Mental Health and the Silver Tsunami

Over the past few years, I’ve been pleased to see mental health getting more of the attention it deserves as a factor in overall health. But as a physician who specialized in geriatrics, I feel more awareness is needed of the mental health of older adults. There’s no better time than now, after we’ve been social distancing for months through the COVID-19 (Coronavirus) pandemic. For many, social isolation has put them at a higher risk for anxiety and depression.

In my experience, dealing with geriatric mental health issues is among the most complex challenges in caring for older adults. With an aging population, this concern will likely grow.

Our Population Is Changing: The Silver Tsunami

The world’s population is aging rapidly. The World Health Organization estimates that the percentage of the geriatric population in the world will nearly double, going from 12 percent in 2015 to 22 percent in 2050! Some call this age boom the “silver tsunami.” With this huge shift in the population, it is critical that we focus on the special needs of older adults — regarding both their physical and mental health.

We all know and love someone who is an older adult. Some are still working, and many volunteer their time. While most may have good mental health, geriatric mental health issues are a concern for others. Older adults are at risk for developing mental disorders, whether alone or in combination with other chronic health conditions.

Geriatric Mental Health Issues, Loneliness, and Aging

About one in four American adults ages 60 and older suffer from some type of mental health issue. Depression and dementia are the top two offenders. Unfortunately, these diagnoses are not always identified by older adults, their caregivers, or their families. Add to that the stigma that surrounds mental illness, and you get an even bigger hurdle to seeking help.

A Mental Health America survey identified several factors that may prevent early diagnosis and treatment of geriatric mental health issues:

• About 68 percent of older adults know little about depression.
• Only 38 percent of older adults think depression is a “health” problem.
• When older adults have depression, they are the group that is most likely to “handle it by themselves.” Less than 50 percent seek help from a health professional.
• About 58 percent of older adults feel it is “normal” to be depressed as we grow older.

Recognizing Depression and Social Isolation in Older Adults

So, what can you do if you feel you or a loved one may be suffering from a mental health problem, particularly depression? Remember that the symptoms can be very subtle — it’s not always obvious signs like sadness and crying. You might notice changes in personality, withdrawal from normal social activities, or a change in weight, appetite, or sleep. Basically, if something just doesn’t seem right, talk to your doctor. Health care professionals are becoming more educated about geriatric mental health issues and can often do a screening in their office. Trust your doctor to get you the help you need.

Even if you don’t suspect something as serious as depression, keep in mind that isolation and loneliness in older adults is an even bigger problem in the United States. According to the U.S. Census Bureau, 11 million people ages 65 and older lived alone in 2010. Living alone doesn’t necessarily mean you will become socially isolated, but it can contribute to it. Social distancing through the COVID-19 (Coronavirus) pandemic doesn’t help.

Keep these important facts about isolation of older adults in mind:

• Isolation and feelings of loneliness can hurt both physical and mental health and increase cognitive decline, risk of dementia, and risk of mortality.
• Social isolation puts seniors at risk for elder abuse.
• Isolated seniors are more likely to need long-term care, which is very expensive for them and our entire health care system.
• Caregivers of older adults are also at risk for social isolation.
• Lonely people are more likely to engage in unhealthy behaviors.

Finding Help for Older Adults in Need

If you are an older adult and considering ways to combat loneliness and isolation, think about volunteering, taking a class, or participating in your local senior center. And talk with your doctor — loneliness and depression don’t have to be part of aging!

If you know an older adult, ask yourself if you think he or she is isolated or lonely. Even in a big city like Philadelphia where you’re surrounded by people, we can be lonely and isolated. Make time to visit or offer to help with little jobs. If you have kids, include them in these visits, too.

Visit the Pennsylvania Department of Aging to find local resources for geriatric mental health issues and other challenges. If you’re concerned about an older adult in another state, you can find information and resources at eldercare.acl.gov.