FINAL Study Guide Mental Health Factors Associated with the risk for mental health disorders in later life Lower SES and education Poor nutrition Reasons why depression may be under diagnosed in older adults Medical ageism which could occur where doctors may perceive depression as a normative part of the aging process so they do not diagnosis it It is also more difficult to diagnosis depression in later life because many of the symptoms e g loss of appetite changes in sleep could also occur with normal aging Older adults may not identify themselves as being depressed because of the stigma around mental illness for older cohorts Higher rates of depression in later adulthood among those in health care settings Physiological causes of late life depression Neurological issues Alzheimer s and other dementias Insufficient supplies of neurotransmitters Social causes of late life depression Loss of loved ones e g widowhood loss of friends Relocation to long term care Poor health chronic disease Feeling unsafe or insecure in the neighborhood Depression treatments Psychotherapeutic interventions effective with older adults o Cognitive therapy alters maladaptive thoughts o Behavior therapy changes activities to modify mood o Therapy is more effective than medication alone o Treatment should be strength based focus on the positives Gender differences in suicide in later life Highest rate is males over the age 85 Males have the most successful attempts because they use more aggressive ways i e guns Risk factors for late life suicide Physical illness chronic pain Depression and alcoholism Unmarried or recent losses e g widowers Challenges associated with identifying older adult alcohol abuse Resembles other medical conditions dementia Medical problems may mask alcoholism Medications and alcohol interact in later life Medication intensifying the effects and the danger Drug abuse is less of a problem for older people than alcohol Main drug abuse involves tranquilizers Consequences falls fractures depressions and memory impairments Sensory loss is associated with paranoid disorders in later life If you can t find something you think someone is hiding it from you If you are having trouble hearing you think people are talking about you There are ways to correct compensate for sensory loss ex hearing aid Symptoms and potential causes of delirium Occurs suddenly and is often temporary and often misdiagnosed Most common trigger is drug interactions medications Other causes fractures infections fever electrolyte imbalances pain head trauma other brain diseases nutritional deficits lack of exposure to sunlight sundowning move to new surroundings stress and alcohol Barriers to older adults using mental health services Expense Stigma of mental illness Skepticism of benefits Two most common types of dementia are Alzheimer s and Vascular Dementia Biological pathological changes in the brain involved in Alzheimer s disease Biological loss of brain neurons progressive and degenerate Pathological Amyloid plagues degenerated never endings with an amyloid core and neurofibrillary tangles tangled protein strands within cell bodies of neurons Factors that may prevent Alzheimer s disease Cardiac fitness reduce cholesterol control blood pressure reduce weight control diabetes eat five servings of fruit and veggies each day eat fish once a week reduce transfats mental exercise more education attend religious services be socially active don t smoke take anti inflammatory drugs and hormone replacements Stress and Coping in Later Life Types of stressors Life Events Require significant adjustment o Ex widowhood retirement and relocation to long term care Chronic Stressors Persistent hardships or problems o Ex Poverty and family caregiving Daily Hassles Routine challenges of everyday life o Ex Arguments mistakes and being late Age differences in exposure and reactivity to stressors Most daily stressors young adults Most interpersonal tensions young adults Most overloads middle aged adults Most network stressors older adults Problem focused coping Doing something directly related to the problem ex studying for an exam Emotion focused coping Dealing with one s feelings situations that are difficult or impossible to tackle ex expressing anger over an illness Strategies older adults use to cope with stressors Practice makes perfect Involves managing the meaning of situations compare self to others in similar positions Change priorities Focus on past successes Physiological stress response changes with age by becoming less responsive more difficult to deactivate or shut down our stress response and stress hormones are elevated in older adults Stress does accelerate the aging process Those under excessive stress show earlier ageing Stress is associated with increased risk of disease diabetes heart disease osteoporosis etc Stress eats away the hippocampus Successful Aging SOC Model of Successful Aging Select Select certain domains of activities select activities that you can still do o Ex Difficulty driving at night so select social events that occur during the day Optimize Performance through practice and new technologies o Ex Pianist practices more before concert Compensate For age related declines ex slowing of behavior memory and physical demands o Ex Pianist slows down before fast segments seems like he s playing faster The Vaillant Study Groupings The happy well physically healthy and find life satisfying the sad sick various ailments who do not seem to enjoy life and prematurely dead Seven keys to aging well Not smoking or quitting early before 50 Ability to take life s ups and downs in stride be adaptive and roll with it Absence of alcohol abuse yourself or your partner Healthy weight A solid marriage solid support system Physical activities exercise Years of education Importance of lifestyle factors for health and aging Financial security productivity and employment independence and mental activity Orientation towards the future Gratitude forgiveness and optimism Ability to reach out Empathy The Demography of Aging Challenges Opportunities Factors related to the changing age structure of the US Increase in average life expectancy Change in immigration patterns Change in fertility patterns across cohorts Implications of changing age structure population aging Medical and technological advances challenges o Predicted increase in long term care services in the future o Multiple chronic conditions heart disease cancer