Presentación Color Pastel

MENTAL HEALTH IN OLDER ADULTS

06/10/18

INDEX

- INTRODUCTION ANXIETY DISORDER - DEPRESSION - DEMENTIA - DIAGNOSIS - THERAPEUTIC OPTIONS CONCLUSION BIBLIOGRAPHY

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INTRODUCTION

INTRODUCTION

- Mental illnesses in older people are psychological and neurological disorders- Mental health problems are not an inevitable consequence of aging - According to global health estimates (GHE, 2019), approximately 14% of adults over 60 years of age live with a mental disorder

NORMAL COGNITIVE CHANGES

MENTAL ILLNESSES

- More intense and disruptive ways, significantly affecting the functionality and quality of life

- Slight forgetfulness- Slowness in processing information

ANXIETY DISORDER

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SYMPTOMS

CLASSIFICATION

CLASSIFICATION

GENEREALISED ANXIETY DISORDER

PHOBIAS AND PANIC DISORDERS

OCD

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ASSESMENT

SOCIODEMOGRAFIC DETAILS , INCLUDING STATUS, OCCUPATIONAL FUNCTIONING , LIVING CONDITIONS , FAMILY TYPES AND SOURCE OF INCOME

DIFFERENCES BETWEEN YOUNG AND OLD PEOPLE

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CAUSES

LIMITED PHYSICAL MOVILITY

FINANCIAL INSECURITY

MISUSE OF ALCOHOL

SLEEP DISTURBANCES

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Depression in the elderly

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Concept and causes

- Moving away from home - Children leaving home - Death of spouse or relatives - Loss of independence - Chronic pain or illness

SYMPTOMS

- Persistent mood of sadness - Loss of interest in once pleasurable activities - Fatigue - Sleep problems - Thougths of suicide - Unplanned weight gain or weight loss

Depressive disorder due to a medical condition

Medication-induced depressive disorder

Persistent depressive disorder (dysthymia)

Major depressive disorder

Medical prognosis

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DEMENTIA

SYMPTOMS: Memory loss

SYMPTOMS

Poor judgement and confusion

Difficulty speaking, reading and writing

Wandering

Trouble handling money

Repeating questions

Hallucinations

Not caring

Motor and balance problems

CAUSES AND TYPES

LESS COMMON CAUSES

1. Alzheimer's disease 2. Vascular dementia 3. Parkinson's disease 4. Dementia with Lewy bodies 5. Frontotemporal dementia 6. Severe head injury

1. Huntington's disease 2. Leukoencephalopathies 3. Creutzfeldt-Jakob disease 4. MS and ALS

HEREDITARY DEMENTIA

APP and PSEN1 genes (amyloid)

RISK FACTORS

1. Age 2. Genetics 3. Smoking and alcohol 4. Athherosclerosis and ↑ cholesterol 5. Plasma homocysteine 6. Diabetes 7. Mild cognitive impairment

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DIAGNOSIS

- By observation of the previous mentioned specific symptoms - Specific tests - Complications and singularities in older people: 1) Less likely to complain about losses 2) More likely to present with physical rather than emotional symptoms 3) Risk of attributing symptoms to 'old age' 4) 'What's troubling you at the moment?' / 'What's on your mind?'

- Any new mental health problem in an older person should be considered an infection until proven otherwise - Exclude medication side effects as a cause of the symptoms

Depression

- Same symptoms as younger adults - Somatization, hypochondria - Delusions of poverty, having no clothes which fit, thoughts of impending death... - 'Do you enjoy visits from your grandchildren?' - Distinguish between depression and dementia - Distinguish betweeen depression and normal grief

Anxiety

- Very common in older people - Can be a presenting feature of dementia, depression and other illnesess (myocardial infarction, arrythmia...) - Symptoms of anxiety can be mistaken as signs of physical illness

Dementia

- Recognize the pattern of loss of skills and function- Ask someone close to the person - You will likely need a number of tests to pinpoint the problem: 1) Cognitive and neuropsychological tests 2) Brain scans (CT, MRI, PET scans...) 3) Laboratory tests 4) Psychiatric evaluation

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Therapeutic Options

Anxiety in Older Adults

Psychological Therapies

Pharmacological Therapies

Lifestyle and Non-Pharmacological Approaches

- Selective Serotonin Reuptake Inhibitors (SSRIs)

- Cognitive Behavioral Therapy (CBT) - Mindfulness-Based Interventions

- Exercise Programs - Social Interaction

DEPRESSION IN Older Adults

Psychological Therapies

Pharmacological Therapies

Lifestyle and Non-Pharmacological Approaches

- Antidepressants (SSRIs) - Combination Therapies

- Cognitive Behavioral Therapy (CBT) - Interpersonal Therapy (IPT)

- Physical Activity - Light Therapy

DEMENTIA in Older Adults

Psychological Therapies

Pharmacological Therapies

Lifestyle and Non-Pharmacological Approaches

- Social Groups

- Cholinesterase Inhibitors (donepezil) - Memantine

- Cognitive Stimulation Therapy (CST) - Reminiscence Therapy -Social Activities

INTEGRATED APPROACH

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CONCLUSION

BIBLIOGRAPHY

- https://pmc.ncbi.nlm.nih.gov/articles/PMC5840911/ - https://www.nia.nih.gov/espanol/depresion/personas-mayores-depresion - https://www.mayoclinic.org/es -https://stanfordhealthcare.org/medical-conditions/brain-and-nerves/dementia/risk-factors.html -https://www.nia.nih.gov/health/alzheimers-and-dementia/what-dementia-symptoms-types-and-diagnosis - https://www.england.nhs.uk/wp-content/uploads/2017/09/practice-primer.pdf

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