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Accelerated ageing and mental health

The accelerated ageing of the populations of developed countries is being matched in the developing world. In fact, in 2017, for the first time in history, the number of persons aged 65 and over will outstrip those aged 5 and under. This population trend is not just a temporary blip, not just due to a short-term outcome of the baby boomer generation. What we are seeing is the increasing lifespan of older persons and the decreasing number of births (but also better survival rates of infants and young children) worldwide, leading to greater equality in the numbers of these two groups over time. The World Bank estimates that in 2015, approximately 8.3% of persons globally were over 65, and this will only increase in the coming decades. Currently the USA is at 15% of persons over age 65, a great percentage of Europe stands at 16+%, with Japan, the oldest nation as a whole, at 26%. By 2050, more than 20% of the population of many nations will be over 65.

While most older adults are content with their circumstances, in the face of increasing years of living, both mid-aged and older persons are concerned with having the ability to pursue their goals and have high quality of life as they age. Health plays a large role in being able to lead the life you want to, particularly after retirement.

People can act to lower the risk of many age-related illnesses, including dementia. Lifestyle modification, and in particular exercise, are important factors here. Most people know that increasing physical activity and keeping mentally active help with ageing well, but being engaged with others is also vitally important. Older adults with adequate social relationships are 50% more likely to survive than those with insufficient social support, an effect comparable with quitting smoking and of greater benefit than avoiding obesity and lack of exercise.

And the benefits of maintaining physical, mental, and social activities extend to mental well-being in later life. It’s a myth that older people are more likely to be depressed and anxious than younger people. Actually, the reverse is true, and this is a global phenomenon  not simply a cohort effect. But among those who are older and experiencing poor mental health, the unfortunate fact is that they are more likely to either have their mental health inadequately assessed or treated, or to be reflexively referred for pharmacological treatment rather than psychosocial treatments. For persons with dementia or those already on multiple medications, such empirically sound non-pharmacological treatments can offer real hope. In fact, many studies suggest that older people would rather seek talking therapies for mental health issues.

In 2017, for the first time in history, the number of persons aged 65 and over will outstrip those aged 5 and under.

Key risk factors for depression in later life include: disability; newly diagnosed medical illness; poor health status; poor self-perceived health; prior depression; and bereavement. Protective factors include greater perceived social support, regular physical exercise, and higher socioeconomic status. Anxiety is actually more common later in life when compared to the incidence of depression, and many risk factors are the same for both anxiety and depression. Key risk factors for anxiety in older persons include poor self-rated general health status, and physical or sexual abuse in childhood. Protective factors include greater perceived social support, regular physical exercise, and higher level of education. Persons who are migrants, particularly those over 65, are at greater risk of mental health issues than non-migrants, and are a particular group of concern in a more globally-connected world.

One common experience across cultures is that of feeling younger than one’s chronological age, which has been demonstrated in several studies internationally. Also, the older one is, the greater the gap between one’s actual age and how old one feels. Typically, after 65, people generally feel about ten years younger than their chronological age.

Despite varying contexts and circumstances, largely individual factors—particularly physical and mental well-being, both objective and subjective—contribute to one’s subjectively imagined age. A longitudinal study found that the higher the person’s subjective age the higher their chance of experiencing poor health and higher mortality, even after adjusting for multiple potential contributing factors. In other words, the closer our perceived and actual ages are, the worse off we are likely to be.

As older adults themselves take increasing interest in pursuing strategies for optimizing physical, cognitive, and emotional health, research in a range of fields will be needed to provide a solid empirical base to guide both consumers as well as health care providers, governments, and policy makers. If the potential of those entering later life is to be realised, understanding the process of aging is important for individuals, but also for societies and nations.

Featured image credit: Hand Age Time by Celiosilveira. Public domain via Pixabay.

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