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Challenges for Old Age Psychiatry

  • Gabriela Stoppe
  • Carlos Augusto de Mendonça Lima
Chapter

Abstract

The increase of life expectancy worldwide leads to a demographic challenge. The aim to reach old age in good mental and physical health comes closer, when prevention throughout the life course takes place and the health-care structures provide integrative and person-centred care and cure. According to the available evidence, education, physical activity, social integration, low or adequately treated cardiovascular risk factors and more reduce the risk for, e.g. dementia or depression, the most frequent mental disorders in late life. The article focuses on four relevant areas: the role of psychiatry in dementia care, the problems of suicide and assisted suicide (prevention), the situation in nursing homes and hospitals and finally, the development of service structures and reflects recent developments in research and policy.

Keywords

Dementia Depression Suicide Nursing home Psychosocial care Service structures 

References

  1. 1.
    World Health Organization. Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, New York, 19–22 June, 1946; signed on 22 July 1946 by the representatives of 61 States (Official Records of the World Health Organization, no. 2, p. 100) and entered into force on 7 April 1948; 1948. http://www.who.int/about/definition/en/print.html. Accessed on 26 May 2013.
  2. 2.
    Huber M, Knottnerus JA, Green L, van der Horst H, Jadad AR, Kromhout D, Leonard B, Lorig K, Loureiro MI, van der Meer JW, Schnabel P, Smith R, van Weel C, Smid H. How should we define health? BMJ. 2011;343:d4163.  https://doi.org/10.1136/bmj.d4163.CrossRefPubMedGoogle Scholar
  3. 3.
    Brandstädter J, Rothermund K. The life course dynamics of goal pursuit and goal adjustment: a two process framework. Dev Rev. 2002;22:117–50.CrossRefGoogle Scholar
  4. 4.
    Kirkwood TB, Austad SN. Why do we age? Nature. 2000;408(6809):233–8.CrossRefPubMedGoogle Scholar
  5. 5.
    United Nations. World population ageing 2009. New York: UN; 2009.Google Scholar
  6. 6.
    World Health Organization. World report on ageing and health. Geneva: WHO; 2015. http://www.who.int/ageing/publications/world-report-2015/en/ . Accessed 28 Feb 2017.Google Scholar
  7. 7.
    Austrian Academy of Sciences. Finnish Academy of Science and Letters, German National Academy of Sciences Leopoldina, Polish Academy of Sciences, Royal Danish Academy of Sciences and Letters, Royal Society, Royal Swedish Academy of Sciences, Swiss Academies of Arts and Sciences: Mastering Demographic Change; 2014. http://www.sagw.ch/…/Mastering_Demographic_Change_in_Europe. Accessed 28 Feb 2017.
  8. 8.
    American Association for Geriatric Psychiatry. Geriatrics and mental health—the facts. http://www.aagponline.org/prof/facts_mh.asp. Accessed on 26 May 2013.
  9. 9.
    World Health Organization & Alzheimer’s Disease International. Dementia: a health public priority. Geneva: WHO; 2012.Google Scholar
  10. 10.
    Matthews FE, Arthur A, Barnes LE, Bond J, Jagger C, Robinson L, Brayne C, on behalf of the Medical Research Council Cognitive Function and Ageing Collaboration. A two-decade comparison of prevalence of dementia in individuals aged 65 years and older from three geographical areas of England: results of the Cognitive Function and Ageing Study I and II. Lancet. 2013;382(9902):1405–12.  https://doi.org/10.1016/S0140-6736(13)61570-6. [Epub ahead of print]CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Satizabal C, Beiser AS, Seshadri S. Incidence of dementia over three decades in the Framingham Heart Study. N Engl J Med. 2016;375:93–4.PubMedGoogle Scholar
  12. 12.
    Richard E, Andrieu S, Solomon A, Mangialasche F, Ahtiluoto S, Moll van Charante EP, Coley N, Fratiglioni L, Neely AS, Vellas B, van Gool WA, Kivipelto M. Methodological challenges in designing dementia prevention trials – the European dementia prevention initiative (EDPI). J Neurol Sci. 2012;322:64–70.CrossRefPubMedGoogle Scholar
  13. 13.
    Tschanz JT, Pfister R, Wanzek J, Corcoran C, Smith K, Tschanz BT, Steffens DC, Ostbye T, Welsh-Bohmer KA, Norton MC. Stressful life events and cognitive decline in late life: moderation by education and age. The Cache County Study. Int J Geriatr Psychiatry. 2013;28:821–30.CrossRefPubMedGoogle Scholar
  14. 14.
    Stoppe G, editor. Competence assessment in dementia. New York: Springer; 2008.Google Scholar
  15. 15.
    Waldemar G, Phung KTT, Burns A, Georges J, Hansen FR, Iliffe S, Marking C, Olde Rikkert M, Selmes J, Stoppe G, Sartorius N. Access to diagnostic evaluation and treatment for dementia in Europe. Int J Geriatr Psychiatry. 2007;22:47–54.CrossRefPubMedGoogle Scholar
  16. 16.
    Gurlit S, Möllmann M. How to prevent perioperative delirium in the elderly? Z Gerontol Geriatr. 2008;41:447–52.CrossRefPubMedGoogle Scholar
  17. 17.
    Inouye SK. A practical program for preventing delirium in hospitalised elderly patients. Cleve Clin J Med. 2004;71:890–6.CrossRefPubMedGoogle Scholar
  18. 18.
    Luppa M, Luck T, Weyerer S, Koenig HH, Braehler E, Riedel-Heller SG. Prediction of institutionalization in the elderly. A systematic review. Age Ageing. 2010;39:31–8.CrossRefPubMedGoogle Scholar
  19. 19.
    Boorsma M, Joling K, Dussel M, Ribbe M, Frijters D, van Marwijk HW, Nijpels G, van Hout H. The incidence of depression and its risk factors in Dutch nursing homes and residential care homes. Am J Geriatr Psychiatry. 2012;20:932–42.CrossRefPubMedGoogle Scholar
  20. 20.
    Scocco P, Fantoni G, Rapattoni M, de Girolamo G, Pavan L. Death ideas, suicidal thoughts, and plans among nursing home residents. J Geriatr Psychiatry Neurol. 2009;22:141–8.CrossRefPubMedGoogle Scholar
  21. 21.
    Huber M, Koelzsch M, Rapp MA, Wulff I, Kalinowski S, Bolbrinker J, Hofmann W, Scholze J, Draeger D, Kreutz R. Antipsychotic drugs predominate in pharmacotherapy of nursing home residents with dementia. Pharmacopsychiatry. 2012;45(5):182–8.PubMedGoogle Scholar
  22. 22.
    Lustenberger I, Schüpbach B, Gunten A, Mosimann U. Psychotropic medication use in Swiss nursing homes. Swiss Med Wkly. 2011;141:w13254.PubMedGoogle Scholar
  23. 23.
    Ballard C, Orrell M, YongZhong S, Moniz-Cook E, Stafford J, Whittaker R, Woods B, Corbett A, Garrod L, Khan Z, Woodward-Carlton B, Wenborn J, Fossey J. Impact of antipsychotic review and nonpharmacological intervention on antipsychotic use, neuropsychiatric symptoms, and mortality in people with dementia living in nursing homes: a factorial cluster-randomized controlled trial by the well-being and health for people with dementia (WHELD) program. Am J Psychiatry. 2016;173(3):252–62.CrossRefPubMedGoogle Scholar
  24. 24.
    Haw C, Harwood D, Hawton K. Dementia and suicidal behavior: a review of the literature. Int Psychogeriatr. 2009;21:440–53.CrossRefPubMedGoogle Scholar
  25. 25.
    Lapierre S, Boyer R, Desjardins S, Dubé M, Lorrain D, Préville M, Brassard J. Daily hassles, physical illness, and sleep problems in older adults with wishes to die. Int Psychogeriatr. 2011;16:1–10.Google Scholar
  26. 26.
    Hegerl U, Rummel-Kluge C, Vaernik A, Arensman E, Koburger N. Alliances against depression – a community based approach to target depression and to prevent suicidal behaviour. Neurosci Biobehav Rev. 2013;37:2404–9.CrossRefPubMedGoogle Scholar
  27. 27.
    Beekman AT, Smit F, Stek ML, Reynolds CF, Cuijpers PC. Preventing depression in high-risk groups. Curr Opin Psychiatry. 2010;23:8–11.CrossRefPubMedGoogle Scholar
  28. 28.
    Alexopoulos GS, Reynolds CF, Bruce ML, Katz IR, Raue PJ, Mulsant BH, Oslin DW, Ten Have T, PROSPECT Group. Reducing suicidal ideation and depression in older primary care patients: 24-month outcomes of the PROSPECT study. Am J Psychiatry. 2009;166:882–90.CrossRefPubMedPubMedCentralGoogle Scholar
  29. 29.
    van’t Veer-Tazelaar PJ, van Marwijk HW, van Oppen P, van der Horst HE, Smit F, Cuijpers P, Beekman AT. Prevention of late-life anxiety and depression has sustained effects over 24 months: a pragmatic randomized trial. Am J Geriatr Psychiatry. 2011;19:230–9.CrossRefGoogle Scholar
  30. 30.
    Graham N, Lindesay J, Katona C, Bertolote JM, Camus V, Copeland JRM, de Mendonça Lima CA, Gaillard M, Nargeot MCG, Gray J, Jacobsson L, Kingma M, Kühne N, O’Loughlin A, Saracenon B, Taintor Z, Wancata J. Reducing stigma and discrimination against older people with mental disorders: a technical consensus statement. Int J Geriatr Psychiatry. 2003;18:670–8.CrossRefPubMedGoogle Scholar
  31. 31.
    World Health Organization. Preventing suicide: a global imperative. Geneva: WHO; 2014.Google Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  • Gabriela Stoppe
    • 1
    • 2
    • 3
    • 4
  • Carlos Augusto de Mendonça Lima
    • 1
    • 2
    • 5
  1. 1.Section of Old Age Psychiatry of the World Psychiatric AssociationBaselSwitzerland
  2. 2.Section of Old Age Psychiatry of the European Psychiatric AssociationLausanneSwitzerland
  3. 3.Old Age Psychiatry, Medical FacultyUniversity of BaselBaselSwitzerland
  4. 4.MentAge Ltd.BaselSwitzerland
  5. 5.Les Toises – Centre de psychiatrie et psychothérapieLausanneSwitzerland

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