As people get older, some mental disorders tend to worsen over time while others may improve or stay the same. Mental disorders that often get worse with age include dementia, depression, anxiety disorders, and schizophrenia.
Dementia
Dementia refers to a group of symptoms related to declines in memory, communication, and thinking skills that affect daily functioning. While dementia is not a normal part of aging, age is the biggest risk factor. After age 65, the risk of developing dementia doubles every 5 years. By age 85, between 25-50% of people exhibit signs of dementia.
Alzheimer’s disease is the most common cause of dementia, accounting for 60-80% of cases. Other types include vascular dementia, Lewy body dementia, and frontotemporal dementia. All types of dementia cause symptoms to gradually worsen over time as more brain cells become damaged and die.
In the early stages of dementia, symptoms may include forgetfulness, getting lost in familiar places, and difficulty with planning and organizing. As dementia advances, people lose the ability to respond to their environment, have conversations, and control movement. In the late stages, a person with dementia may be completely dependent on others for care and unable to communicate.
Depression
While depression can affect people of any age, the risk tends to increase with age. The precise reasons for this are complex, but may involve factors like changes in brain chemistry, co-existing medical conditions, medications, genetics, psychosocial factors, and hormonal changes.
According to the CDC, over 50% of nursing home residents suffer from depression. Between 5-10% of older adults who live at home also experience depressive symptoms. The suicide rate is highest among those ages 85 and older.
Late-life depression often goes undiagnosed and untreated because symptoms like fatigue, sleep disturbances, appetite changes, and concentration problems overlap with other medical conditions common in aging adults. Persistent or worsening depression warrants medical attention.
Anxiety Disorders
Many different types of anxiety disorders exist, including generalized anxiety disorder (GAD), phobias, panic disorder, obsessive-compulsive disorder (OCD), and post-traumatic stress disorder (PTSD). Research shows that anxiety disorders can persist and even first appear in older adulthood.
Up to 10% of older adults suffer from anxiety disorders that cause excessive, irrational fear or worry. As people age, the symptoms of anxiety may increase due to health problems, disabilities, financial concerns, loneliness, and dependence on others for care.
In late life, anxiety disorders are associated with decreased physical function, poor sleep quality, cognitive impairment, and reduced quality of life. Older adults with anxiety tend to have more medical problems, higher healthcare costs, and increased mortality.
Schizophrenia
Schizophrenia typically emerges in the late teens to mid-twenties. While many people with schizophrenia improve over time, around one-third continue experiencing severe symptoms as they age. In people with ongoing schizophrenia, the disorder usually persists and may worsen with age.
Schizophrenia is characterized by positive symptoms like delusions, hallucinations, and disorganized thinking as well as negative symptoms like apathy, social withdrawal, and lack of emotions. Later in life, negative symptoms tend to become more prominent.
Other late-life challenges of schizophrenia include higher smoking rates leading to health problems, weight gain, loneliness, suicide risk, and cognitive decline. The life expectancy for people with schizophrenia is 10-25 years less than the general population.
Factors That Contribute to Worsening Mental Disorders
Aging itself brings biological changes that may impact mental health. However, other factors occurring simultaneously with aging also play a role in worsening mental disorders.
- Physical health problems – Chronic conditions like diabetes, heart disease, and arthritis become more common with age and can worsen mental health problems.
- Functional impairments – Declining sensory abilities, mobility, and independence can increase isolation and depression.
- Neurological changes – The aging brain undergoes structural and functional changes that may contribute to cognitive, mood, and behavioral issues.
- Medications – Adverse side effects of medications are common causes of symptoms like brain fog, agitation, and altered mood in older adults.
- Death of loved ones – Bereavement, loss, and grief can trigger or exacerbate depression and anxiety.
- Major life changes – Adjusting to retirement, medical problems, care facilities, and loss of independence is challenging.
- Stress – Chronic stress can worsen psychological symptoms.
- Lack of support system – Isolation and loneliness make disorders more difficult to cope with.
- Lack of mental healthcare – Many older adults do not receive appropriate diagnosis and treatment for mental health issues.
Strategies for Coping with Worsening Mental Disorders
While some people develop age-related mental disorders for the first time later in life, others have pre-existing conditions that worsen with aging. In either case, there are strategies that can help.
- Get medical support – See a doctor regularly and work closely with them to manage physical and mental health conditions.
- Connect with others – Make an effort to reduce isolation through social visits, activity groups, volunteer work, etc.
- Adopt healthy habits – Follow an exercise routine, healthy diet, stress reduction techniques, and good sleep hygiene.
- Consider therapy – Counseling provides coping strategies for dealing with age-related life changes.
- Join a support group – Connecting with others facing similar challenges combats loneliness and depression.
- Ask for help – Don’t be afraid to lean on loved ones for practical and emotional support.
- Find purpose – Pursuing meaningful activities provides a sense of joy and accomplishment.
- Manage medications – Work with doctors to minimize drug side effects and interactions.
- Plan ahead – Discuss future care preferences and put legal documents in place while still of sound mind.
When to Seek Professional Help
It can be difficult to determine when age-related mental health declines cross the line into needing medical intervention. Warning signs that it may be time to see a doctor include:
- Withdrawing from regular social activities
- Displaying unusual mood swings, anger, or irritability
- Showing signs of paranoia or delusions
- Neglecting personal hygiene, nutrition, or home environment
- Exhibiting reckless behaviors like unsafe driving or financial mismanagement
- Having trouble concentrating, recalling details, or following instructions
- Feeling down, hopeless, worthless, or suicidal
- Finding little pleasure in previously enjoyed activities
- Changes in sleep patterns, appetite, or weight
- Fatigue or loss of interest that persists for two weeks or more
A doctor can check for underlying medical conditions, screen for depression or dementia, review medications, and connect older adults to helpful resources. Don’t assume mental health problems are just a normal result of aging. With the right support, many disorders can be managed effectively.
Conclusion
Mental disorders that become more prevalent or severe with advancing age include dementia, depression, anxiety, and schizophrenia. Biological aging, health status, genetics, psychosocial factors, and stress contribute to this worsening. Supportive strategies for coping include self-care techniques, medications, therapy, social connection, planning ahead, and seeking medical advice when symptoms interfere with daily functioning. While some deterioration in mental health can occur as a normal part of aging, significant declines likely warrant professional assessment and treatment.