Older Adults and Mental Health: What To Watch for and How To Help

It’s natural to worry about the people you love most. And as your loved ones get older, it can sometimes be difficult to tell whether they’re struggling or just … well, getting older.

Is Dad just getting a little bit “Get off my lawn”-style cranky, or is he dealing with something more troubling, like depression or anxiety? Is your kooky aunt just a little bit forgetful like she’s always been, or is it actually a sign of dementia-related memory loss?

But you can make an effort to observe signs of memory and mental health issues and take steps to help your loved ones stay healthy.

Risk factors for depression in older adults

Adults 65 and older are especially at risk for loneliness, says geriatric physician Kathleen Rogers, MD. “This increases the risk of being diagnosed with anxiety and depression or both.”

Chronic loneliness is associated with rising levels of the stress hormone cortisol, which can cause memory problems and other declines in mental and physical health, including a weakened immune system and an increased risk of cardiovascular problems.

“Many seniors were already dealing with isolation, and it worsened during the pandemic,” Dr. Rogers says. “As a result, we’ve seen more people with anxiety, depression and worsening memory loss.”

Here are some of the factors that can contribute to mental health issues in older adults:

• Retirement: When you retire, your routines change and your social interactions become different. An estimated one-third of retirees faces depression upon this transition.
• Grief and loss: With aging may come the loss of friends, spouses and loved ones, which can contribute to loneliness, depression and even grief-related illness.
• Health concerns: A decline in physical health and ability can affect older adults’ sense of self and impact quality of life, which can contribute to isolation and depression.
• Dementia: One study found that 1 in 10 Americans aged 65 and older has some type of dementia, and another 22% has some other form of cognitive decline. Untreated depression and social isolation can also contribute to memory loss. “Anxiety and depression are hardwired into dementia,” says geriatric psychiatrist John Sanitato, MD.

How older adults can protect their mental health

Because of their past life experience, this age group is often able to be resilient in times of stress, which can protect people from some of the negative effects of aging.

And there are specific steps people can take to protect their mental health as they age. “We’ve recognized for a long time that certain protective factors help fend off depression in older adults,” Dr. Sanitato says.

He explains what they are and what they might look like in your life or in the lives of older loved ones.

1. Stay (or become) socially active

Remember what we said about the effects of loneliness? It’s no surprise, then, that having a social support network is one of the keys to good mental health as you age.

“It’s really important that people stay connected or get reconnected,” Dr. Sanitato says. That may mean joining a new club or group, reconciling with siblings you haven’t seen in years or calling up old friends to renew past relationships.

Neighbors, he adds, can be an especially rich source of social support.

“Many times, they’re in a similar life circumstance,” Dr. Sanitato continues. “Sometimes, it can just be like, ‘We’ve lived next door to one another for 40 years. Do you want to go get coffee?’ I’ve seen those relationships become a major lifeline for people.”

2. Engage with your spirituality

Whether you’re devoutly religious or just love spending time in the great outdoors, Dr. Sanitato says that feeling connected to a sense of something bigger than you can go a long way for your mental health as you age.

“This doesn’t have to mean following Jesus or the Buddha, though it could,” he continues. “It may mean being a part of an organized religious faith, or it may be participating in a 12-step program, spending a lot of time in the sun or just having some feeling of connection to a higher power.”

And active engagement is key, whether it means being involved with your church, synagogue, temple or mosque, or joining a hiking club so you can regularly marvel at the wonders of nature.

3. Find physical activities you enjoy

Let’s say you used to be a star athlete, but now your physical health prevents you from participating in the sport you once loved. That can be a real blow to your sense of identity. And you may feel like your days of movement and exercise have come to an end.

“Loss of physical function and functional ability — like being unsteady on your feet or having joint issues — can limit your ability to participate in life as you know it,” Dr. Sanitato notes, “but it’s important to try to find adaptive strategies to keep moving and to sustain the social interactions that comes with physical activity.”

If you were a tennis player in your youth, maybe you’ll love playing pickleball on a senior league now. If you were once a runner, you may find the same high these days from walking laps around your neighborhood (and catching up with neighbors as you do). Depending on your specific health needs, look into other options like:

• Bodyweight training.
• Cycling.
• Pilates.
• Swimming.
• Water aerobics.
• Yoga.

Your local gym or community center may offer classes specifically geared toward seniors, which is a great way to get moving and make new friends. “Just find a way to do something,” Dr. Sanitato encourages.

How to support your loved ones as they age

If you’re worried about the older adults in your life, do your best to make sure they have these things in place to keep their mental health and cognitive abilities in check:

• Keep up with a daily routine: “I sometimes recommend that people use a large calendar to orient themselves in the morning — to figure out what day it is, what medications they need to take and if they have any appointments,” Dr. Rogers says. “Keeping a routine is very important.”
• Plan regular social engagement: Help your loved one tap into community and social groups to participate in, like a book club, a support group, a volunteer program or a place of worship. All of these can help older adults maintain a sense of purpose and belonging.
• Do activities to stimulate the brain: This could be something as simple as looking at photo albums or recipe books, or something more complex. “Studies have shown that learning a new language, coloring or listening to classical music can improve memory in some patients,” Dr. Rogers adds.

Supporting older adults from a distance

Older adults are at greater risk for getting very sick with or dying from COVID-19, so some seniors are still significantly limiting their in-person social interactions. And of course, sometimes, you just don’t live as close as you’d like to the people you love.

While connecting virtually with your loved ones isn’t the same as hugging them and being with them physically, it’s a super-safe way to stay in touch and to keep spirits high.

“There are tablets with bigger monitors they could use, or even hook up the television to a webcam so they can see it on the big screen,” Dr. Rogers suggests. “They just might need somebody to help set that up.”

Signs that your loved one is struggling

Signs of depression, anxiety or worsening memory loss often go unnoticed in older adults — which is especially troubling, given the high rates of suicide among this age group.

“Sometimes, people don’t want to deal with small talk or pleasantries anymore, or they simply don’t want to be seen,” Dr. Sanitato recognizes. “This can result in social withdrawal, a lack of interest in activities and changes in appearance and comportment.”

Keep an eye on the people you love as they age. Pay attention, especially, if they:

• Stop enjoying things they used to love.
• Distance themselves from communities, activities and other social groups they used to be part of.
• Shower less often and/or stop caring about their appearance.
• Stop taking their medications or going to doctor’s appointments.
• Stop maintaining their home or yard, especially if they previously cared a lot about them.
• Miss bill payments or overpay their bills.
• Show other signs of dementia or cognitive impairment.

Your loved one may not ask for help or even realize they’re struggling with mental or cognitive health issues. But if you become aware, you can help set up an appointment with their primary care doctor. You can also call or text 988, known as the 988 Suicide & Crisis Lifeline, from anywhere in the U.S. to be connected to professionals who can help you work through your concerns and figure out next steps. They can even send a mobile response team and provide long-term support.

“Early diagnosis is really important,” Dr. Rogers stresses. “The earlier you diagnose depression, anxiety or memory loss, you can put things in place to help prevent or delay further decline.”