Mental Health: Subjective evaluation of overall quality of life (QOL) Happiness, life satisfaction, morale, trait effect, etc. Quality of Life (QOL)

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1 Mental Health: Subjective evaluation of overall quality of life (QOL) Happiness, life satisfaction, morale, trait effect, etc. Quality of Life (QOL) Multidimensional concept Includes: Physical health Cognitive functioning Behaviours Subjective evaluation Social relationships

2 Clinical Depression American Psychiatric Association (APA) says: Clinical (major) depression at least 5 symptoms including any one of the first 2 lasting for 2 weeks Depressed mood Loss of interest in pleasurable activities Loss of appetite Sleep disturbance Difficulty in concentration Fatigue/Loss of energy Feelings of worthlessness and guilt Psychomotor disturbance Suicidal attitudes Geriatric Depression Scale (GDS) (short form) Choose the best answer for how you have felt over the past week: 1. Are you basically satisfied with your life? YES / NO 2. Have you dropped many of your activities and interests? YES / NO 3. Do you feel that your life is empty? YES / NO 4. Do you often get bored? YES / NO 5. Are you in good spirits most of the time? YES / NO 6. Are you afraid that something bad is going to happen to you? YES / NO 7. Do you feel happy most of the time? YES / NO 8. Do you often feel helpless? YES / NO 9. Do you prefer to stay at home, rather than going out and doing new things? YES / NO 10. Do you feel you have more problems with memory than most? YES / NO 11. Do you think it is wonderful to be alive now? YES / NO 12. Do you feel pretty worthless the way you are now? YES / NO 13. Do you feel full of energy? YES / NO 14. Do you feel that your situation is hopeless? YES / NO 15. Do you think that most people are better off than you are? YES / NO Score: /15 1 point for No to questions 1,5, 7, 11, 13 1 point for Yes to all other questions Normal 3+/- 2 Mildly depressed 7 +/- 3 very depressed 12 +/- 2 Is aging related with depression? Aging related factors: health decline, health decline, chronic illness, restricted activity, low income, lack of social network

3 Uncertain prevalence among older adults It is estimated that -- 30% have transient depression 2-3% true clinical depression Institutionalized elderly: 35% clinical depression Gender differences: Women report higher levels of depressive p g p symptoms than men

4 Why do women have more depression? Work and family responsibility Chronic illnesses are more common in women Hormonal changes More women live alone Deterrents: Social network, activity, voluntary work Kahana and Kahana (1996) 3 skills are helpful in coping and adaptation Tapping into social support stress buffer New social roles compensation for lost social roles Modify current environment or move to suitable environment Dementia Brain degeneration leading to mental disorder Effects memory, learning, personality, judgment Most common forms: Alzheimer s disease Vascular dementia

5 Dementia Statistics Canada 480,600 people in Canada have Alzheimer s or a related dementia (1.5% of the population) 103,700 new cases in Canada each year Every 5 minutes, 1 person in Canada is diagnosed with Alzheimer s or a related dementia What is Dementia? A group of signs or symptoms that show that the brain is malfunctioning. These include difficulties with memory, concentration and judgment. The symptoms are caused by an organic disease or a disorder of the brain and are accompanied by emotional disturbance and personality changes. C A U S E S S Y M P T O M S What is dementia? Vascular (Multi-infarct) Alzheimer s Disease Dementia Frontotemporal Dementia Lewy Body Disease Other BRAIN DAMAGE Death of brain cells & impaired function of remaining cells DEMENTIA A cluster of symptoms related to a decline in cognitive abilities

6 Four most common types of dementia: -- Alzheimer s disease (over 50% of the cases) -- Vascular dementia -- Lewy body dementia -- Frontotemporal dementia Alzheimer s Disease (AD) Discovered by Dr. Alois Alzheimer in 1906

7 The brain in Alzheimer s -- Plaques and Tangles in the brain cells Normal brain Alzheimer brain

8 4 A s of Alzheimer s Disease (AD): Anxiety Agitation Aggression Apathy No known cure of Alzheimer s Disease Medications available include --Cognex, Aricept Stabilize the progression of dementia Stages of Alzheimer s Early Stage Middle Stage Late Stage Mild Dementia Moderate Dementia Severe Dementia Time Stages of Alzheimer s - Early Mental: forgetfulness, difficulty learning new things Emotional: moods shift easily, depression Behaviour: passiveness, withdrawal, restlessness Physical Abilities: mild coordination problems

9 Stages of Alzheimer s - Middle Mental: intensified memory problems, difficulty recognizing familiar things Emotional: personality changes, anxiety, suspicion Behaviour: inability to concentrate, restlessness, uninhibited behaviour Physical Abilities: assistance needed for daily tasks Stages of Alzheimer s - Late Mental: loss of ability to remember, process information Emotional: possible complete withdrawal Behaviour: non-verbal communication (e.g. eye contact, crying, groaning) Physical Abilities: sleeps longer, difficulty eating and swallowing, unable to perform self-care, may lose weight Exact cause of AD is not known Linked to G ti di iti Genetic predisposition Environmental influences

10 Genetic predisposition Study with twins Fraternal twins less than 1% chance of both twins having Alzheimers Identical twins 35% chance Environmental factors Nutrition, stress associations not substantiated Linguistic abilities positive contribution in less occurance of AD