Key facts
- By 2030, one-sixth of the world's population will be 60 years of age or older.
- Loneliness and social isolation are major risk factors for mental health conditions in later life.
- One in six older people experiences abuse, often at the hands of caregivers.
- About 14% of adults 60 years or older live with mental disorders.
- Psychological disorders among the elderly represent 10.6% of the total years of living with disability for this age group.
Overview
The world's population is rapidly aging. In 2020, there were one billion people in the world aged 60 or over. This number will increase to 1.4 billion by 2030, representing one in every six people in the world. By 2050, the number of people aged 60 or over will double to 2.1 billion. The number of people aged 80 or over is expected to triple between 2020 and 2050, reaching 426 million people (1).
Older people contribute to society as family and community members, and many are volunteers and workers. While most are healthy, many are at risk of developing mental health conditions such as depression and anxiety disorders. Many may also have decreased mobility, chronic pain, weakness, dementia or other health problems that make them need some form of long-term care. As people get older, they are more likely to have multiple health problems at the same time.
Prevalence rate
About 14% of adults 60 years or older live with mental disorders (2) . According to global health estimates for the year 2019 , these cases represent 10.6% of the total cases of disability (in terms of disability-adjusted life years) among the elderly. Depression and anxiety are among the most common mental health conditions among older people. Global health estimates for 2019 show that approximately a quarter of deaths resulting from suicide in the world (27.2%) occur among people aged 60 years or over.
In many cases, critical health conditions in older people are not known or adequately treated, and the stigma associated with these conditions may make people reluctant to seek help.
Risk factors
In advanced stages of life, mental health is shaped not only by the physical and social environment, but also by the impact of accumulated experiences of past life and stresses related to aging in particular. Exposure to adversity and a significant decline in basic and functional abilities may lead to psychological distress.
Older people are more likely to experience adverse events such as losing loved ones, declining incomes, or feeling a lack of purpose in life after retirement. Despite their significant contribution to society, many older people face discrimination on the basis of age, which can seriously affect people's mental health.
Social isolation and loneliness, which affect nearly a quarter of older adults, are major risk factors for mental health conditions that affect them in later life (3), as well as elder abuse , which includes any type of physical, verbal, psychological, or sexual abuse. Or financial, as well as negligence. One in six elderly people are exposed to abuse, often at the hands of caregivers (4). Elder abuse has serious consequences and may lead to depression and anxiety.
Many elderly people care for their spouses who suffer from chronic health conditions, such as dementia . The responsibilities associated with this care may exceed the caregiver's capabilities and affect his or her mental health.
Some older people are at risk of depression and anxiety as a result of harsh living conditions, poor physical health, or lack of access to quality support and services. This includes older people living in humanitarian crises and those living with chronic diseases (such as heart disease, cancer or stroke), neurological conditions (such as dementia) or problems caused by substance abuse.
Health promotion and prevention
Mental health promotion and prevention strategies for older people focus on supporting healthy aging . This means creating physical and social environments that support well-being and enable people to carry out tasks they find important, despite their declining abilities.
Key strategies for mental health promotion and prevention for healthy aging include:
- Measures to reduce financial insecurity and income inequality;
- Programs to ensure safe and accessible housing, public buildings and transportation;
- Social support for older people and their caregivers;
- Support healthy behaviours, particularly following a balanced diet, physical activity, abstaining from tobacco use, and reducing alcohol use;
- Health and social programs targeting vulnerable groups such as those living alone or in remote areas and those with chronic health conditions.
Social communication is especially important for older people, in order to reduce risk factors such as social isolation and loneliness . At this stage of life, meaningful social activities can significantly improve positive mental health, satisfaction, and quality of life; It can also reduce symptoms of depression. Examples of interventions include befriending initiatives, community and support groups, social skills training, creative arts groups, recreation and outreach services, and volunteer programs.
Protection from age discrimination and abuse is also crucial. Key interventions include anti-discrimination policies and laws, awareness-raising interventions and intergenerational activities. A range of carer-specific interventions - including respite care, counselling, awareness-raising, financial support and psychological interventions - can support carers in maintaining a good, healthy relationship with the care recipient in which there is no room for abuse.
Treatment and care
Rapid recognition and treatment of mental health conditions (and associated neurological and substance use conditions) in older people is essential. This should follow the standards of integrated care for the elderly , which is community-based and focuses on the long-term care of older people with mental health conditions and declining basic capabilities, as well as on the awareness, training and support of caregivers. A combination of mental health interventions and other forms of support is usually recommended to meet the health, personal and social needs of individuals.
Dementia is often a significant source of concern, as it affects people's mental health (by causing symptoms of psychosis and depression, for example), and requires access to quality mental health care.
Addressing elder abuse is also crucial. Promising interventions include mandatory reporting of abuse, self-help groups, telephone helplines and emergency shelters, psychological programs for abusers, training of health-care providers, and other interventions to support caregivers.