Geriatric psychology

Loneliness is an emotional response to the process of social isolation. It typically entails the feelings of anxiousness due to the lack of social connectedness or communication with others. Research has shown that loneliness has negative impacts on biological, cognitive and immune functioning. It is prevalent throughout all age groups from childhood to old age.

Nurses and other individuals who work in association with the elderly learn the various theories of loneliness, as they may need to implement these perspectives into enhancing the lives of their patients. They are particularly problematic in old age due to the changes an individual goes through such as decreasing economic stability and resources, changes in family structures, reduced social communication and the death of a relative or spouse.[7]

The most researched outcomes of loneliness are depression and cardiovascular health. Lonely individuals have found to have increased arterial stiffness, decreased blood circulation and associated with elevated blood pressure.[8]

Social isolation and feelings of loneliness are also major risk factors for poor cognitive and physical health. A poor sense of social connectedness has a negative impact on neural processing and cognitive abilities. In a four-year prospective study of initially dementia-free old-age adults, the risk of Alzheimer's was more than twice in lonely individuals compared to non-lonely. The study concluded that loneliness led to lower cognitive abilities and a rapid decline in cognition during the four-year course.

Depression in the elderly community can have severe consequences, which is why it is an important public health problem and research area. Older adults facing this debilitating condition are less likely to endorse affective symptoms and are more likely to instead display cognitive changes, somatic symptoms, and loss of interest than are younger adults. It is comorbid with "morbidity, increased risk of suicide, decreased physical, cognitive and social functioning, and greater self-neglect", all of which are associated with an increase in mortality.[9]

Risk factors

A common pathway to depression in older adults may consist of predisposing risks as well as the life changes experienced in old age. The development of late-life depression has several risk factors that likely compose of "cognitive diathesis, age-associated neurobiological changes, genetic vulnerabilities, and stressful life events".

Insomnia is often an overlooked factor in late-life depression. Impacts of sleep deprivation are reduced glucose tolerance, elevated evening cortisol levels, and increased sympathetic nervous system activity. Sleep quality at an old age is just as important as sleep duration to avoid lack of sleep. Research shows that feelings of loneliness and depression can result in poor sleep quality and daytime dysfunctions. These daytime impairments include physical and intellectual fatigue, irritability, and low cognitive abilities.[10]

Dementia is a variety of symptoms that apply to a decline in mental ability, not a specific disease. There are a variety of different symptoms that affect one's behavior as well as their memory and thought processes. These impairments make it hard to carry out day-to-day activities. They also give way to emotional problems as well as decreased motivation for living. Due to dementia not being a disorder of consciousness, a person's conscious is not usually affected. Geriatric psychologists work with dementia by aiding in the diagnosis of this disease. This is done through various cognitive tests and assessments. They will also look at research and potential treatment for dementia.[11]

Alzheimer's disease is the most common type of dementia, accounting for 60-80 percent of dementia cases. The effects of Alzheimer's are subtle at first but worsen as time passes. A common early symptom relates to difficulty recalling events of the recent past. Numerous symptoms arise as the disease progresses. These symptoms include: speech problems, disoriented states, issues with mood, lack of motivation, etc. Similar to dementia, a geriatric psychologist's role regarding Alzheimer's disease is the assessment, treatment, and research of the disease.[12]

Vascular dementia, the second most common type of dementia, is the result of a stroke.[13] Often times, it is difficult to differentiate between various types of dementia due to overlying symptoms and pathology. Ultimately, vascular dementia is the result of difficulties involved in blood supply to the brain. A geriatric psychologist aids in the assessment, diagnosing, treatment, and research of vascular dementia.[14]

Parkinson's disease is a movement disorder that has symptoms like tremors, slowed movement, stiffness, and impaired balance. It primarily affects the motor system, which supports motor functions used for movement. As the disease advances, it is common for individuals to experience dementia that is specifically associated with Parkinson's disease. Those who suffer from this disease can also experience issues with sensory systems. A geriatric psychologist's role for those with Parkinson's disease would be helping the person diagnosed deal with the stress they may encounter regarding Parkinson's disease. Since it is not a brain disorder, the geriatric psychologist would not help with diagnosing or the treatment of the disease.[15]