Disorders of the Elderly: Dementia, Depression, Anxiety, and Late-life Schizophrenia

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Millions of America’s elderly suffer from late-life mental disorders, including Alzheimer’s disease, dementia, paraphrenia (late-life schizophrenia), depression and anxiety. In this program, Dr. William McDonald from Emory University School of Medicine discusses how best to help our loved ones as they age. Nearly a third of older people suffer from anxiety or depression. They can often be treated effectively with psychotherapy or non-addictive medications like Prozac, Paxil and Zoloft, which increase serotonin in the brain. Since the elderly have a suicide rate six times higher than the rest of the population, it’s essential to recognize symptoms and take your loved ones to a doctor early. The elderly are often guarded about discussing depression, so you will want to inform the doctor of symptoms yourself.

About 40 percent of Americans age 85 and older have clinically diagnosable Alzheimer’s disease. Alzheimer’s has a strong genetic component, but changing your lifestyle can greatly reduce its likelihood. Physical exercise, mental activity such as solving puzzles and word games, and avoiding smoking and bad foods can push back its onset. Some memory loss is a normal part of getting older, and something as simple as a B-12 vitamin deficiency can cause memory loss. For serious cases of dementia, it can be difficult to switch roles and to act as a caregiver for your parents. It is important to establish a durable power of attorney and draw up an updated will while they still have their mental faculties. The Alzheimer’s Association can help you deal with legal issues and offer support for caregivers.

Dr. McDonald is Chief of Geriatric Psychiatry at Emory University and Director of Emory’s Fuqua Center for Late-Life Depression. In this program, he answers questions from listeners. Susan asks for advice about her 78-year-old father, who has expressed thoughts of suicide since his wife passed away. Beatrice writes in to ask about her mother who has Alzheimer’s, yet refuses to go to a nursing facility. Hear how best to care for aging loved ones suffering from late-life disorders.

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Andrew Schorr:

Hello and welcome once again to Patient Power. I'm Andrew Schorr. It's the only program on radio or on the internet day after day where we talk about really significant health issues and we do it from the patient's perspective. So I ask the questions you're probably wondering. I've lived through some of it through cancer and some other chronic conditions in my family, and so I'm kind of your advocate. And we are blessed with the fact that we always have leading, high credibility experts on.

Now, if you think, just a few days ago if you were listening live on Health Radio Network to my program we were talking to a psychiatrist from Massachusetts General Hospital in Harvard about an approach for treatment- resistant depression for maybe the 10 to 20 percent of people who may not be responding to individual or combination drug therapy. We're going to talk about depression a little more today but from a different perspective and not just depression but also other things that affect the elderly. Dementia, and does that mean it's Alzheimer's or something else, and it can be, anxiety and even late life schizophrenia. Now, as you get older is your mind as sharp as it was before? And is that just aging or is that illness? And can somebody be helped back to better health or is it just the way things go when you get older?

So there's a lot to talk about, and it could be you or any of us who get older, and when does that again process start and affect your mind in that way or is it mom or dad or grandma or grandpa or Uncle Charlie or Aunt Susie who you love very much and want the best for.

So here's our expert for today, and I'm looking forward to this conversation because I think so many of us just don't know what to make of changes in the mind as we get older for ourselves or a loved one. That's Dr. William Mc Donald. He joins us from Atlanta and the Emory University School of Medicine. He's chief of geriatric psychiatry and he's director of the Fuqua Center for Late Life Depression at Emory.

Dr. McDonald, thanks so much for being with us on Patient Power today.

Dr. McDonald:

Well, thanks for having me, Andrew. I look forward to talking with people about this.

Andrew Schorr:

Yeah, I know. It's really important.

So I always start with sort of my personal frame of reference. So I had Aunt Bella when I used to live in Los Angeles and I reconnected with my mom's aunt, so my great aunt, Aunt Bella. And she was sharp as a tack at 96, I think till her dying day. And then I've got my in-laws also in Los Angeles, and I love them dearly, and I've been wondering, and I'd say this directly to my father-in-law, sometimes he seems a little forgetful at 75 or 76. So he's not like Aunt Bella who, you know, she just noticed everything and just seemed like she was 20, and then there's my father-in-law where he seems a little forgetful and I’ve read books and people say, Well, gee, maybe we should have some tests to see is that early onset of Alzheimer's or could it be something else, or is he just the nutty professor, you know.

Dr. McDonald:


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