Estimates suggest that up to 23% of the elderly population could experience psychotic symptoms during their lifetime. These could be due to a mental health condition like Schizophrenia that they developed earlier in their life or it could be due to some conditions that are known to develop much later in life.
Some of the factors that could cause psychotic symptoms are:
- Alzheimer’s disease and other dementias
- Depressive disorder
- Medical/toxic causes including substances
- Bipolar Disorder
- Delusional disorder
- Schizophrenia spectrum disorders
Of the abovementioned disorders, the first five could lead to the development of psychosis in old age, without any prior history of such symptoms.
RISK FACTORS IN THE DEVELOPMENT OF PSYCHOSIS:
- Sensory deficits
- Social isolation
- Cognitive decline
- Medical comorbidities
- Comorbid psychiatric illnesses such as dementia and delirium
- Age-related changes in structures of the brain
- Neurochemical changes in the brain associated with aging
LATE ONSET PSYCHOSIS OR PARAPHRENIA:
This disorder affects 2-4% of those over the age of 60years. In this disorder, an individual who has never experienced symptoms such as hallucinations and delusions suddenly develops them in old age. These symptoms can sometimes be a part of other conditions such as dementia, but many a times, the symptoms also occur independent of any diagnosed mental health condition. Those at risk would have factors such as genetic disposition, problems with sensory perceptions, abnormality in brain structures as well as personality characteristics such as remaining aloof, suspicious of others, quarrelling extensively and being ‘emotionally cold’. The treatment involves medication and extensive therapy.
Delirium is characterized by a confusion and disorientation that may last for a few hours to a few days, but usually fluctuates in severity. Other symptoms such as problems in memory, language, perception as well as emotional disturbances may be present. It is commonly seen in older adults, especially those who have been hospitalized for long or those with more than one chronic disease. It is also seen in those suffering from conditions like dementia. Those older adults who have several chronic illnesses tend to be on a variety of medications, for a long time. It is more difficult for the body at an older age to eliminate drugs from their system. Delirium could also be caused by any of several reasons such as drug or alcohol intoxication, recent surgery, metabolic imbalances, inadequate sleep for a long duration or even severe emotional stress.
Conditions such as those mentioned above require a multi-dimensional approach to treatment. Our team of Doctors and Psychologists will collaborate to ensure that the disorders are addressed in a holistic manner, so as to ensure that the patient lives a productive life.