Researcher investigates mental illness in elderly

With a dramatically increasing population over 65, the need for qualified, well-educated psychiatrists and psychologists who specialize in the treatment of older patients is bordering on becoming a national crisis.

According to UCSD researcher Dilip Jeste, M.D., who holds the Estelle and Edgar Levi Chair in Aging and serves as director of the Sam and Rose Stein Institute for Research on Aging, today’s average life span is 73 years for men and 79 years for women. In 40 years, it will have increased to 86 for men and 92 for women.

About a quarter of that population will experience late-in-life mental health issues. Jeste estimated that there are currently fewer than 3,000 board-certified geriatric psychiatrists in the U.S.

“We have not really paid attention to how we are going to (treat) this population,” Jeste said. “It’s a highly specialized area.”

A recent grant from the Hartford Foundation will enable Jeste to continue researching the mental health needs of the elderly, while also training geriatric practitioners and caregivers.

In 1900, the average life span in the U.S. was 47 years. The number of citizens over 65 was approximately 3 million. By 2000, that demographic had risen to 35 million, a number experts expect to double by 2030.

Jeste’s research has identified several unique factors that can influence the diagnosis and treatment of mental illness such as schizophrenia, anxiety, depression and dementia in older adults.

Some of the physiological problems that may contribute to decreased mental wellness include hearing and vision problems, side effects from medication and a normal decline in memory.

Surprisingly, many of the dynamics that impact mental health are social.

Decreased mobility makes it harder for seniors to get to the doctor’s office. Isolation due to the death of a spouse and children leaving home may delay detection of mental illness. Financial concerns may prohibit individuals from seeking and receiving treatment.

Many practitioners are unaccustomed to assessing a patient’s social issues, said Jeste, who points to the lack of reimbursement as part of the problem.

“There is no reimbursement for doing behavioral, psychosocial intervention, which people often need,” he said.

Jeste’s studies have also revealed factors that positively influence mental health in older Americans: having an optimistic attitude toward aging, physical activity, mental agility, social support, calorie restriction and continually learning new things.

Through the research conducted at the UCSD geriatric psychiatry program, Jeste hopes to find more effective interventions and train in-demand professionals.

“My center can’t solve the world’s problems,” he said, “but my center can be a model.

“The Hartford grant is really very helpful. It provides support and training in this area which are otherwise hard to come by. There are not too many private foundations that spend money on helping research and education work for geriatric psychiatry.”