Ageing and Mental Illness
The older members of the population are increasing, with recent indication that people who are over 60 years old are growing in number in the past years. This social phenomenon can be attributed to the advancement in medical technology that provided for the people’s health and well being. With better technology and medical attention, older people can enjoy their advanced years, and can still be valuable members of the society, not only in their capacity as family members but also as active contributors in the workforce. However, while there are older people who enjoy good health, there are those who have some health concerns such as those who developed mental health problems. It was found that more people aged 60 and above are at risk of suffering from mental disorders, an illness that is highly stigmatized, making people reluctant to seek medical attention. Moreover, people who suffer from mental illness are said to have developed the disease due to health neglect during their younger years. Studies showed that depression and cognitive impairment are among the most common mental health problems among the older population, in it being linked to vascular risk (Carmasin et al, 2012); the co-occurrence between these two (Villareal et al, 2015); their association with socio-demographic and psycho-social factors (Boranlingiah et al, 2012; Esmayel et al, 2013; Hsiao et al, 2014). This paper aims to establish the relationship of depression and cognitive impairment, and other factors in the development of mental disorder among the elderly. It is hypothesized that the depression and cognitive impairment, coupled with other social, health and environmental factors increased the risk of developing long term mental problems among the older population. The following five literature reviews are geared towards demonstrating how depression and cognitive impairment, combined with other elements can trigger long term mental health problems.
In an article by Carmasin et al (2014), the researchers suggest that high vascular risk is associated with greater incidence of depression, with an indication that baseline vascular risk is predictive of change in the level of depression and cognitive ability. Further, the findings specifically supported the hypothesis that vascular risk factors were valuable predictors of depression among elderly African Americans (Carmasim et al, 2014). The study was conducted according to approved research standards and the researchers proceeded by requesting the participation of 435 older African Americans. The baseline data were gathered sometime between 2007 to 2008, while the follow-up data were collected from 2008 to 2010.
The research focused on diabetes, cardiovascular disease, high blood pressure, heart attack, angina, circulatory problems and stroke and it was found that a high baseline VRFs has a direct relationship with increased symptoms of depression. Nevertheless, it was found that while vascular risk factors are positive predictors of depression and cognitive, these two factors do not necessarily predict one another. The findings that depression and cognitive factors do not necessarily predict one another, is similar to the findings in Villareal et al (2015), where it was established that the participants have cognitive impairment with depression, as well as incidence of depression without cognitive impairment. Further, study of African Americans is similar to other studies on European Americans, thus it should be noted for its importance in other intervention studies. The limitations of this study was that it was restricted to African Americans in Baltimore, and was highly reliant on self-reports; moreover, it did not include an assessment of the major VRFs during the baseline visits.
In another study by Villareal et al (2015), the researchers examined the cognitive impairment, depression and co-occurrence of these two illnesses as well as other factors to participants over 65 years of age. The data were gathered from the Panama Ageing Research Initiative, and the participants were chosen from among the elderly who expressed willingness to become part of the baseline interview and the follow-up part. The participants went through an interview, physical exam, clinical interview, and non-fasting blood draw, and the chronic health cases were self-reported. They were evaluated by responses to inquiries about medical diagnosis and current treatments. Further, the analyses were completed using SPSS 21.0 statistical software. It was found that there was a co-occurrence of cognitive impairment and depression was further aggravated by increased age, low education as well as the existence of other chronic illnesses. A limitation of the study was the existence of selection bias due to loss of some of the participants, resulting to the possible underestimation of the cognitive impairment. There is also a need to be cautious when comparing the results of this examination because of the effect of socio-cultural functions. Another limitation is the self-report evidences that were gathered from the participants.
A research by Esmayel et al (2013), showed that depression and cognitive impairment are prevalent among the elderly members of the population, and further examination revealed that these two conditions are linked to sociodemographic elements. Specifically, there was a direct association of depressive symptoms and cognitive impairment among patients from low income families and those who were advancing in age (Esmayel et al, 2013). It was also found that there was a higher level of depression among hospitalize patients, compared to the incidence rate of depression from among those who were not hospitalized. The examination was conducted among elderly people aged 65 and above, who were confined at the internal medicine department of a university hospital in Egypt. The participants were assessed according to the comprehensive geriatric evaluation system, while the sociodemographic variables were evaluated through interviews with the patient as well as family members.
Another study that aimed to determine the psychosocial problems of the elderly and the extent of functional impairment was conducted by Boralingaiah et al (2012). Another objective of the study is the determination of the psychological distress among the elderly people through the use of the general health questionnaire (GHQ). Based on the research, it was found that there was a significant link between depression among the elderly, with factors, such as marital status, living arrangements, type of family, decision making, adjustment to old age, the feeling of isolation, and feeling insecure (Boralingaiah et al, 2012). This study is similar to the study conducted by Esmayel et al (2013), as both studies socio-cultural factors and its relationship with the incidence of depression and cognitive impairment in the elderly. Both studies indicated that socio-cultural factors have a positive impact on the progression of depressive mood and cognitive impairment among the older population. The limitation of the study is that it was conducted in a limited span of time, and this can have an impact on the results of the study, in addition to that, it was restricted only in the Urban Health Center of Mysore city.
In a study by Hsiao et al (2014), the researchers aimed to establish that the level of depression will increase as people advance in age, and that productive role occupancy are predictive of subsequent intraindividual changes in depression. It is the objective of this research to determine how the changes in productive role occupancy can impact the changes in the level of depression among participants. The bivariate latent different score analysis was employed to examine the relationship between the productive role occupancy and the cases of depression among elderly Chinese for the duration of eight years. While his study is largely different from the other studies, it offers the same conclusion on the positive impact of other social factors on the level of depression in the elderly. Some of the limitations of this study are that the data were not collected with the use of experimental standards, further, it does not also offer a sufficient control of factors that was not observed during the research.
The global population is aging rapidly, and the older population is at a higher risk of developing health issues such as mental health problems. There is therefore a need to conduct studies, not only to understand their predicament, but also to determine measures to help them with their health concerns. The results of the different research showed that depression and cognitive problems are prevalent among the elderly, and there is therefore a need to address their concerns by having a closer examination of what are the causes of their depression. Knowing the factors that impact their mental health can help the medical professionals and family members to work towards supporting them to get over their predicaments. It is suggested that future research should be conducted to accurately establish the relationship of different factors and the level of the elderly’s mental health.
References
Boralingaiah, P., Bettapa, P., Kashyap, S. (2012) Prevalence of psycho-social problems among elderly in urban population of Mysore City, Karntaka, India. Indian Journal of Psychological Medicine, 34(4). Retrieved from
Carmasin, J., Mast, B., Allaire, J., Whitfield, K. (2014) Vascular risk factors, depression, and cognitive change among African American older adults. International Journal of Geriatric Psychiatry http://web.b.ebscohost.com/ehost/pdfviewer/pdfviewer?vid=32&sid=f181913d-b316-4870-b6f0-50a08556d442%40sessionmgr105&hid=102#
Esmayel, E., Eldaraway, M., Hassan, M., Mahmoud, A., Mohamed, S.(2013) Mental health problems and sociodemographic correlates in elderly medical inpatients in a University Hospital in Egypt. Retrieved from http://web.b.ebscohost.com/ehost/pdfviewer/pdfviewer?vid=16&sid=f181913d-b316-4870-b6f0-50a08556d442%40sessionmgr105&hid=102#
Hsiao, H., Xu, L., Chi, I., Silverstein, M., (2014). Does productive role occupancy prevent depression among older rural Chinese adults? A latent difference score analysis. Aging and Mental Health 18 (1). Retrieved http://web.b.ebscohost.com/ehost/pdfviewer/pdfviewer?vid=31&sid=f181913d-b316-4870-b6f0-50a08556d442%40sessionmgr105&hid=102#
Villareal, A., Grajales, S., Lopez, L., Britton, G., (2015) Cognitive impairment, depression, and co-occurrence of both among the elderly in Panama: Differential Associations with multimorbidity and functional limitations. Biomed Research International. Retrieved from http://web.b.ebscohost.com/ehost/pdfviewer/pdfviewer?vid=14&sid=f181913d-b316-4870-b6f0-50a08556d442%40sessionmgr105&hid=102#
