Aging Related Concerns

More than one in every seven Americans is an older adult, aged 65 or older. The aging population is set to continue to grow rapidly in the future, meaning it’s becoming even more important to focus on good mental health across the entire lifespan.

Many of the challenges experienced by older adults are similar to those encountered by younger adults. That said, the inevitable change that is part of the aging process brings with it a range of unique concerns, such as:

  • Cognitive changes: For many older adults, cognitive changes such as memory loss can affect daily functioning and impair emotion regulation.
  • Dementia and Alzheimers: Dementia, which affects 13.9% of Americans aged 71 and older (1), involves more severe cognitive changes to memory, thinking, and behavior.
  • Health and physical change: Later in life, people are at greater risk of developing health conditions such as arthritis, heart disease, or hearing loss. Most older adults have at least one chronic health condition, and adaptation to this can be challenging. Chronic pain can sometimes accompany these changes, bringing distress and further adjustment difficulty.
  • Coping with loss and change: Older adults more often must cope with the loss of friends and family, and the subsequent grief, loss, and social network change.
  • Mental health concerns: Older adults can be affected by mental health concerns just like any other age demographic. Depression, anxiety, and sleep disturbance are among the more common challenges experienced by this segment of the population.

In the US, the aging population is continuing to grow; it’s estimated that by 2030, around 20% of the population will be aged 65 or over. Estimates suggest that around 20-22% of older adults in America meet criteria for a mental health diagnosis (including dementia).

According to the World Health Organization, some of the most common mental and neurological disorders experienced by older people include:

  • Dementia (5%)
  • Depression (7%)
  • Anxiety (3.8%)

Whether you’re having difficulty adapting to the changes that come with aging, or are experiencing mental health challenges, a range of treatment options can help:

  • Therapy: Individual or group therapy can help people feel and function better, and have a better quality of life. Therapy can be the main, or an additional form of treatment, depending on your individual circumstances. Look for a therapist with experience working with older adults, who will be able to help you understand your unique challenges. See more tips below on types of therapy and selecting a therapist.
  • Check-ups: It’s important to have regular check-ups with your primary care doctor as health concerns tend to increase with age. Your doctor can provide treatment for or rule out physical conditions that may contribute to mental health symptoms. They can also help to link you in with community supports, for practical and emotional support.
  • Self-care: Pay attention to your diet, try to maintain a regular sleep pattern, and exercise regularly. Find activities that you enjoy, and make time for them in your schedule. Such lifestyle factors can help to regulate our mood. For help or more information, visit the National Institute on Aging Go4Life website.
  • Social support: Family and friends are important supports for older adults. Nurturing these relationships and spending time with your network can have a big impact on emotional wellbeing.
  • Hotlines: The Institute on Aging’s Friendship Line provides 24-hour support for older adults at 1-800-971-0016. If you’re having thoughts of suicide or need immediate support, call the National Suicide Prevention Hotline at 1-800-273-8255.

There is no clear particular mode of therapy that has emerged as the most effective for older adults (8), so it’s important to consider different therapy types and how they resonate with you before choosing. Common modalities to consider include:

  • Cognitive Behavioral Therapy (CBT): CBT is a common evidence-based type of therapy that helps us to become aware of and change unhelpful thinking patterns, beliefs, and behaviors that influence our emotions.
  • Mindfulness Practices: Mindfulness encourages moment-to-moment awareness and deliberate, non-judgemental awareness of the present. This enables us not to get caught up in unhelpful thoughts or automatically react to our experiences as problematic.
  • Art therapy: Art therapy can enable those struggling with cognitive impairments to find new ways to connect with others. It provides a sense of purpose and helps reduce feelings of stress and anxiety.
  • Psychodynamic therapy: Psychodynamic therapy involves the exploration of past experiences and how they influence current patterns of thought, emotion, and behavior. This can help people who want to gain insight into how their past is shaping their current experience.

If you’re unsure which modality will be most suited to your needs, your prospective therapist is a great person to seek advice from.

There are several factors to keep in mind when selecting a mental health professional, including:

Specialization: Look for a therapist who specializes in working with older adults; these professionals will be able to adapt therapeutic modalities to meet your needs. For example, some older adults experiencing cognitive changes can benefit from a slower pace of therapy. Therapists often include their specializations in their biographies on their website or online profile. Depending on your age and concerns, you might look out for terms like ‘aging’, ‘geropsychiatry’, ‘geropsychology’, or ‘geriatric psychotherapy’.

Qualifications: With so many different provider types available, it can be difficult to decide which type of mental health professional to see. The most important thing is to look for a currently licensed therapist. That said, if you think medication might be needed, make sure you see a psychiatrist. This particular type of mental health professional is able to prescribe.

Personal fit: The trusting relationship between you and your therapist, known as the “therapeutic alliance” can have a huge impact on the efficacy of therapy. The best way to judge how you might feel about a therapist is to ask for a preliminary phone call. This also enables you to ask about their experience and what therapy with them will be like. Try to speak to a few different therapists before deciding on a provider.

If you’re caring for someone who is aging, it’s important to also pay attention to your own wellbeing. There are plenty of steps you can take to nurture and care for yourself as well as the older adult during times of stress. Enlisting the help of a therapist can make a huge difference to the quality of life for you both.

Sources and references

  • (1) Plassman et al., 2007, “Prevalence of dementia in the United States: the aging, demographics, and memory study”, Neuroepidemiology, 29(1-2).
  • Administration on Aging, “2018 Profile of Older Americans”, PDF at https://acl.gov/sites/default/files/Aging%20and%20Disability%20in%20America/2018OlderAmericansProfile.pdf
  • American Psychological Association website, “Working With Older Adults”, https://www.apa.org/pi/aging/resources/guides/practitioners-should-know
  • World Health Organization website, 2017, “Mental Health of Older Adults”, https://www.who.int/news-room/fact-sheets/detail/mental-health-of-older-adults
  • Walsh, R., 2011 “Lifestyle and Mental Health”, PDF at https://escholarship.org/content/qt0786x6tw/qt0786x6tw.pdf
  • Hearing, C.M., et al., 2016, “Physical Exercise for Treatment of Mood Disorders: A Critical Review”, https://link.springer.com/article/10.1007/s40473-016-0089-y
  • Reid, K.J., et al., 2006, “Sleep: A Marker of Physical and Mental Health in the Elderly”, https://www.sciencedirect.com/science/article/abs/pii/S1064748112608628
  • Atiq, R. & Gillig P.M., 2006, “Common Themes and Issues in Geriatric Psychotherapy”, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2990651/#B1
  • American Psychological Association website, “Guidelines for Psychological Practice with Older Adults”, https://www.apa.org/practice/guidelines/older-adults