by Emily-Sarah Lineback

Medical director shares insight into the emotional stability of older adults.

J. Sinclair Photo

A critical part of good health is mental stability. CenterPoint Human Services’ Dr. Chad Stephens, who came onboard last month as the center’s medical director, talks about the senior segment of the population and ways to ensure mental health for older adults.

How common are mental health disorders in seniors?
Mental disorders are prevalent in the elderly and often go unrecognized and untreated, but in general, the rates are not increased above younger adults except for dementia. It is estimated that 16 percent of the elderly have mental health issues other than dementia that are significant enough that the difficulties impair their ability to function. The primary problems are depression, anxiety disorders, sleep disorders, and abuse of alcohol and prescription medication. About 10 percent of the elderly have dementia; however, this is very age-dependent. Only about 1 percent of people ages 60 to 64 have dementia, but the rate doubles every five years. Over age 85, close to half of people have dementia.

It’s said that older adults are underdiagnosed for depression because it is mistaken as a normal part of aging or misdiagnosed when it’s physical problems. What can seniors—and family members—do to make sure they get diagnosed correctly?
This is a very real problem because the diagnostic criteria that were developed for the younger and middle-aged adult population do not work as well when applied to the elderly. The elderly may have depression that significantly impairs their ability to function but not meet the list of standard criteria. This has been called “subsyndromal depression” and occurs three times as often as classic depression in the elderly.

About 18 percent of elderly will eventually suffer with depression. They may have prominent physical symptoms such as change in appetite and weight, constipation, body pain, and insomnia, and it is often combined with a strong component of anxiety. There are more physical comorbidities in the elderly, and cardiovascular illness and stroke are very commonly associated with depression, even in someone who has no prior history of depression.

What things can seniors do to combat mild depression?
The key factors are socialization and attention to overall health, diet, and avoidance of substance abuse. Exercise and light therapy can be very helpful.

Older adults deal with additional transitions: retirement, reduced mobility, a shrinking circle of friends, and/or changing health concerns. How can seniors successfully cope with changes and also stress and trauma?
It is well-documented that an active social support network is central to coping with the inevitable transitions that will occur with aging. Families, churches, neighbors, and agencies that can help engage the elderly in social contact are critical in helping an individual cope with stress. Social structures tend to decline as one ages with the loss of family and friends and limitations the individual may experience. Actively assisting with the social network enhancement and even advocating for services for the elderly who do not have that support can make a tremendous difference.

What are ways that seniors can maintain or regain good mental health, and how can we help them?
This is something we can all prepare for throughout our lives by living healthy lifestyles and engaging ourselves in social activities and learning activities that continue our learning processes. Connecting people with social groups and learning activities and ensuring adequate nutrition and sleep are vital. Another area that is of growing concern is the medications one is on: Are they essential, and are they helpful? Do any have potential adverse effects on cognition, balance, sleep, appetite? Are there drug interactions [side effects or potential problems from multiple medications] that are important?

CenterPoint Human Services is a state-mandated local management entity in charge of overseeing the delivery of publicly funded mental health, developmental disabilities, and substance abuse services in Forsyth, Stokes, Davie, and Rockingham counties. Contact CenterPoint via its 24-hour phone line at 888-581-9988 or learn more at cphs.org