Let’s look at the conditions themselves. What are they, who do they affect, and what evidence is available to back up this information?
Anxiety
Anxiety can be crippling for any age group. Its impact on a person’s quality of life can be significant; from mental health concerns such as constant worrying and lack of focus, to physical issues like digestive and immune system problems.
It’s been shown to have a substantial effect on those over 50 too, with 2023/24 studies reporting that anxiety impacts 42% of those aged 50-59.
Although men and women of this age group share many of the same anxiety causes (physical ailments, empty nest syndrome, financial stress), biological changes increase the likelihood of anxiety in women. These include menopausal and hormonal shifts, which can vary in severity - from hot flashes to mood changes, intense migraines and physical discomfort.
For men, lifestyle changes rank highly as a cause for anxiety. This stems from issues such as a lack of routine in retirement or a change in their social or family life. The stigma around men’s mental health can also be damaging, with a large percentage feeling reluctant to talk about their feelings, which in turn leads to suppressed and often worsening anxiety.
What impact does anxiety have on those over 50?
Anxiety has the potential to impact every facet of a person's life. In terms of physical health, though not directly responsible, the results of anxiety - including lack of motivation - can result in mobility issues due to lack of physical activity. National polling reports this as common in those 50 and above, with 34% feeling less motivated to do things they previously enjoyed.
These feelings can lead to a lack of autonomy and ability to look after oneself, triggering other issues such as social anxiety, dietary problems and depression (often a comorbid of anxiety).
Depression
Another common condition impacting this age group is depression. It can stem from a number of causes, including the decline of physical health which often accompanies ageing.
The mental weight of conditions such as cancer and heart disease, alongside mobility limitations, can have a psychological impact. These challenges often result in a need for care, making patients feel they are a burden, while also being a reminder of their mortality.
Isolation can also be a contributor. One study - which attempted to identify what percentage of participants aged 50 and above felt lonely - showed one in five people developed depression up to a year after experiencing loneliness. They concluded that tackling loneliness - which included feeling left out or a lack of companionship - could help prevent future occurrences of depression.
What impact does depression have on those over 50?
Similar to anxiety, depression can trigger a lack of drive or motivation, leading to an increase in physical health conditions like heart disease, compromised immune system and chronic pain.
It’s also been reported that suicide among older adults - specifically men - is more likely to be associated with depression than at any other age. This is likely due to factors such as mobility problems, isolation and cognitive decline, which can contribute to sadness and distress.
Cognitive impairment
While cognitive impairments such as dementia are considered neurodegenerative conditions, they can result in mental health challenges. Their impact on memory, ability to focus and decision-making can create roadblocks in daily life - leading to frustration caused by an inability to perform routine tasks that were once straightforward.
Neurodegenerative conditions often signal a decline in cognitive functions, too. This can result in the worsening of existing mental health conditions, while increasing the likelihood of new conditions, such as depression and mood disorders.
Not all impairments of this type are degenerative, though; certain conditions - such as those relating to lifestyle choices, deficiencies, and infections can at times, be maintained with the right treatment or planning.
What are the impacts of cognitive impairments on those over 50?
The effects of cognitive impairments often come down to the severity of the condition. Mild cognitive impairments (MCI) fall into two categories: Amnestic and non-amnestic - with the former affecting memory, and the latter impacting language, focus and visual spatial processing.
MCIs can often result in speech difficulties, as well as issues with decision-making and problem-solving. This can lead to feelings of helplessness, causing individuals to withdraw from their social and family lives - while also being a catalyst for depression and anxiety.
While most MCIs can be stabilised, and at times improve - 10-15% of older adults with MCI are likely to develop more serious impairments such as dementia. Dementia can significantly diminish quality of life, affecting executive function and, in some cases, may lead to death.
It can result in a lack of mental and physical awareness, making it difficult for individuals to perform once simple tasks (e.g. tying shoes or taking medication), risking injury and causing severe memory loss. It also poses risks to physical health, causing breathing issues and weakening the immune system - which can be dangerous in older individuals who may be more vulnerable to infection.
Sleep disorders
While not a mental health ailment, sleep disorders appear in this article because they can be both a cause or occur as a result of mental health conditions. Sleep disorders come in different forms, including:
- Insomnia: A condition which results in not being able to sleep or sleeping too much. Studies show that 10-30% of adults live with insomnia, which increases as they age.
- Sleep Apnoea: Though there are a range of sleep apnea types, commonalities across these conditions include interruptions in breathing while asleep. It often results in loud snoring and is frequently linked with other conditions - most notably heart disease. Between 13-32% of recorded adults over 50 suffer from sleep apnoea, with the condition being more common in males.
- Periodic Limb Movement: Involuntary, sometimes repeated limb movements that are not dissimilar to Restless Leg Syndrome - a neurological condition that can interrupt sleep and lead to tiredness. Estimates state that around 25-58% of those 65 and above experience PLM, while the likelihood of the same age bracket experiencing RLS is lower, at between 5-10%.
- Circadian Rhythm Disorders (CRD): CRDs are a common occurrence as we age, and happen when our body clock is out of sync with what’s going on around us during sleep. There are a number of different CRDs prominent in over 50s, with the most common being Advanced sleep-wake disorder (ASWPD), which results in waking earlier than normal and feeling tired long before your usual bedtime hours.
What are the impacts of sleep disorders on those over 50?
While each type of sleep disorder impacts individuals differently, frequent lack of or disturbed sleep can increase the risk of depression or anxiety. This can be because sleep disturbances slow the release of serotonin - one of the body’s main mood regulators. It’s also possible that existing conditions may worsen for the same reason.
Existing mental health conditions can also be the cause of certain sleep disorders. For example, instances of manic episodes associated with bipolar disorder may trigger insomnia, while persistent thoughts caused by anxiety can also lead to difficulty sleeping.
Older-Age Bipolar Disorder (OABD)
Though bipolar disorder is often diagnosed early, it can still occur into mid-life, with nearly 25% of those with the condition being around 60 years old. Prominent traits include rapid mood shifts, changes in energy or focus, and severe cases of manic or hypomanic states - though episodes like these are more common in younger individuals.
It has also been shown to cause frustrating symptoms, such as challenges with processing information, while also impacting speech and the ability to verbalise thoughts.
What impact can OABD have on those over 50?
Studies show that OABD contributes to rapid ageing. These investigations reported links between regular bipolar episodes and the decline of executive function, alongside increased comorbidities. Comorbidities are conditions which are likely to exist alongside other conditions.
For OABD, this includes ailments which can negatively impact individuals of an advanced age, including dementia, diabetes, heart disease and increased likelihood of strokes.
For older adults, awareness is a great first step in discovering the mental health conditions that may lie ahead. It’s also useful to know if these conditions can be prevented or maintained, while also understanding how treatments may impact quality of life.
Therapy and counselling
For symptoms of depression and anxiety in older adults, psychotherapy has been shown to be effective. A common avenue is Cognitive Behavioral Therapy (CBT), which allows individuals to work to replace depressive thought patterns - for example, “more of my friends are passing away, I feel alone” - with a positive reframe of that thought.
Therapy can also help those with serious cognitive conditions to address associated challenges such as isolation and lack of autonomy. Through discussing these feelings of loss, therapists help individuals create a plan for treatment, or ways to help lessen the emotional weight of their feelings.
For sleep disorders, there are a range of therapies available that cater to specific conditions. Supervised sleep restriction therapy - which limits the time you spend in bed to help your body associate your bed with sleep - has proven effective for treating insomnia. Another popular treatment is CBT-I (CBT for insomnia) - a structured treatment that supports individuals in learning how their thoughts and actions impact sleep.
Lifestyle interventions
Mental health conditions can affect motivation considerably, leading to less physical activity, weight gain and other debilitating physical conditions. Interventions which focus on fitness can also be beneficial, with regular exercise being linked to positive brain health in older adults.
Elsewhere, changes to diet - such as an increase in fruit, vegetables and foods containing omega-3, have been shown to reduce the risk of depression in this age group. Dietary interventions can also have a domino effect, preventing potential obesity, which is linked to both depression and type 2 diabetes.
Medication
Selective Serotonin Reuptake Inhibitors (SSRIs) and Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) are common antidepressants used to treat depression and anxiety in older adults. The former increases the influence of serotonin in the brain, whereas the latter is used to treat similar conditions. It also influences norepinephrine in the brain, which helps regulate mood, sleep, and social behaviours.
For OABD, the main medication available in the UK is Lithium. Lithium is a mood stabiliser that works to influence both serotonin and dopamine, helping to combat mood swings and boost focus. As a bonus, it also has anti-inflammatory properties for the brain, which, while also supporting mental health, have also been linked to positive effects of inflammatory bowel disease (IBD).
While CBT-I is often the first port of call for sleep disorders, medication is still commonly issued; though it is often a short-term solution used alongside therapy. This is due to the increased risk of cognitive impairment in older adults who take the specific drugs prescribed for sleep disorders.
Treatments range from over-the-counter antihistamines like diphenhydramine, to Benzodiazepine Receptor Agonists (BzRAs), which lower excitement in the brain and deliver sedating effects.
Though there is no fix for cognitive impairment like dementia, Acetylcholinesterase Inhibitors (AChEI) can be used to delay cognitive decline. Depending on the stage of cognitive impairment, AChEIs allow individuals to manage their condition and carry out their daily tasks with clarity.
Whether you’re an individual or a family member caring for a loved one, it’s important to know what support is available to you and what it can offer to your situation.
Social support
Social prescribing is a fantastic initiative for those with long-term conditions. Your assigned link worker pulls together a support plan that helps you link up with activities, groups, and services in their local area.
These services can be hugely beneficial for those with anxiety, depression or any illness which reduces motivation, saving individuals the stress of researching what’s available to them in their community.
An example may be attending a support group and having conversations in an environment that specialises in discussing their condition. These situations can also act as encouragement for individuals who may have withdrawn from socialising due to their condition.
Creative support
Organisations like Age UK offer creative arts groups which pop up in different areas of the country. They allow older adults to gather and indulge in a range of art and creative practices. For those who attend and enjoy the groups, it can give them a sense of purpose and help reduce the chance of cognitive decline, while distracting from and minimising the impacts of their specific condition.
Mindfulness and wellbeing support
While mindfulness has risen in popularity since the late 90s, its impacts on mental health - specifically in older adults - shouldn’t be understated. Alongside being proven to reduce stress, its focus on the present moment can help to lower the risk of depression and anxiety.
There are also links between meditation and slowing cognitive decline. One study engaged participants with Alzheimer’s disease in key mindful practices over five years. The study concluded that those involved showed increased attention and memory - indicating the positive impact of mindfulness on those with cognitive impairment.
Online support
For immediate support, it may be a good idea to look at the various resources available online. Organisations such as Live Life to the Full (LLTTF) provide online or classroom-based learning materials that help educate individuals and support them in managing their conditions.
It may also be beneficial - specifically if you lack mobility or transport - to seek online therapy or counselling. Resources like this one from the National Council on Ageing guide help you to understand the benefits therapy offers, while supporting you in signing up.
Depending on your condition, you’ll likely find directories online packed with the contact details of relevant support, as well as helpful guides and articles.
Whether for current or future use, we hope you’ve found our latest guide useful. Looking after our mental health is important regardless of age. However, because we are more likely to develop new conditions as we age, educating ourselves on common mental health conditions can help us to prepare - allowing us to live as full a life as possible alongside them.
If you’re interested in covering yourself for future mental health conditions, our article on Over 50s health insurance in the UK has all of the information you need. In it, we discuss why taking out coverage is beneficial as you age, what you’ll be covered for, and the best policies available across the health insurance market.
If you’d like to learn more about mental health conditions and how health insurance can support you, contact myTribe today.
