Psychiatrist Blog

What Should You Know About Geriatric Psychiatry?

geriatric psychiatry

Geriatric psychiatry is a field of medicine that specializes in preventing, diagnosing, and treating geriatric patients or seniors who are 65 years or older. Aging is a natural process that all of us endure at one point in our lives, but for some, it can come with unwanted changes in their mood, cognition, and quality of life, along with a couple of late-life mental disorders.

Geriatric Psychiatrists Can Diagnose and Treat Various Mental Health Issues

There are three main diagnoses that are made most often in geriatric psychiatry, which are delirium, dementia, and depression. These three late-life psychiatric syndromes come with different psychiatric symptoms. Keep reading to learn more.

Delirium

delirium

Delirium is described to be a sudden onset of a state of confusion. This is not to be confused  

Delirium is described to be a sudden onset of a state of confusion. This is not to be confused with dementia, which generally is a slowly progressing disease that affects a patient’s memory over time. 

Causes and Symptoms

Typically, Dementia has a certain cause, which is most commonly due to medication or some kind of infection. Symptoms of delirium can include:

  • Inattention
  • disorganized thinking
  • altered level of consciousness
  • Disorientation
  • memory impairment

Managing Delirium

This state can be reversed in most cases but may take some work in figuring out what precipitated the episode. Managing a delirium episode can be challenging and the main goal is to keep the patient as comfortable as possible by creating a calm and soothing environment until treating the root cause.

Dementia

dementia

Dementia is the second most commonly seen diagnosis in geriatric medicine and can range from Alzheimer’s Disease, Parkinson’s Disease with dementia, Lewy-Body dementia, and frontotemporal dementia. 

Screening and Tests for Dementia

Screening can also be done with the guidance of mental health professionals if the patient is experiencing some memory loss to evaluate for mild cognitive impairment, which could be a precursor to dementia. 

A patient needs to come in for an evaluation with a geriatric psychiatrist as soon as possible if they are showing some signs of dementia as early intervention always creates the most ideal outcome. A series of tests may also be indicated such as lab work, x-rays, and MRI or CT of the brain to evaluate for any other possible causes of the memory loss or behavioral changes. 

Treatments

There are several treatments available currently that could potentially slow the progression of dementia, some of which include cholinesterase inhibitors and NMDA-receptor antagonists. A combination of these two classes of medications together could delay the need for nursing home placement.

 Not sure when to get tested and treated? Read the 10 Signs of Dementia 

Depression

depression

Lastly, depression and anxiety-related psychiatric disorders are also commonly addressed by geriatric psychiatrists. 

As we age our biology changes and also can put us more at risk for developing medical conditions. Statistics have shown that older adults have double the suicide rate when compared to the overall population, as well as higher psychosis associated with uncontrolled depression. 

Treatment for Depression

Depending on the state and severity of the depression, antidepressants, such as SSRIs, can be safely used in treating the symptoms of older adults. In treatment-resistant or severely depressed patients, procedures such as electroconvulsive therapy, transcranial magnetic stimulation, vagal nerve stimulation, and/or deep brain stimulation may be warranted. 

Generalized anxiety disorder is also very commonly seen in geriatric psychiatry and is often diagnosed along with major depressive disorder. This is typically brought on by stress, worry, and/or life circumstances such as illness or loss of family members and loved ones.

 [Read: What To Know About Transcranial Magnetic Stimulation (TMS) For Depression

Other Geriatric Diseases

An honorable mention to touch on would be geriatrics that struggle with insomnia. There can be several causes contributing to the decrease in quality of sleep, some of which include sleep disturbances (related to underlying medical problems, sleep apnea or other sleep breathing disorders), restless leg syndrome (could be caused by medication), periodic limb movements of sleep, and fluctuation in hormones, specifically melatonin. 

Medication options are available to improve the quality of sleep, but it is important to talk with your doctor about which one would be right for you.

Seek Help from a Geriatric Psychiatrist

geriatric psychiatrist

Overall, geriatric psychiatry is a newer field of medicine that is still gaining some traction. Over the last several years, there have been more studies published by the American Journal of Geriatric Psychiatry (AJGP) regarding the correlation between mental health and older age. 

If you or a loved one is over the age of 65 and experiences mood changes, memory loss, insomnia, or other behavioral concerns, please speak with your geriatric psychiatrist or primary care physician to get the help you need.  

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