Pictured above: Family members attend a rally for Alzheimer’s awareness at the Arkansas State Capitol.

 

Mental well-being is just as important as physical health, and though there has been a decades-long initiative to remove stigma from seeking help, mental illness continues to impact the aging population. According to National Alliance on Mental Illness (NAMI), one in five adults in the United States experience mental illness each year, and 457,000 adults in Arkansas had a mental health condition as of 2021.

 

While not all adults with a mental health condition fall into an aging population, which is classified by the Population Reference Bureau as adults 65 years old and over, it is important to remember that aging individuals are not exempt from common struggles with mental health.

 

Mental Health is Physical Health

 

According to NAMI, mental health is physical health because the mind and the body are interconnected. This means that those who struggle with mental health may often face additional physical health problems such as chronic conditions or cardiovascular and metabolic diseases. While common, chronic conditions such as these can result in a worsened quality of life and may even shorten life expectancy, according to NAMI.

 

The relationship between physical and mental health can be seen in a patient of any age, however this trend can become worrisome for both children and providers of aging adults.

 

Carol Johnston

 

“Research has revealed that the aging population is suffering more from anxiety and depression than what is reported,” said Carol Johnston, administrator for Superior Senior Care. She explained that anxiety and depression rates in the aging population can be attributed to loneliness, losing independence and grief.

 

Tammy Hawkins, APRN with Renew Mental Health and Wellness,  said she believes the aging population is also being heavily impacted by anxiety and depression, which can present with physiological diagnosis.

Tammy Hawkins

 

“I encourage children and loved ones of an aging person to be aware of the symptoms and effects of depression and anxiety,” Hawkins said. “The most common thing I see impacting the elderly is depression, which deals a lot with the isolation that aging can bring. It can also be due to coping with grief and loss, in addition to dealing with loss of senses such as hearing and eyesight.”

 

Losing hearing or eyesight can commonly result in further isolation and withdrawal from social events. Hawkins and Johnston also attribute anxiety, sleep issues and memory problems as common mental health battles for geriatric individuals.

 

“Physical ailments such as loss of hearing and eyesight, dementia or loss of independence can significantly limit their ability to socialize,” Johnston said.

 

According to Hawkins, warning signs of grief and coping skills should also be evaluated closely.

 

“Grief can come from a variety of sources such as grieving a loss of a job through retirement, grieving friendships and grieving family members,” Hawkins said. “It is so common that people think grief follows a specific timeline, and truthfully, there is no right or wrong way to grieve. Our job is to help grieving people cope while validating their feelings and helping them work through that grief.”

 

The 2019 Arkansas State Plan on Aging showed a 72 percent increase in the aging population in Arkansas from 2000 to 2019, meaning many more could be suffering from a decline in mental health in their later years.

 

“The population of 65-year-olds and up in the United States and in Arkansas continues to rise,” Johnston said. “When you are looking at mental health affecting physical health in the aging population, research is showing that a positive mental health stance can result in a family member living longer and being physically healthier. I think most families of an aging individual would want to do anything they can to support their loved one in doing both of these things.”

 

While younger populations seem to have a more focused outlook on mental health research, Johnston said the older individuals she has worked with have commonly been hesitant or resistant to the topic.

 

“It really does fall on the family members to educate themselves on the research around aging and the effects of mental health on physical health,” Johnston said. “It’s also important for family members to reach out to the necessary support systems such as home, community-based services such as agency care.”

 

Johnston also said family members should strive to become aware of signs of hopelessness in their aging loved ones. Among these signs, isolation tends to be a huge sign of deteriorating mental health and can be attributed to mental disorders such as anxiety and depression, according to NAMI.

 

“In paying attention to a loved one’s physical pain and discomfort, you will likely see a decline in mental health, just as you would with a chronic or serious health diagnosis. As your family ages, there really isn’t a way around it,” Johnston said.

 

In addition to being aware of how mental health can impact physical health and vice versa, Johnston said the loss of independence can be a trigger for a decline in mental health.

 

“When we look at the aging population, we see how identity roles shift as men and women age,” she said. “It could be something such as losing the ability to prepare family meals for holidays or losing the ability to provide for your family after retirement. People may feel like they’re, in a way, losing who they are as they age and you can see a negative impact in that if the family is paying attention.”

Memory and Aging

 

Outside of mental health disorders, memory diseases are also important to be aware of as the aging population continues to grow. According to Hawkins, a large number of people are at risk for developing dementia, however it is important to not assume memory issues are directly related to dementia such as Alzheimer’s disease.

 

“Losing memories or experiencing a decline cognitively is not always directly tied to dementia,” she said. “Memory can be lost in the aging population for a number of reasons, including physiological reasons, side effects to medications or even thyroid disorders..”

 

According to the Alzheimer’s Association, dementia can be described as a general term for loss of memory, language, problem solving, and other cognitive abilities needed for completing tasks in daily life. There are several forms of dementia, including Korsakoff Syndrome, Frontotemporal dementia, Parkinson’s Disease and the most common form, Alzheimer’s disease.

 

While some memory issues can be attributed to non-memory loss related diseases, it is equally important for relatives to understand the likelihood and warning signs of dementia and Alzheimer’s disease, to augment the diagnostic process by mental and physical health providers.

 

There are 10 signs of Alzheimer’s disease for family members to make themselves aware of including memory loss that disrupts daily life; challenges in planning or solving problems; difficulty completing daily tasks; confusion with time or place and trouble understanding visual images or spatial relationships. Also of note are new problems with words in speaking or writing; misplacing things and losing the ability to retrace steps; decreased or poor judgment; withdrawal from work or social activities; and changes in mood and personality.

 

“The biggest barrier for families in the process of getting a diagnosis is having the first conversation with a physician about their cognition,” said Jacob Simburger, communications manager at Alzheimer’s Association. “Only 40 percent of Americans say they would talk to their doctor right away when experiencing symptoms of MCI. Many dismiss changes in memory as normal aging.”

 

According to the Alzheimer’s Association, 70 percent of Americans said they would want to know early if they have Alzheimer’s disease if it could allow for earlier treatment. However, data also explains that physicians are not talking to patients as proactively as they should.

 

“Nearly all PCPs report waiting for patients, 97 percent, or family members, 98 percent, to make them aware of symptoms or request an assessment,” Simburger said.

 

Early diagnosis for Alzheimer’s disease and dementia have been shown to positively impact the course of treatment. The Alzheimer’s Association also attributes earlier diagnosis to being useful for developing a treatment plan early on that is manageable for adult children and siblings to implement and maintain.

 

“Getting an early diagnosis gives families time to form a support network for their loved one,” Simburger said. “And for the person newly diagnosed with Alzheimer’s, early treatment can allow the individual the chance to communicate about what they want during each stage of the disease.”

 

Simburger added that new treatments for dementia are most effective in the early stages of the disease, and these treatments are only made available to patients after being diagnosed.

 

“We never hear from families that wished they had waited longer before they sounded the alarm. The earlier Alzheimer’s is diagnosed, the earlier it can be treated,” he said.

 

Current research has also been beneficial, having resulted in new treatments and awareness of certain preventive measures. These advancements have been proven to delay or slow the speed of decline in dementia patients.

 

“There are now FDA-approved treatments such as aducanumab and lecanemab that treat one of the underlying causes of Alzheimer’s. Additional clinical trials are underway and offer the hope of additional treatments,” Simburger said.

 

“It’s important to remember that no two treatments are the same, even if they are in the same class of drug. They act differently in the brain, even if they achieve similar end results. As new treatments are approved, early detection and diagnosis are even more critical to ensure individuals receive the most benefit at the earliest point possible.”

 

As far as preventing the onset of the disease, practices such as regular activity, not smoking or drinking alcohol, and staying social have shown to be beneficial to overall cognitive health.

 

“Although a balanced diet has not been proven as an effective treatment to address symptoms of Alzheimer’s, the best current evidence suggests that heart-healthy eating patterns, such as the Mediterranean diet, also may help protect the brain,” Simburger said.

 

A Mediterranean diet includes relatively little red meat and emphasizes whole grains, fruits and vegetables, fish and shellfish, nuts, olive oil and other healthy fats.

 

One of the most beneficial things in promoting early detection of Alzheimer’s disease or other forms of dementia is raising awareness of warning signs, symptoms and behaviors. The nonprofit Alzheimer’s Association is committed to not only providing local resources, but also educating the community about cognitive health and memory diseases.

 

“We want people to know we are here to help them navigate the many issues they will be facing after a loved one receives a dementia diagnosis,” Simburger said. “We can provide information on local resources and providers, education through our community classes and programs, a 24/7 helpline and connections to support groups for families. Our Walk to End Alzheimer’s is an annual opportunity for these families to come together in support of each other’s stories and to involve the community in the fight against Alzheimer’s.”

 

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