Report claims mental health of people in later life has been overshadowed by systemic and interpersonal ageism

By Dr. Priyom Bose, Ph.D.Mar 7 2024Reviewed by Danielle Ellis, B.Sc.

A recent Center for Mental Health briefing documents the evidence on the mental health of older people in England and what kind of support they receive.

About the study

To better understand the current mental health status of older people residing in the United Kingdom, the Age UK commissioned the Centre for Mental Health to explore the same. As part of this initiative, research was conducted to understand better the mental health status of older people in England. The type of support these people receive and the policies that have been formulated to improve their mental health were analyzed.

This review highlighted that few studies are being conducted and few policies are being developed to support the mental health of people during their later life. This review focused on the publications and policies on the mental health of older adults in the last five years. Older literature was explored if inadequate evidence on a particular aspect was obtained. This approach helped close the gaps wherever possible.

A wide gap in research was identified in accordance with the number of studies on the mental health of the younger and older population. It was observed that in the last five years, scientists have primarily conducted research on dementia and coronavirus disease 2019 (COVID-19).

Older adults and mental health

The current briefing observed that the UK’s population is rapidly aging. In comparison to the entire population, for older people, mental health has a greater impact on life satisfaction than physical health. A US-based survey on older people revealed that being independent held greater weightage than staying alive or pain reduction. The majority of studies have prioritized the health of older people to uplift their quality of life. These studies show that even though mental health is important for a better quality of life in older groups, it is not prioritized or equally valued.

It has been observed that the majority of older people from the UK, particularly those who are above 65 years of age, experience significant anxiety and low mood. Around 25% and 40% of people above 65 and 85 years of age, respectively, experience depression in care homes. It has been documented that 1 in 10 people above 75 years of age is diagnosed with clinical depression.

In 2018, the Faculty of Old Age Psychiatry and the Royal College of Psychiatrists highlighted an increase in hospital admissions due to drug and alcohol abuse in older adults. These people were found to be particularly vulnerable to developing mental health issues and require nursing home care. Older adults living with dementia, poverty, and belonging to minority communities and immigrants are at a higher risk of experiencing adverse mental health conditions.

Factors that increase later life mental health problems 

Mental health problems in later life are complex due to age-specific risk factors, such as loneliness and multimorbidity. In addition to frailty due to aging, poverty, prior exposure to traumatic events, and racism also contribute to mental health problems in later life. Food insecurities, bereavement, and physical disabilities also lead to the development of mental health conditions.

A significant proportion of older people develop long-term conditions (e.g., diabetes) and neurodegenerative conditions (e.g., Alzheimer’s disease) that raise the treatment burden and increase the risk of harmful interactions between different medications. Neuroinflammation can cause chronic pain and depression.

Interestingly, studies have shown that people belonging to specific demography experience greater mental health issues, which could be due to inadequate mental health services. Older people residing in care homes are also more vulnerable to developing depression, anxiety, and neurodegenerative conditions.

How to protect older adults from adverse mental health conditions?

One of the factors that could help prevent mental health issues among older adults is positive relationships. This could include family, friendships, community groups, and social networks. Furthermore, having a meaningful option to work past retirement age and volunteering opportunities will help prevent adverse mental health conditions. It is important for this group of individuals to have a sense of purpose and to have control over life choices.

In the majority of cases, awareness and open mind to therapies and healthy life behavior to address mental and physical health help prevent adverse outcomes. A healthy diet and regular physical activity have been recommended for a better quality of life.

Mental health services and policies for older people

In England, the national policy documents provided little insight into how mental health support should be provided to the older population. The National Institute for Health and Care Excellence (NICE, 2015) provided recommendations regarding the type of intervention that should be provided to prevent mental health problems in older adults.

The lack of government investment to support older people’s mental health also contributes to their increased prevalence. The notion that mental health issues in older adults are inevitable or untreatable also increases their prevalence. An increase in age-friendly digital options could alleviate some of the key risk factors, such as loneliness, among older people. 

Not many policies related to mental health care in later life exist. However, the Community Mental Health Framework (NHS England, 2019) provided insights into how severe or complex mental health problems could be met over a long-term plan.