PSYC 168 Lecture 15: Disorders of Aging and Cognition-CLASS
Disorders of Aging and Cognition
- Old age brings special pressures, unique upsets, and major biological changes
- Variety of psychological disorders are tied closely to later life
- Psychological pressures related to aging
- Unique traumatic experiences
On the Rise
- The population of people ages 65+ in the U.S. has increased 14-fold since the beginning
of the 20th century
- The % of elderly people in the population is expected to be more than 20% in 2030
- Older women outnumber older men 3:2
Old Age and Stress
- Geropsychology is the field of psychology dedicated to the mental health of elderly
people
- The stresses of elderly people need not result in psychological disorders; however:
- As many as 50% of elderly people would benefit from mental health services
- Fewer than 20% actually receive them
- ~1/2 of all adults > 65 y.o. have 2 or 3 chronic illnesses
- 15% have 4+
The Oldest Old
- There are currently ~65,00 centenarians in the U.S. (older than 100)
- On average, they are more healthy, clear-headed, and agile that those in their 80s
- Many are employed, sexually active, and enjoy outdoors and the arts
- What is the secret? Longevity gene, engaged lifestyle, robust personalities
Old Age and Status
- The psychological problems of alertly persons may be divided into two groups
Depression in Later Life
- One of the most common mental health problems of older adults
- As many as 20% of people experience this disorder at some point during old age;
highest in older women
- 11.4 mill widow vs. 2.8 widowers
- Depression among older people raises risk of developing significant medical
problems and committing suicide
- Therapy
- Behavioral therapy
- Interpersonal
- Medication
- Combo of all
- Impact
- Depression improvement with over 50% of older patients
- Antidepressant drugs side effects
Anxiety Disorders Later in Life
- Common among elderly
- Around 11% of elderly in U.S. experience at least one of the anxiety disorders
- Prevalence of anxiety increases throughout old age
- These numbers may be low as anxiety in elderly often goes unrecognized by
clinicians
- Causes
- Declining health, health related events
- Losses
- Treatment
- Psychotherapy (particularly CBT)
- Anxiolytics
- Proceed with caution (notable effect on cognition in older people)
Substance Abuse Later in Life
- Alcohol-related disorder
- 3-7% of older people, particularly men, have alcohol-related disorders in a given
year
- Differences b/w new and LT older problem drinkers
- Alcohol use disorder is treated much the same as in younger adults
- Detox, Antabuse, AA, CBT
- Prescription drug misuse
- Leading kind of substance use disorder in the elderly
- Most often unintentional
- People > 50 buy 77% of al Rx drugs and 61% of all OTC drugs
- Elderly receive 2x as many Rx as younger people and around 1/2 of them take at
least 5 Rx and 2 OTC (^ risk of mixing up!)
- Nursing home medication misuse
Psychotic Disorders in Later Life
- Elderly people have a higher rate of psychotic symptoms than younger people
- Causes
- Among aged people, these symptoms are usually due to underlying medical
conditions such as the disorders of cognition
- Can also be due to schizophrenia or delusional disorder
- Schizophrenia is less common in older people than younger ones
- Symptoms lessen later in life
- Emergence of new cases uncommon
- Delusional disorder develops in a few elderly people
- Rare in all age groups but prevalence increases in the elderly
Disorders of Cognition
- With age, memory difficulties and lapses of attention increase, and they may occur
regularly by the age of 60 or 70
- Most diagnosable cognitive problems have organic roots, particularly when they appear in
later life
- The leading cognitive disorders among elderly people are delirium, neurocognitive
disorder, and mild neurocognitive disorder
Delirium
- Characterized by a major disturbance in attention and orientation to the environment
- Awareness of the environment becomes less clear and often accompanies great
difficulty concentrating and thinking in an organized way
- Leads to misinterpretations, illusions, and, on occasion, hallucinations
Alzheimer’s Disease and other Neurocog Disorders
- Neurocog disorder is characterized by significant decline in at least one area of cognitive
functioning
- Memory/learning
- Attention
- Visual perception
- Planning/decision making
- Language ability
- Social awareness
- Personality and behavior changes
Document Summary
Old age brings special pressures, unique upsets, and major biological changes. Variety of psychological disorders are tied closely to later life. The population of people ages 65+ in the u. s. has increased 14-fold since the beginning of the 20th century. The % of elderly people in the population is expected to be more than 20% in 2030. Geropsychology is the eld of psychology dedicated to the mental health of elderly people. The stresses of elderly people need not result in psychological disorders; however: As many as 50% of elderly people would bene t from mental health services. ~1/2 of all adults > 65 y. o. have 2 or 3 chronic illnesses. There are currently ~65,00 centenarians in the u. s. (older than 100) On average, they are more healthy, clear-headed, and agile that those in their 80s. Many are employed, sexually active, and enjoy outdoors and the arts. The psychological problems of alertly persons may be divided into two groups.
