As many of
you might already know, psychology is an umbrella term that branches into a
multitude of different specialized fields. A few examples would be the field of
abnormal psychology, neuropsychology, or geriatric psychology. In this piece,
we are hoping to broaden your knowledge of the other areas of psychology,
specifically, geriatric psychology.
What is geriatric psychology?
Geriatric psychology is defined as the branch of psychology that focuses on treating and upholding the mental and physical health of individuals in the geriatric population, usually age 65 years old and above, as well as studying the effects of aging on these factors. In fact, the world ‘geriatric’ itself refers to an elderly person.
The importance of geriatric psychology
A common
question that often pops up when being first introduced to geriatric psychology
is ‘what’s so special about the psychology of the elderly that it needs its own
subcategory?’.
The significance
of geriatric psychology, like a flower, unveils itself to us slowly as we progress
through our lives. As time flows by, our bodies undergo new and unpredictable
changes, leading us to become more susceptible to new diseases and disorders. Additionally,
many classical tell-tale symptoms of specific disorders or illnesses in our
youths may differ quite significantly from those in our seniors. For instance, the
diagnosis of anxiety, depression, or psychosis in the elderly becomes especially
complex due to the difficulty in distinguishing between its symptoms and normal
aspects of aging.
Another factor that demonstrates the importance of the study of geriatric psychology is the high prevalence rates of mental disorders among the elder, especially depression. Recent epidemiological studies have indicated that a large number, over 20%, of the geriatric population without dementia have one or more mental disorders.
The prevalence of geriatric depression
The most common among them is depression, with a prevalence rate of 5% to 10% and 1% to 5% for Major Depressive Disorders. Furthermore, these figures have not included consideration that the study was conducted in a rural community, which means the prevalence may be even higher in more developed areas. A pooled assessment of multiple previous studies have also pointed out that the prevalence of depression may also increase with age, showing that the rates of depressive symptoms increase to 17.1% in individuals age 75 years and above, to 20% to 25% for those age 85 years old and lastly spiking to 30% to 50% for those 90 years old and above.
Thankfully, this trend was only found in depressive symptoms and does not apply to major or minor depression. Nevertheless, we cannot forget that these reported rates may not be an accurate representation due to the difficulty in accurately distinguishing the normal effects of aging from depression. This poses another potential danger to the elderly in the form of overdiagnosis and underdiagnosis. Overdiagnosis of disorders may result in unnecessary stressors for the elderly ranging from the consumption of unneeded medication to labels and stigmatization associated with mental disorders. All of which can lead to the development of an actual mental disorder. On the other hand, underdiagnosis can lead to the elderly who are clinically depressed to be ignored and refused treatment, resulting in the disorder being left unchecked, which may have serious consequences.
Dangers of geriatric depression
Despite
the stereotype of a happy and stress-free elderly life, the dangers associated
with depression do not get less severe with age. In truth, they are even worse in
comparison to the youth population. Previous studies have shown that geriatric
depression has been correlated with greater non-suicide and suicide mortality
in comparison to youth or adults. Although the studies investigating geriatric
suicide indicated that suicide ideation decreases with age, individuals in the
geriatric population are still more likely to act on their suicidal ideation and
complete it.
In fact, 1 in 4 suicide attempts are completed in the elderly as compared to 1 in 200 completed suicide attempts in the general population. Additionally, an increase in age has been further correlated with increased self-destructive acts with even fewer warning signs. Therefore, a large portion of our elderly are in great peril and we must remain vigilant to the possible symptoms and warning signs of not only depression but suicidal ideation as well.
Risk factors and contributors of geriatric depression
Now that
you are aware of the prevalence and dangers of geriatric depression, it would
be fitting to inform you about what can lead to its development. Risks factors
for geriatric depression can be split up into two distinct groups, biological
risk factors, and psychosocial risk factors.
The main biological contributors consist of vascular diseases, cerebrovascular injury, and cerebral compromise with droves of studies displaying a strong correlation between them and geriatric depression. While these factors alone do not directly cause depression, they create a disruption in the functioning of multiple brain areas such as the prefrontal systems, hippocampus, anterior cingulate cortex, orbitofrontal cortex and basal ganglia which affects our mood and leads to the development of depression.
These findings also show that our physical and mental health are just different sides of the same coin and making an effort to maintain our bodies in tiptop shape can do wonders for our mental health as well.
On the
other side, we have the psychosocial contributors. Personality attributes,
specifically neuroticism, which is the increased tendency to experience
negative states, was discovered to be a significant and consistent predictor of
geriatric depression. Elderly who possessed neurotic personalities had shown a higher
likelihood of developing depression and depressive symptoms as compared to
those without neurotic personalities.
The circumstances that come along with geriatric life is another psychosocial contributor. Common unfortunate circumstances such as chronic illnesses and daily hassles, may result in the cultivation of cognitive distortions and negative thought patterns like learned helplessness. All of which are strong predictors of depression and may have adverse effects on one’s mood. Sadly, other common adverse life events such as the death of a loved one and functional decline can also further increase the risk of depression by 3.7 times in a single year.
One of the biggest psychosocial contributors to depression is actually the lack of social support, social isolation, and loneliness. Social support is so critical to psychosocial wellness that just the perception and satisfaction of social support are better predictors of depression than any other measure of network relationships.
Additionally, the repercussions of fractured social relationships in the elderly’s lives are dire and can lead to suicidal behaviours. Hence, all it takes to stave off one of the biggest risk factors for depression is to simply visit our grandparents or having a chat with them over the phone regularly. A small piece of our time can mean the world to them.
It may seem like there are a multitude of psychosocial factors that are responsible for the development of depression, but don’t let that scare you, they all revolve around three common themes, circumstances of aging, negative cognitions, and social support. Thus, our awareness of how the elderly are coping in just these three areas can help prevent the development of geriatric depression in our loved ones.
What we can do to prevent or treat geriatric depression
Despite
the grim nature of what we have discussed in the above paragraphs, not all hope
is lost. There are multiple things we can encourage the elderly to do to
prevent depression.
For example, the World Health Organization (WHO) recommends that maintaining contact with friends and family, disclosing your feelings with those you trust, regular exercise, keeping up with hobbies and trying new activities are good ways to prevent the development of depression. So, the next time you visit your grandparents, how about taking them down for a walk, or introducing them to something new that you love, or just have a chat with them to see how they are doing? Who knows, you might learn a lot from their wealth of knowledge and experience they have accumulated throughout their lives.
Even if the elderly individual is already depressed, fret not, a variety of options for treatment are available, such as a range of psychotherapy and medication that show good effectiveness and relapse prevention. Plus, these services are now much more accessible thanks to new government initiatives and subsidies.
In conclusion, the understanding of geriatric psychology and geriatric depression is crucial in our fight to ensure that our elderly live their golden years as healthily and happily as possible. Hopefully, after reading this, you would all see the world of the elderly in a clearer light and be more aware of not only their physical but psychological needs, so that we may ensure that they are able to enjoy the lives they deserve.
Written by Ng Xinyao. Xinyao is a psychology graduate from NTU, and a writer for hobby to advocate for greater awareness of mental health issues in Asia, with a research interest in the region of neuropsychology. On the flip side, Xinyao enjoys reading manga, playing puzzle games and the guitar.
References
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