Comorbidity of Medical and Psychiatric Disorders in Geriatric Population

Ageing is a universal phenomenon that has not only social but also economic, political, and health-related implications. With the advancement in healthcare facilities and better availability of health services, the geriatric population is gradually increasing. But, this group is at an increased risk of developing both physical and psychological co-morbidities due to age-related factors and changes in the social circumstances. The present chapter proposes the concept and issues related to co-morbidity in the geriatric population. After discussing the issues and consequences of medical and psychiatric co-morbidities, their effective treatment regime and care/management in relation to the geriatric population are addressed.

Impact of Tuberculosis in Elderly Population

The World Health Organization has declared that the spread of tuberculosis is a global emergency. Despite the implementation of strong tuberculosis-control initiatives by WHO, this highly infectious disease continues to affect all vulnerable populations, including the elderly population. Adverse social factors and poor living conditions also affect the elderly much more than the young. The clinical characteristics of tuberculosis in older adults can be unusual and may be confused with age-related illnesses. Various factors related to old age can also cause complications in the diagnosis, treatment, and disease outcomes for tuberculosis patients. The contributory factors may be poor memory, deafness, mental confusion, or impairment of speech. In addition, therapy for tuberculosis in elderly individuals is challenging because of the increased incidence of adverse drug reactions. Hence, understanding the impact of these substantial aspects will help to overcome the problem of tuberculosis in the elderly population.

Cognition in Ageing

This chapter focuses on cognitive functions and impairment in the elderly; its implications in daily functioning with inputs on differences in the existing literature. The chapter further focuses on the diagnostic and assessment issues and intervention strategies. Ageing is an inevitable phase of life and encompasses changes in physical, psychological and social realms of an individual. Concern with the dwindling health and presence of any medical issues make the geriatric population prone to develop mental health conditions. Poor memory and reduced functional ability is one of the common complaints from older adults coming to psychiatric or neurology clinics. Cognitive functions have been well documented regarding their role in daily functioning of an individual. With growing age of the brain; while some cognitive functions do slow down; some of the functions do evolve better with experience. In this context, it is important to differentiate between normal age related cognitive changes and symptoms of any degenerative disease.

Promoting Successful Positive Aging Across the Health Continuum

The increase of human lifespans and the aging has brought increased attention to what factors contribute to aging healthy. People are not only interested in longevity but how to remain in the best health in their later years. Therefore, the aim of this chapter is to (a) understand the concept of positive aging (b) identifying the factors contributing to successful positive aging across health continuum (c) review strategies that promotes management healthy aging in elderly, and (d) identify future directions to promote successful population health management programs/interventions. The holistic approach, therefore provide an opportunity to improve the situation of older people in society.

Sleep and Sleep Disorders in Old Age

Sleep complaints are prevalent among older adults. Sleep quality and quantity changes with advancing age. There are changes in sleep patterns that are normal with ageing but many changes are the sign of disordered sleep. Sleep can be divided into rapid eye movement (REM) sleep and non-rapid eye movement sleep (NREM). Each has unique characteristics that are differentiated by their waveforms on the electroencephalogram (EEG) and by other physiological signals; several physiological age-related changes are thought to produce alterations in circadian rhythms. While there are numerous psychological and social factors contributing to quality and quantity of sleep, specific sleep disorders more prevalent in old age are insomnia, sleep apnea, and rapid eye movement disorder. Non-pharmacological treatment is effective in management of sleep disorders. Cognitive behaviour therapy is most effective to tackle insomnia. Cognitive behavior therapy along with meditation is beneficial for other sleep disorders and a new technique is also emerging: mindfulness.

Diabetes Mellitus and Aging

Aging mirrors all the changes that occur over the period of life. It comes with various changes both positive and negative. Among all medical illnesses, Diabetes Mellitus is one of the most common and serious medical condition that has affected not only the aging population but also the young children and adults as well. Diabetes and its complications can contribute to aging process in a number of ways and the complications can speed up the aging process as well. For people with type 2 diabetes managing their emotional health can be as important as keeping their blood sugar under control. Patients with diabetes mellitus need psychological support throughout their life span from the time of diagnosis. However, provision of psychosocial support is generally inadequate due to its challenging nature of needs and demands on the healthcare systems. The present chapter will cover different aspects of diabetes mellitus and its impact on human life and also how with healthy coping mechanism one can prevent the distressing effect of diabetes on aging and vice versa.

Aging, Quality of Life, and Social Support

The present chapter presents an intertwined view on aging, quality of life and social support. Aging is a sensitive process of transformation from a young age structure to old age. It is a pressing problem for many countries in this century. Therefore, attention to needs and problems of this age has an importance. The domains that need more attention in elderly is both quality of life and social support in their life. Though social support and quality of life have received much attention in studies of the psychological issues of older adults but still researches are needed in special attention at the intervention level.

Factors Contributing of Ageing

Ageing is related to problems in physical, emotional, and mental health. If we can delay the ageing process, we may be able to live more happily and successfully. Several factors are responsible for ageing: age, sleep, dietary habits, nutrition, physical activity, general health condition, emotional well-being, physical impairment, cultural factors, life events, social support, family well-being, financial resources, cognitive functioning, and diseases. The chapter is based on the above views and mainly focuses on the various factors that contribute to ageing.

Ageing and Mental Health

Estimated research findings suggest that almost two-thirds of adults with psychiatric conditions do not receive the required treatment services. This chapter enables readers to understand various aspects of ageing, how physical and mental health aspects are correlated, and which mental health conditions are most common in later life. The chapter also discusses major models of mental health in the context of ageing. Major psychiatric and psychological conditions that are most common in old age are outlined along with a major milestone of old age (i.e., retirement: a major lifestyle change that pushes older people towards psychological problems and adjustment issues with a new phase of life). A brief description is presented on the current status of psychiatric and psychological services for mental health issues of the elderly. The chapter concludes by summarizing the contents of discussed areas. Studies are presented throughout the chapter to accompany and enrich the discussion and validate the chapter content.

Management of Elder Abuse Through Social Support

This chapter is an attempt to highlight the numerous ways in which elders are abused in our society and the ways to support them. A concise account in ways elders are vulnerable and how they are exploited are discussed in the chapter as well as remedies to these problems. The chapter includes types of abuse faced by elders and the consequences they face due to it. It also discusses Social Support as the main remedy, social support as an acronym of 13 types of social support. The chapter concludes by recommendation of how elder abuse can be stopped or at least controlled.