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Depression and seniors About 20 percent of people ages 55 and older experience mental health concerns, federal data show. And depression, by far the most common condition, is treatable in 80 percent of cases. But the majority of older Americans do not receive the mental health services they need, according to the American Psychological Association. Less than 3 percent of adults over age 55 see a mental health professional. — Chicago Tribune
Measles on the march
Ron Dellecker, 79, left, Philip Baur, 78, and Bonnie Sanfield, 71, get ready for a group ride of the “Old Spokes” on Sept. 28, 2009, in Valley Forge, Pa. The group gets together to ride for fun and exercise. TOM GRALISH | PHILIDELPHIA INQUIRER/MCT
What — us tired? Elderly say they’re less exhausted than teens By EMILY ALPERT REYES, LOS ANGELES TIMES
lderly people say they feel much less tired than teenagers and younger adults, according to a surprising new study that tracked how nearly 13,000 Americans rated their exhaustion. The results counter earlier studies and defy stereotypes of older people as weak and tired, said Laura Kudrna, a researcher at the London School of Economics and Political Science. What’s even more surprising, she said, is that the unexpected results can’t be explained away by elderly people sleeping longer or doing fewer activities they find tiring. “There’s something else going on here,” Kudrna wrote in an email to the Los Angeles Times.
Kudrna and a fellow researcher analyzed answers from the 2010 American Time Use Survey, a nationally representative survey sponsored by the Bureau of Labor Statistics that included nearly 13,000 U.S. residents. Earlier rounds of the survey explored how Americans spent their time, but the 2010 survey was the first to ask how people felt during different activities. Each person filled out a diary of what they did the previous day and how they felt about some of their activities. They rated how tired they felt while doing those activities on a scale of 0 to 6. Remarkably, Americans ages 65 and older reported being less tired than older teens and young twentysomethings, pegging themselves almost one point lower on the tiredness scale. Tiredness dropped off after the age of 40 and continued to decrease with age, Kudrna said.
The results were controlled for how healthy people thought they were and other background characteristics, such as gender, ethnicity, number of children and how much people slept. Researchers also factored in how much of the day was spent doing tiring activities. So why might older people report feeling less tired than teens, twentysomethings and other adults? Kudrna wonders if technology might be making younger people feel more tired, or if other, untracked health factors are influencing the results. The bottom line, however, is that “we don’t know,” Kudrna said. “And I’d love to find out.” The study, recently published online in the Journals of Gerontology, Series B: Psychological Sciences and Social Sciences, urged more research to understand the unexpected results.
Depression common as Americans grow older Mental illness stigma keeps elderly folks from seeking treatment BY HEIDI STEVENS CHICAGO TRIBUNE
Depression is alarmingly common in older Americans. It’s highly treatable, but a number of obstacles, led by a nagging generational stigma surrounding mental health, often stand in the way of proper care. About 20 percent of people ages 55 and older experience mental health concerns, federal data show. And depression, by far the most common condition, is treatable in 80 percent of cases. But the majority of older Americans do not receive the mental health services they need, according to the American Psychological Association. Less than 3 percent of adults over age 55 see a mental health professional. Experts say this must change. “We have to do more,” says Richard Birkel, senior vice president at the National Council on Aging. “Depression is not just a separate condition. It’s the key to treating so many other health conditions. Depression will, in fact, short-circuit other treatments. You’ve got to tackle it to really get the patient’s cooperation and engagement in working on other health conditions.” With Americans ages 65 and up accounting for 13 percent of the population and estimated to grow to 19 percent by 2030, according to the Health and
GETTING HELP Older adults and their families should utilize the mental health resources they can access, says Dolores Gallagher-Thompson, associate professor at the Stanford University school of medicine and director of the school’s Older Adult and Family Research and Resource Center. “Tell your doctor: ‘I’m feeling depressed.’ ‘I’ve been drinking more.’ ‘I don’t want to get out of bed.’ There are people with specialized skills and training in geriatric social work and psychiatry and psychology who can help,” she says. “There’s no way a primary care physician can possibly go over all the issues an elderly patient needs to talk about in 15 to 20 minutes,” says Richard Birkel, senior vice president at the National Council on Aging. “They should be screening for falls, substance abuse, memory impairment. If you simply ask an older person, ‘Are you feeling depressed?’ They’ll say ‘no.’ That’s a no-go. The clinician has to be very artful.” Most counties, Gallagher-Thompson says, operate mental health centers, to which a primary care physician can direct patients. Birkel says senior centers can also direct people to the proper professionals. Human Services’ Administration on Aging, a significant number of lives are affected by the mental health of older people. We talked to health care professionals about how and why our approach should evolve. The risks: At its most severe, depression is a major risk factor for suicide. The elderly have a
slightly higher suicide rate (14.22 of every 100,000 people) than the general population (11.16 per 100,000), according to the Centers for Disease Control and Prevention, and men 65 and older die from suicide at more than twice the national rate. “Depression is not simple sadness,” says Birkel, who has also served as the executive director of the National Alliance on Mental Illness. “It’s a very serious illness.” And its effects are many. Even mild depression lowers a person’s immunity and can compromise the body’s fight against infections and cancers, according to the American Psychological Association. “Depression is a co-traveler with lots of other health conditions,” Birkel says. “The guidelines now for treating diabetes urge physicians to test for depression. Same with heart disease, hearing loss, eyesight loss. “You have to get them out of that cycle of feeling defeated, feeling like they have no energy and can’t take care of themselves.” The hurdles: “Most older people grew up in a generation taught to tough it out and suck it up,” says Dolores Gallagher-Thompson, associate professor at the Stanford University school of medicine and director of the school’s Older Adult and Family Research and Resource Center. “It was believed that one should be able to handle one’s own problems. Or if you needed help, you would go to family or friends or a clergy member.” Sadness and anxiety, Birkel
says, are often viewed as personal failures by older adults. “Today’s seniors grew up in a society where mental health issues were not freely discussed, and there was great shame associated with mental illness,” he says. Early impressions of mental health treatments only added to the stigma. “The availability of psychotherapy and other mental health services was not great before the ‘60s, when President Kennedy formed a series of federally funded mental health centers,” Gallagher-Thompson says. “Prior to that, the average person couldn’t pay for private psychotherapy, and the treatments were extremely long and severe.” “Since then we’ve developed a number of evidence-based models and approaches to psychotherapy, many of which are relatively short term,” she continues. “You don’t have to sign up for three or four years of treatment. Often you’re looking at 10 to 20 sessions, very focused on a particular problem.” Gallagher-Thompson says the number of geriatric mental health professionals is likely to increase as baby boomers age. “My expectation is there will be tremendous pressure and need for mental health services from the boomers as more of them get to the point where they’re more frail and dependent, have had more losses, experience more depression,” she says. “They will drive the marketplace to create more trained professionals.”
Measles infections have risen dramatically this year, with outbreaks erupting as the highly infectious virus is imported from abroad. Measles has made an astounding comeback in such unexpected parts of the world as Britain, the European continent and Israel, and it is in these regions where American travelers are contracting it. Worse, more than 98 percent of Americans who’ve become infected were unvaccinated, according to the Centers for Disease Control and Prevention, which voiced concern about the measles upsurge last week. “This isn’t the failure of a vaccine,” said Dr. Thomas Frieden of the CDC. “This is the failure to vaccinate.” There have been nearly three times as many measles cases nationally this year compared with each of the past 13 years. Measles was declared eliminated in this country and the rest of the Western Hemisphere in 2000, Frieden said. But elimination doesn’t equate with eradication, he said during a news briefing. When pockets of the population remain unimmunized, the virus can spread remarkably fast. — Newsday
Long-term needs 70 percent of people now turning 65 will need longterm care at some point during their lives. Families provide most longterm care, with 42 million caregivers providing basic care to family members on a typical day in 2009. The value of family caregiving is estimated at $450 billion a year, compared with all paid caregiving at $211 billion. — The Atlanta Journal-Constitution
Power to persevere What gives some people the ability to persevere through difficult situations? New research published online Dec. 5 in the Cell Press journal Neuron may provide a clue. The study pinpoints a region of the brain that, when stimulated, causes an individual to anticipate a challenge and possess a strong motivation to overcome it. “That few electrical pulses delivered to a population of brain cells in conscious human individuals give rise to such a high level set of emotions and thoughts we associate with a human virtue such as perseverance tells us that our unique human qualities are anchored dearly in the operation of our brain cells,” said Dr. Josef Parvizi of Stanford University, the study’s lead author. The study involved two individuals with epilepsy who had electrodes implanted in their brains to help doctors learn about the source of their seizures. The electrodes were situated in the anterior midcingulate cortex, a brain region that is thought to be involved in emotions, pain, and decision-making. When an electrical charge was delivered to a location within this region, both patients described feeling the expectation of an imminent challenge coupled with a determined attitude to surmount it. — Cell Press
Tuesday, December 10, 2013
To Your Health