiety symptoms was not statistically significant. ConclusionsThis prospective study of older adults from Ireland found significant associations between falls and incident anxiety and depressive symptoms. Future research may focus on whether interventions to reduce fear of falling could also alleviate anxiety and depressive symptoms.

Prevalence and factors associated with suspicion common mental disorders in older adults: a population study

RESUMO Objetivo Investigar a prevalência e os fatores associados à suspeição de transtornos mentais comuns (TMCs) em idosos de um município de pequeno porte do Nordeste brasileiro. Métodos Estudo epidemiológico populacional, com delineamento transversal, realizado com idosos da área urbana de Aiquara-BA. As informações sociodemográficas, de hábitos de vida e de condições de saúde foram coletadas, em entrevistas, a partir de um instrumento próprio. O nível de atividade física foi averiguado por meio do International Physical Activity Questionnaire. Foram considerados insuficientemente ativos os entrevistados que despendiam tempo < 150 mim/sem em atividade física. A identificação da suspeição de TMCs foi realizada pelo Self-Reporting Questionnaire, com ponto de corte de sete ou mais respostas positivas. Para as análises inferenciais, utilizou-se o teste qui-quadrado de Pearson, regressão logística multivariada e seus respectivos intervalos de confiança (ICs) de 95,0% (p ≤ 0,05). Resultados Participaram do estudo 232 idosos (58,6% mulheres), com média de idade de 71,6 ± 7,5 anos e prevalência de suspeição de TMCs de 32,6%. No modelo final de regressão, foi observado que estiveram associadas à suspeição de TMCs: as mulheres (RP: 2,49; IC95%: 1,27-4,88); os idosos com autopercepção negativa de saúde (RP: 2,73; IC95%: 1,46-5,10); os idosos que referiram ter distúrbios do sono (RP: 3,12; IC95%: 1,56-6,21); e os insuficientemente ativos (RP: 2,30; IC95%: 1,20-4,41). Conclusão Em Aiquara-BA, identificou-se elevada prevalência de suspeição de TMCs, principalmente em mulheres, nos avaliados com autopercepção de saúde negativa, entre os que referiram ter distúrbios do sono e nos participantes insuficientemente ativos.

AAGP Session to Highlight Research on Resilience, Emotional Well-Being in Aging

AAGP Session to Highlight Research on Resilience, Emotional Well-Being in Aging

Mental health care for older adults: recent advances and new directions in clinical practice and research.

The world's population is aging, bringing about an ever-greater burden of mental disorders in older adults. Given multimorbidities, the mental health care of these people and their family caregivers is labor-intensive. At the same time, ageism is a big problem for older people, with and without mental disorders. Positive elements of aging, such as resilience, wisdom and prosocial behaviors, need to be highlighted and promoted, both to combat stigma and to help protect and improve mental health in older adults. The positive psychiatry of aging is not an oxymoron, but a scientific construct strongly informed by research evidence. We champion a broader concept of geriatric psychiatry - one that encompasses health as well as illness. In the present paper, we address these issues in the context of four disorders that are the greatest source of years lived with disability: neurocognitive disorders, major depression, schizophrenia, and substance use disorders. We emphasize the need for implementation of multidisciplinary team care, with comprehensive assessment, clinical management, intensive outreach, and coordination of mental, physical and social health services. We also underscore the need for further research into moderators and mediators of treatment response variability. Because optimal care of older adults with mental disorders is both patient-focused and family-centered, we call for further research into enhancing the well-being of family caregivers. To optimize both the safety and efficacy of pharmacotherapy, further attention to metabolic, cardiovascular and neurological tolerability is much needed, together with further development and testing of medications that reduce the risk for suicide. At the same time, we also address positive aging and normal cognitive aging, both as an antidote to ageism and as a catalyst for change in the way we think about aging per se and late-life mental disorders more specifically. It is in this context that we provide directions for future clinical care and research.

Trends and Geographic Variabilities in Benzodiazepines Prescription in Primary Care to Older Adults: A 3-Year Population-Based Ecological Study in Portugal.

(1) Background: According to the World Health Organization (WHO), benzodiazepines (BZD) are considered essential medicines for the treatment of several mental disorders in older adults over 65 years old. However, the long-term use of BZD could present a harmful impact on this population, leading to cognitive deficits, drug dependence, falls, and fractures. This study aims to analyze trends of BZD prescription to Portuguese older adults in the primary care setting, and to analyze the change in the prescription rate of BZD over time, assessing the geographical variability in mainland Portugal. (2) Methods: A nationwide, retrospective ecological study was performed between January 2019 and December 2021 for BZD prescribing data reported in a national public database for all persons aged 65 and older in mainland Portugal (about 2.4 million). Trends of BZD by defined daily doses (DDD) and per 1000 older adults’ inhabitants per day (DID) were analyzed. (3) Results: A total of 19 BZD were included in this study and more than 1 million BZD prescriptions were recorded in each year of this study period. BZD prescriptions were three times higher in females than in males. Alprazolam, lorazepam, diazepam, ethyl loflazepate, and bromazepam were the most prescribed BZD over the years, presenting the higher DDD and DID values. (4) Conclusions: Despite the DID value growth of several BZD, Portugal is now showing stable BZD prescriptions in older adults, between the years 2019 to 2021. More studies are needed to access if these results are a consequence of successful health programs or just a consequence of the pandemic context that we are facing, which limited older adults’ clinical appointments.

Introducing New Paths towards Public Primary Healthcare Services in Greece: Efforts for Scaling-Up Mental Healthcare Services Addressed to Older Adults.

The exponential growth in the aging population challenges the Primary Care Providers (PCPs) who provide health care services to older adults who are considered highly vulnerable and are in need of specialized healthcare services. The development of new policies and the adoption of appropriate health strategies by PCPs may improve the early detection and prevention of mental disorders in older adults. This reduces both queuing and costs in outpatient clinics while preventing stigma for patients and families. To this end, specialized training for PCPs at the Local Primary Health Care Unit (LPHCU) was provided in order to conduct efficient assessments of older adults (65 and above years old, without previously diagnosed depression or dementia, and willing to participate). The assessment is based on the Mini Mental State Examination (MMSE) and Geriatric Depression Scale (GDS). Older adults identified with MMSE <20 and GDS >5 were referred to the psychiatric outpatient clinic. The aim of this study is to discuss evidence-informed policymaking in Greece with a focus on advancing mental health practices and scaling up quality primary healthcare services for older adults.

Effectiveness of late-life depression interventions on functional limitations: A systematic review.

ABSTRACTDepression is one of the most prevalent mental disorders in older adults and leads to considerable decreases in health, well‐being, and impaired functioning. Intervention studies have focused on the effects on symptomatic recovery, and most do not include functional recovery as an outcome. Reduction of functional limitations as a treatment goal in old‐age psychiatry aligns with the values of older persons. The objective of this review was therefore to evaluate the effectiveness of late‐life depression interventions on functional limitations. This systematic review identified 15 randomized controlled trials in which the effectiveness of different interventions on functional limitations was evaluated in patients with late‐life depression. The interventions were categorized into four categories: psychological interventions, drug treatment, physical exercise, and collaborative care. Multicomponent and collaborative‐care interventions appear to be the most promising for improvement of functional limitations, particularly in primary care and community‐dwelling populations of older persons with symptoms of depression. There is, however, a lack of evidence regarding studies in specialized mental health care.

Prevalence, Structure, and Risk Factors for Mental Disorders in Older People

This review focuses on assessing the prevalence and risk factors of mental disorders in older people in the modern era, including the COVID-19 pandemic. A systematic review of the literature was conducted in PubMed, Elsevier, and Google using keywords over the past 10 years. Substantial discrepancy of data on the prevalence of psychiatric disorders has been shown in the elderly population. The significant incidence of mental disorders among nursing home residents is highlighted. The relevance of nonpsychotic depressive and anxiety disorders is demonstrated for the elderly, along with the difficulty of diagnosing mental disorders associated with physical pathology and cognitive impairments. The risk factors for mental disorders in older adults are socio-demographic but also economic, psychological, and physical. The problem of mental health of the elderly is characterized for the conditions of the COVID-19 pandemic associated with specific risk factors for psychiatric disorders. The shortage of evidence-based research in the treatment of mental disorders in the elderly and the urgency to improve the organization of psychiatric care for such patients are noted. Understanding the structure and prevalence of mental disorders among the elderly will allow optimizing the functioning of healthcare systems.

Screening tools for common mental disorders in older adults in South Asia: a systematic scoping review.

Common mental disorders (CMDs), particularly depression, are major contributors to the global mental health burden. South Asia, while diverse, has cultural, social, and economic challenges, which are common across the region, not least an aging population. This creates an imperative to better understand how CMD affects older people in this context, which relies on valid and culturally appropriate screening and research tools. This review aims to scope the availability of CMD screening tools for older people in South Asia. As a secondary aim, this review will summarize the use of these tools in epidemiology, and the extent to which they have been validated or adapted for this population. A scoping review was performed, following PRISMA guidelines. The search strategy was developed iteratively in Medline and translated to Embase, PsychInfo, Scopus, and Web of Science. Data were extracted from papers in which a tool was used to identify CMD in a South Asian older population (50+), including validation, adaptation, and use in epidemiology. Validation studies meeting the criteria were critically appraised using the Quality Assessment of Diagnostic Accuracy Studies - version 2 (QUADAS-2) tool. Of the 4694 papers identified, 176 met the selection criteria at full-text screening as relevant examples of diagnostic or screening tool use. There were 15 tool validation studies, which were critically appraised. Of these, 10 were appropriate to evaluate as diagnostic tests. All of these tools assessed for depression. Geriatric Depression Scale (GDS)-based tools were predominant with variable diagnostic accuracy across different settings. Methodological issues were substantial based on the QUADAS-2 criteria. In the epidemiological studies identified (n = 160), depression alone was assessed for 82% of the studies. Tools lacking cultural validation were commonly used (43%). This review identifies a number of current research gaps including a need for culturally relevant validation studies, and attention to other CMDs such as anxiety.

Prevalence of Common mental disorders in older adults: Results from the National Mental Health Survey of India

We estimate the prevalence of common mental disorders (CMD) among older adults and compare them with that of younger adults at the national level. We analysed data on older adults from the National Mental Health Survey of India undertaken across 6 regions and 12 states of India during 2015-16. Multi-stage cluster sampling technique was adopted which permitted state level and subsequently pooled national estimates. Mini International NeuroPsychiatric Interview (MINI) adult version 6.0 was used for measuring psychiatric morbidity. Older adults had a higher lifetime (6.93%) and current (3.53%) prevalence of depressive disorders as compared to the younger adults (4.96% and 2.54%). There was no difference in the prevalence of anxiety disorders in different agegroups. The most prevalent anxiety disorder in older adults was specific phobias (1.72%) followed by agoraphobia (1.6%). All CMD in the older population were more common in females, those living in urban metros, the unemployed, who were not currently married and those with lower household income. These findings support planning better mental health policies and programs for older adults in India.

Reference architectures for ambient assisted living: a scoping review protocol

IntroductionFor the first time in human history, the number of older people will be higher than the number of children. The prevalence of chronic diseases, such as hypertension, cardiovascular disease,...

The Relationship between Depression and Fear of Falling in Older Adults Referred to Rasht Comprehensive Health Centers

Background: Increased life expectancy has increased the likelihood of chronic diseases. Depression, as the most common mental disorder for older adults, and fear of falling, which may lead to lower self-esteem and self-efficacy, can be barriers to proper physical activity. Objectives: The current study aimed to determine the relationship between depression and fear of falling in older adults. Methods: This descriptive-correlational study was conducted in 2018 on 90 randomly selected older adults aged 60 years and older referred to comprehensive health centers in the city of Rasht. Data were collected using a questionnaire on demographic information, a 15-item Geriatric Depression scale, and Falls Efficacy Scale-International Form. Data were analyzed through SPSS version 21 using descriptive and inferential tests (the Spearman and the Mann-Whitney U correlation coefficient). A P value of &lt; 0.005 was considered as statistically significant. Results: Most of the participants (60%) were female. The mean age was 68.44 ± 7.60 years, the mean depression score was 7.40 ± 2.03, and the mean fear of falling was 36.97 ± 12.73. There was a significant positive correlation between depression and fear of falling (r = 0.420, P = 0.0001). Conclusions: These findings clarify the importance of proper planning by health authorities to prevent and treat mental disorders in older adults.

Depression Agency-Based Collaborative: Effect of Problem-Solving Therapy on Risk of Common Mental Disorders in Older Adults With Home Care Needs

Interventions to prevent depression in older adults have mainly focused on young-old ambulatory adults, not on the old-old with disabilities who receive supportive services in their homes. The Depression Agency-Based Collaborative (Dep-ABC) is a single-blind pilot randomized controlled trial assessing the effect of an intervention-development strategy using problem-solving therapy (PST) on the risk of common mental health disorders in this vulnerable population. The intervention involved six to eight sessions of PST over 12 weeks. Participants were followed up to 12 months postintervention. Dep-ABC randomized 104 participants-68.4% of eligible and 17.5% of all older adults screened. The proportion of participants with incident major depressive disorder or generalized anxiety disorder was 11.4% in PST and 14.3% in the enhanced usual care control arm. A test of the interaction between time and intervention for anxiety symptoms favored the PST arm (p = 0.04). PST did not lower the risk of incident common mental illness but did lower anxiety symptom burden. Apart from low power, the effects of PST may have been blunted by referral for medical and aging services in the enhanced usual care group.

Feasibility and Conceptualization of an e-Mental Health Treatment for Depression in Older Adults: Mixed-Methods Study.

BackgroundDepression is one of the most common mental disorders in older adults. Unfortunately, it often goes unrecognized in the older population.ObjectiveThe aim of this study was to identify how Web-based apps can recognize and help treat depression in older adults.MethodsFocus groups were conducted with mental health care experts. A Web-based survey of 56 older adults suffering from depression was conducted. Qualitative interviews were conducted with 2 individuals.ResultsResults of the focus groups highlighted that there is a need for a collaborative care platform for depression in old age. Findings from the Web-based study showed that younger participants (aged 50 to 64 years) used electronic media more often than older participants (aged 65 years and older). The interviews pointed in a comparable direction.ConclusionsOverall, an e-mental (electronic mental) health treatment for depression in older adults would be well accepted. Web-based care platforms should be developed, evaluated, and in case of evidence for their effectiveness, integrated into the everyday clinic.

Identified mental disorders in older adults in primary care: A cross-sectional database study

Introduction: Identifying and managing mental disorders among older adults is an important challenge for primary care in Europe. Electronic medical records (EMRs) offer considerable potential in this regard, although there is a paucity of data on their use for this purpose.Objectives: To examine the prevalence/treatment of identified mental disorders among older adults (over 55 years) by using data derived from EMRs in general practice.Methods: We utilized data from a cross-sectional study of mental disorders in primary care, which identified patients with mental disorders based on diagnostic coding and prescribed medicines. We collected anonymized data from 35 practices nationally from June 2014 to March 2015, and secondary analysis of this dataset examined the prevalence of mental disorders in adults aged over 55 years.Results: 74,261 patients aged over 55 years were identified, of whom 14,143 had a mental health disorder (prevalence rate of 19.1%). There was considerable variation between practices (range: 3.7–38.9%), with a median prevalence of 23.1%. Prevalence increased with age, from 14.8% at 55–59 years to 28.9% at 80–84 years. Most common disorders were depression (17.1%), panic/anxiety (11.3%), cognitive (5.6%), alcohol (3.8%) and substance use (3.8%).Conclusions: Examining mental disorders among older adults using data derived from EMRs is feasible. Mental disorders are common among older adults attending primary care and this study demonstrates the utility of electronic medical records in epidemiological studies of large populations in primary care.

Prevalence, Correlates, and Treatment of Mental Disorders among Lebanese Older Adults: A National Study

Data on the mental health of older adults in the Middle East is lacking. Prevalence of mental disorders in Lebanese older adults (age: 60+ years) as well as accounts of their attitude towards seeking professional help for mental disorders were investigated. The results of older adults were compared to a younger age group (18-59 years). Cross-sectional nationally representative study, using data from the Lebanese Evaluation of the Burden of Ailments and Needs of the Nation. Community-based epidemiologic survey. Community-dwelling adults (N = 2,857) in Lebanon. Mental disorders were evaluated using the World Health Organization Composite International Diagnostic Interview. The lifetime and 12-month prevalences of having "any mental disorder" in older adults (N = 593) were 17.4% and 10.6%, respectively, and were significantly lower than the prevalence in younger adults (25.7% and 18.5%, respectively). Female sex, low household income, social disability, and exposure to war trauma were significant correlates of 12-month mental disorders in older adults. Of those with a 12-month mental disorder, 16.0% sought professional help for their condition in the past year. As shown in other epidemiologic studies, the prevalence of mental disorders in Lebanon was lower in older adults as compared to younger adults. Several factors in epidemiologic studies, however, may contribute to the underdiagnosis of mental disorders in older adults. No significant differences in attitude towards mental health services were found between older and younger age groups. The importance of interventions that improve the social relationships of older adults is highlighted.

Book Review: Geriatric Psychiatry: Mental Disorders in Older Adults: Fundamentals of Assessment and Treatment, 2nd Edition

Book Review: Geriatric Psychiatry: Mental Disorders in Older Adults: Fundamentals of Assessment and Treatment, 2nd Edition