Many chronic conditions can be improved, if not cured, by treatment and/or medication, and so it is always worth seeking the advice of a doctor.
Many people mistakenly believe that mental disorders like depression or dementia are normal in older people and that no effective treatments are available. Another myth suggests that older people cannot change, experience psychological and spiritual growth, or contribute to society. Therefore, efforts to enhance their mental health might mistakenly be considered futile.
The subject of mental illness still makes some people uncomfortable. Some feel that getting help is a sign of weakness. Many older people, their relatives, or friends may mistakenly believe that a depressed person can quickly "snap out of it" or that some people are too old to be helped.
Once the decision is made to get medical advice, start with the family doctor. The doctor should check to see if there are medical or drug-related reasons for the depression. After a complete exam, the doctor may suggest talking to a mental-health specialist. The special nature of depression in older people has led to a new medical specialty: geriatric psychiatry.
Be aware that some family doctors may not understand aging and depression. They may not be interested in these complaints. Or, they may not know what to do. If your doctor is unable or unwilling to take your concerns about depression seriously, you may want to consult another health care provider.
If a depressed older person won't go to a doctor for treatment, relatives or friends can help by explaining how treatment may help the person feel better. In some cases, when an older person can't or won't go to the doctor, the doctor or mental-health specialist can start by participating in a phone call. The telephone can't take the place of the personal contact needed for a complete medical checkup, but it can break the ice. Sometimes a home visit can be made.
Don't avoid getting help because you are afraid of how much treatment might cost. Short-term psychotherapy, with or without medication, will work in many case and is often covered by insurance. Also, community mental health centers offer treatment based on a person's ability to pay.
There is no known cure for Alzheimer's disease. However, scientists have found some medications that may help control some of the symptoms. People with AD must work closely with their doctor to determine which drugs and activities are best for them, because reaction to medications varies for each person. Organizations such as the Alzheimer's Disease Education and Referral Center (ADEAR) and the Alzheimer's Association can provide up-to-date information, support, and advice.
Research has shown that a healthy lifestyle is more influential than genetic factors in helping older people avoid the deterioration often associated with aging. People who are physically active, eat a healthy diet, do not use tobacco, and practice other healthy behaviors reduce their risk of suffering from chronic disease and have half the rate of disability compared with those who do not. Screening to detect chronic diseases (such as diabetes or cancers of the breast, cervix, and colon) early in their course can save many lives.
Immunizations against influenza and pneumococcal disease will also reduce a person's risk for hospitalization and death from these diseases. Other preventative measures include removing tripping hazards in the home and installing grab bars, which can greatly reduce the risk of falls and fractures.
Regular exercise is a preventative measure that will enhance quality of life. Research has shown that even among frail and very old adults, mobility and functioning can be improved through physical activity. However, anyone at risk for any chronic diseases, such as heart disease or diabetes, or who smokes or is overweight, should first check with her doctor before becoming more physically active. Older adults also have special considerations:
- Exercise can help older people feel better and enjoy life more, even those who think they're too old or too out of shape.
- Most older adults don't get enough physical activity.
- Regular exercise can improve some diseases and disabilities in older people who already have them. It can improve mood and relieve depression, too.
- Staying physically active on a regular, permanent basis can help prevent or delay certain diseases (like some types of cancer, heart disease, or diabetes) and disabilities.
Plan on making physical activity a part of your everyday life. Do things you enjoy. Go for brisk walks. Ride a bike. Dance. And don't stop doing physical tasks around the house and in the yard. Trim your hedges without a power tool. Climb stairs. Rake leaves.
Make sure you are exercising safely:
- Start slowly. Build up your activities and your level of effort gradually. Doing too much too soon can hurt you, especially if you have been inactive.
- Avoid holding your breath when exerting yourself. It may seem strange at first, but the rule is to exhale during muscle exertion and inhale during relaxation. For example, if you are lifting something, breathe out on the lift; breathe in on the release. If you have high blood pressure, pay special attention to this tip.
- If you are on medications or have any conditions that change your natural heart rate, don't use your pulse rate as a way of judging how hard you should exercise. "Beta blockers," a type of blood pressure drug, are an example of this kind of medicine.
- Use safety equipment, such as helmets, knee and elbow pads, and eye protection.
- Unless your doctor has asked you to limit fluids, be sure to drink plenty when you are doing endurance activities that make you sweat. Many older people do not drink enough fluids, even when not exercising.
- When you bend forward, bend from the hips, not the waist. If you keep your back straight, you're probably bending correctly. If you let your back "hump," you're probably bending from the waist.
- Make sure your muscles are warmed up before you stretch. For example, you can do a little easy biking, or walking, and light arm pumping first.
None of the exercises you do should hurt or make you feel really tired. You might feel soreness, a slight discomfort, or a little weariness, but you should not feel pain. Physical activity and exercise will probably make you feel better.
Finally, exercising the mind is as important as keeping physically active. Recent research suggests that people who regularly engage in mentally stimulating activities such as reading, playing games, doing puzzles, listening to the radio, and visiting museums have a decreased risk of developing Alzheimer's disease. Thus the Japanese proverb "We begin aging when we stop learning" may well prove accurate.
Aging. Last reviewed 12/04/2007
- Centers for Disease Control and Prevention (2007).
- Federal Interagency Forum on Aging-Related Statistics
- National Institute on Aging (2005).
- National Alliance of Mental Illness.
- National Center for Chronic Disease Prevention and Health Promotion
- He W, Sengupta M, Velkoff VA, DeBarros KA (2004). 65+ in the United States: 2004
- Public Health Service (1999). Mental Health: A Report of the Surgeon General
- Social Security Administration (2004). Retirement Benefits