Mental health articles

The mental health of the world's elderly is an increasingly important issue as the numbers of aged grow at unprecedented rates. Most discussion of demographics regarding countries in the developing world has traditionally focused on issues, such as high birth rates and low life expectancies, relating tonon-elderly parts of the populations rather than on issues concerning the elderly. Whereas we have thoughtof populations in these countries as predominantly comprised of the young, soon they will also hold most of the elderly in the world. Current evidence indicates rapid increases in numbers and proportions of elderly people in developing countries. In 1950 the200 million people aged over 60 in the world were evenly distributed between developed and developing countries. By 2000 the total will have grown to 614million, with 62% living in developing countries, and by 2025 this percentage will reach 72%, correspondingto 1.2 billion people.

Not only is the distribution of the world elderly population shifting, but the rates of change are remarkable. Between 1980 and 2025, the global population over 60 will grow by 198%, in comparison to less developed countries, in which it will rise byalmost 293%]. Older age groups will see the high estrates of growth. The UN predicts that the overall population in the developing world will expand 47%between 1980 and 2000, but the age groups 60 +, 70 + and 80 + will grow 75, 85 and 104%, respectively.

Projected numerical increases, especially for the older age groups, are greater for women than men. Between1985 and 2025, the UN expects the number of malesaged 70 and above in the developed world to increase by 32 million and the number of females by 38 million.Corresponding figures for the developing regions are284 million for males and 317 million for females.

Existing data does not allow for certainty indetermining whether or not incidence and/orprevalence rates of organic and non-organic mental illnesses are on the rise among the aged, but the increase in absolute numbers and proportions of elderly inpopulations portends a greater global burden of mental illness. Population aging will result in an inevitable expansion in organic, age-related mental diseases, such as the dementias. Also, forces in the developing world,such as urbanization [6, and war and displacement, have been linked to increased levels of non-organic, minor psychiatric morbidity among theelderly. Demographic and economic trends and accessto education for the young may alter family structure and function and correspondingly damage traditional(often rural) care patterns for the aged (for example,Refs). Empirical studies from the anthro pological literature show that new care patterns, reflecting achanged society, frequently are inferior to those thatpreviously existed. Possible results for the aged are a variety of poor mental healthoutcomes, such as depression, anxiety and suicide, aswell as serious constraints on the quality of life.Not all researchers, however, support the idea thatcertain forces, like urbanization, cause mental health problems and that new patterns of family care indeveloping countries result inevitably in poorer care for the elderly. For example, studies have arrived atdifferent conclusions regarding the direct effects ofurban living on mental health. Also,at least a few studies indicate that despite rapidsocioeconomic change, care systems in some societiesstill accomplish their function in a satisfactory, albeitdifferent, manner. Also, care systems inindustrialized societies, where the nuclear family ismore prevalent, may involve institutional careresources and social security that allow the elderly tolive independently from their families. Thus, the popular concept that 'modern' care systems are not as adequate as 'traditional' ones, where the extendedfamily is said to provide care, may not be accurate.What does seem probable, however, is that the rapidpace of demographic, economic and social change indeveloping countries does not always allow for the development of alternative care mechanisms to the extended family and the community, as occurred historically in countries where changes proceeded more slowly. Moreover, when such changes occurwithout concurrent economic improvement, and/orin a context of poverty, the elderly are often isolated from their previous roles and left more vulnerable tolack of care. The"intimacy at a distance" pattern of care of Western industrialized nations may not be easily duplicated in countries without communication and transportationinfra structure and where the elderly have very little or no income to live apart from family members.

Tags: disorders, Mental health