Mental health and psychiatric disorders in older women

Abstract

An increase in the number and diversity of resources designed to optimize psychosocial function in people and especially women over age 65 is inevitable in the next decade as both the size and political influence of this group increase. The successful implementation of such programs is dependent on widespread change throughout society, involving many disparate groups, including older people themselves, politicians, health care administrators, and researchers from a range of disciplines. Clinicians in medicine and allied professions have a pivotal role in this regard. At present there are many reversible causes of psychiatric morbidity in the elderly, including depression, anxiety, cognitive defects, sensory impairment, malnutrition, and adverse effects of alcohol abuse and polypharmacy that are often not recognized or treated appropriately. It is therefore essential that family practitioners receive both undergraduate and postgraduate training to recognize and manage the wide range of psychosocial disorders prevalent in older women. Intervention may require little more than an opportunity for the women to ventilate concerns or obtain information and advice about community resources. In other circumstances in which there are complex interactions of physical, social, and psychological factors, optimal management may involve interventions that require specific skills beyond the scope of the individual practitioner. Referral to a psychogeriatric team is likely to be helpful in such situations. The team, with its access to a full range of health professionals and community resources, is well placed to deal economically with complex issues. The special care units are best equipped to manage the tertiary care of the chronically ill who do not have adequate community-based support available. Increased information derived from research relating to the spectrum of mental ill health and mental health is essential to adequately address the causes, correlates, and treatments of illness, and to answer questions about the positive aspects of mental health that may have implications for all age groups and both sexes. For example, it is intriguing that older women maintain a high level of psychological health despite greater social disadvantages than any other major section of the community. It is likely that psychological factors, such as better coping skills and ability to adapt to stressful life events, influence both the quality of life in older women and possibly also its duration. Alternatively, it is possible that the commonly held view that the life expectancies of women and men will converge as women undertake more of the roles and activities currently the province of men may occur.(ABSTRACT TRUNCATED AT 400 WORDS)