Читать книгу Pathy's Principles and Practice of Geriatric Medicine - Группа авторов - Страница 84

Ageing is on the rise. The world population aged 65 and older is expected to nearly double from 9% in 2019 to 16% by 2050 (United Nations, 2019). This significant demographic shift will require commensurate increases in attention to health issues in this cohort, particularly aspects of mental health. The importance of attention to the psychological well‐being of the elderly becomes obvious when considering the established links between mental health problems (e.g. depression and life stress) and medical outcomes such as premature mortality, coronary heart disease, diabetes, disability, and other chronic conditions Steptoe (2006). More plainly stated, overall psychological well‐being (i.e. one’s sense of purpose and meaning in life) is strongly associated with longevity. For example, the English Longitudinal Study of Ageing (ELSA) found that almost 30% of those with the lowest levels of psychological well‐being had died by the end of the 8.5 year follow‐up period as compared to only 9% of those with the highest levels of psychological well‐being. Notably, this effect occurred independent of age, gender, demographic factors, and baseline mental and physical health (Steptoe, Deaton, & Stone, 2015). Older adults themselves recognize these effects and have rated preserved cognitive and functional abilities as essential elements to successful ageing (Nosraty, Jylhä, Raittila, & Lumme‐Sandt, 2015; Nosraty, Sarkeala, Hervonen, & Jylhä, 2012). Similarly, having a sense of purpose in life has been found to be associated with a 30% decreased risk of dementia in older adults (Sutin, Stephan, & Terracciano, 2018). Thus, it is apparent that psychological factors may have important implications for preventing chronic medical conditions, increasing longevity, and improving overall quality of life in older age. This chapter covers relevant psychological aspects of ageing that practitioners should be cognizant of when caring for this population. More specifically, we will discuss both normal and abnormal changes in mental health and cognitive function in older adulthood as well as interventions that can help with adapting to these changes and maintaining function.