Running head: Improving Mental Health 1

Improving Mental Health in the Geriatric Population: Dementia and Alzheimer’s

Bianca A. Dodson

James Madison University

NSG 325: Concepts in Aging

Professor Andrews

November 26, 2020

Abstract

The purpose of this research paper aims to evaluate and discuss the comorbidities of mental

health disorders and physiological health conditions in the geriatric population. Specifically,

depression and anxiety will be examined in the geriatric population, along with those who suffer

from dementia and/or Alzheimer’s disease. Studies have been conducted that evaluate gender

differences in the impact of mental health disorders, ways to improve mental health in the

community, and mental health issues that arise in later-life. All of which were analyzed for this

research paper.

Keywords: geriatric depression, anxiety, dementia, Alzheimer’s, aging and mental health, mental

illness, physiological conditions, quality of life

Improving Mental Health in the Geriatric Population: Dementia and Alzheimer’s

A person’s condition with regard to their psychological and emotional well-being is often

described as a person’s mental health. Mental health signifies a person’s ability to cope

effectively and manage life’s stresses in an effort to maintain a balance of emotions (Eliopoulos,

2018). Most older individuals have an advantage over other age groups in that they often times

have more experience with coping, problem-solving, and managing crises because of the time

they have lived (Kropft, 2018). Many myths still prevail regarding mental health and the geriatric

population. For example, many people still believe that the loss of mental function and/or mental

incompetence is a natural part of the aging process because of the commonality of impaired

cognitive function that presents in many older individuals. When in fact, cognitive function in

later life is highly individualized (Eliopoulos, 2018). It is based off of personal resources to

health care, health status, and the unique experiences of the person’s life (Eliopoulos, 2018).

Health care is also faced with an ageing population with highly complex needs due to

multimorbidity and associated disabilities (Baladón, 2016).

Selected Mental Health Problems

For each condition listed, a brief summary of the nature of the mental illness is described,

as well as the impact it has on a patient’s quality of life.

Depression

Depression is a mental health disorder characterized by a “persistent depressed mood or

loss of interest in activities”, which can often cause a significant impairment in a patient’s daily

life (Kropft, 2018). Consider the adjustments and losses an older person faces, such as the

independence of one’s children’ the reality of retirement; significant changes or losses of roles;

reduced income restricting the pursuit of satisfying leisure activities and limiting to the ability to
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meet basic needs; decreasing efficiency of the body; changing self-image; death of family

members and friends, and the reality of one’s own shrinking life span (Villarreal, 2015).

According to Eliopoulos, it is the most frequent problem that psychiatrists treat in older adults

(2018). Depression can be very complex and is demonstrated in a variety of ways in the geriatric

population. The most common manifestations of this disease within this population are insomnia,

fatigue, anorexia, weight loss, and constipation (Eliopoulos, 2018).. Hygienic practices may also

be neglected, as well as the way a person socially interacts with others. Depressive symptoms

often times mimic symptoms of dementia and/or Alzheimer’s, which is often why depression is

overlooked and/or neglected (Eliopoulos, 2018). Studies have shown that the impact of mental

disorders and physical conditions affect men and women equally but affected patients with other

chronic conditions with a greater impact (Baladón, 2016).

Anxiety

Anxiety is a mental health condition that is often described as a feeling of worry,

nervousness, or unease (Eliopoulos, 2018). Typically, the person feels this way about an

impending event or something with an uncertain outcome. Anxiety is manifested in various

ways, including somatic complaints, rigidity in thinking and behavior, insomnia, fatigue,

hostility, restlessness, chain-smoking, pacing, fantasizing, confusion, and increased dependency

(Eliopoulos, 2018). Anxious people need their lives to be simplified and stable, with few

unpredictable occurrences, which is often why the geriatric population struggles with anxiety.

Their lives are often unstable due to significant changes in independence, roles, decreasing

efficiency of the body, death of family members and friends, and the reality their own shrinking

life span (Eliopoulos, 2018).

Dementia/Alzheimer’s

Dementia is defined as an “irreversible, progressive impairment in cognitive function

affecting one’s memory, orientation, judgement, reasoning, attention span, language, and ability

to problem-solve”, that is caused by damage or injury to the brain (Eliopoulos, 2018).

Alzheimer’s disease is the most common form of dementia and is characterized by two changes

in the brain’ presence of neuritic plaques and neurofibrillary tangles in the cortex. Other changes

that are seen in Alzheimer’s patients are changes in the neurotransmitter systems, including

reductions in serotonin receptors, which are also associated with depression. Symptoms of this

disease are progressive and develop gradually at different rates among affected individuals.

Promoting Mental Health in Older Adults

Mental health implies a satisfaction and interest in life when it comes to the geriatric

population. Practicing “good” mental health throughout an individual’s life often promotes good

mental health in later life. In order to do so, people should maintain the activities and interests

that they find enjoyable. This gives them the opportunity to “sense their value as a member of

society” and it also reinforces their feeling of self-worth (Eliopoulos, 2018).

Treatments

There is a wide range of options available when it comes to treating depression and

anxiety, ranging from outpatient-based to inpatient-based treatment services. Knight’s study

focused on the use of a mental health day treatment service, specifically for the elderly

population. According to Knight, the “purpose of this study was to evaluate a 10-week multi-

modal mental health day treatment program for elderly clients with mood and anxiety disorders”

(2017). The results showed statistically and clinically significant improvements in client’s

symptoms, evidenced by reductions on the Geriatric Depression Scale in clients who completed
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the program (Knight, 2017). Other pharmacological treatments for depression and anxiety

include the use of SSRIs, SNRIs, benzodiazepines, etc (Eliopoulos, 2018).

Conclusion

Mental health signifies a person’s ability to cope effectively and manage life’s stresses in

an effort to maintain a balance of emotions (Eliopoulos, 2018). There are many of factors that

play into the role of an individual’s mental health. These factors affect each person individually

and take part in the development of mental health comorbidities. For example, a patient may

experience depression and/or anxiety after loosing a loved one, which makes them more

susceptible to developing some sort of dementia as they age. The more trauma a person

experiences, the more likely they are to struggle with mental health. Although mental health is a

constant battle there are many different treatments that aim to mask the symptoms of anxiety and

depression, as well as treatments to slow or stop the progression of dementia and/or Alzheimer’s.
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References

Baladón, L., Rubio-Valera, M., Serrano-Blanco, A., Palao, D., Fernández, A., Baladón, L.,

Palao, D. J., & Fernández, A. (2016). Gender differences in the impact of mental

disorders and chronic physical conditions on health-related quality of life among non-

demented primary care elderly patients. Quality of Life Research, 25(6), 1461–1474.

Eliopoulos, C. (2018). Gerontological Nursing. Philadelphia, PA: Wolters Kluwer.

Knight, C. A., & Alarie, R. M. (2017). Improving Mental Health in the Community: Outcome

Evaluation of a Geriatric Mental Health Day Treatment Service. Clinical Gerontologist,

40(2), 77–87.

Kropf, N. P. (2018). Older Adults, Caregiving, and Late-Life Mental Health Issues. Generations,

42(3), 23–29.

Villarreal, A. E., Grajales, S., Lopez, L., Britton, G. B., & Initiative, P. A. R. (2015). Cognitive

Impairment, Depression, and Cooccurrence of Both among the Elderly in Panama:

Differential Associations with Multimorbidity and Functional Limitations. BioMed

Research International, 2015, 1–7.