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Mental health interventions for the elderly
Encyclopedia entry   Open access   Peer reviewed

Mental health interventions for the elderly

Lisa Mikesell
Older Age Psychiatry
The Palgrave Encyclopedia of Critical Perspectives on Mental Health, Rutgers University
2021
DOI:
https://doi.org/10.7282/00000003

Abstract

Mental health interventions elderly depression pharmacological treatment psychotherapies brain stimulation therapies integrated care Dementia
This is a chapter to be published in the volume Older Age Psychiatry, which is part of The Palgrave Encyclopedia of Critical Perspectives on Mental Health (Eds. J.N. Lester & M. O'Reilly). Drawing primarily on the evidence from randomized controlled trials, systematic reviews and meta-analyses, this entry overviews current interventions and their effectiveness for the two most common neuropsychiatric disorders to impact older adults: depression and dementia. The interventions reviewed for late life depression include pharmacological treatments (SSRIs, SNRIs, TCAs, MOAs), nonpharmacological psychotherapies (Cognitive Behavioral Therapy, Problem Solving Therapy, Interpersonal Therapy and Life Review and Reminiscence Therapy), exercise, and brain stimulation therapies focusing on electroconvulsive therapy (ECT), which is the most commonly used brain stimulation therapy for older age adults suffering from depression. Interventions targeting symptoms of dementia include pharmacological and nonpharmacological treatments for both cognitive symptoms and behavioral and psychological symptoms of dementia (BPSD). Pharmacological interventions for cognitive symptoms include acetylcholinesterase inhibitors and Nmethyl-D-aspartate antagonists, while nonpharmacological interventions include various forms of cognitive stimulation, reality orientation, and exercise. The two most common pharmacological interventions for BPSD – antidepressants and antipsychotics – and the sparse evidence that exists regarding their imapct on BPSD are also outlined. Considering that dementia and depression are strongly associated and often co-occur, this entry ends by reflecting on the promise of integrated care to better address the complex needs of elderly patients, calling attention to the need for research to include patient-centered outcomes and examine the effects of interventions on overall quality of life and well-being.
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