In fact, it is this kind of stereotyping that can make it difficult at times to identify psychiatric illness in ourselves or our loved ones who are older. Changes in mood or behavior may be the first sign that there is a problem. A physician can help you determine if the problems you or a loved one experience may require treatment.

An article in the June 7, 2000, issue of The Journal of the American Medical Association (Rabins et al) reports on an outreach program for individuals 60 years old and older living in public housing. The outreach program's goal was to identify older individuals with psychiatric illnesses and to provide treatment.

Pseudodementias (False Dementias)

Some medical problems and drugs may cause symptoms similar to dementia, but are not true dementia. The dementia-like symptoms are reversible if treated. Rapid onset of confusion due to the effects of drugs or illness is called delirium. Evaluation by a physician is essential for persons experiencing symptoms of delirium or any of the conditions listed below.

Some of the causes of dementia-like symptoms:

• Some drugs, such as sleeping pills, tranquilizers and certain pain medications
• Drug interactions or an overdose of a drug
• Malnutrition caused by a poor diet or problems absorbing nutrients
• Other mental problems, such as depression
• Alcohol or substance abuse

Dementia

Dementia is the progressive loss of memory, awareness, judgment and the ability to reason. Dementia has different causes. The most common cause is Alzheimer's disease, a progressive brain disorder.

Some of the common symptoms of dementia are:

• Confusion not due to drugs or other illnesses
• Disorientation, such as not knowing the date or the place where one is located
• Memory loss (more severe than forgetting names)

Depression

Depression is a common mental disorder that can affect people of any age.

Some of the common symptoms of depression are:

• Feelings of hopelessness, helplessness or worthlessness
• Persisting sadness
• Tiredness, lack of energy
• Loss of interest in or pleasure from everyday activities
• Sleeping problems
• Problems focusing and making decisions

Schizophrenia

Schizophrenia is a term used for a group of mental disorders that are all forms of psychosis. Psychosis is a serious mental condition in which a person loses touch with reality and has difficulty telling fact from fantasy.

Some of the common symptoms of schizophrenia are:

• Delusions - False beliefs (for example, the notion that someone can "steal" your thoughts).

• Hallucinations - False perceptions and sensations (for example, hearing voices that are not there).

• Disordered thinking - Lack of logical thought process (thoughts and communication become disorganized and fragmented).

• Problems with emotional expression - Severe reduction in emotional expressiveness (for example, the person may not show signs of normal emotion and may withdraw from social contacts).

For More Information

• National Institute on Aging
  Alzheimer's Disease Education and Referral Center
  (800) 438-4380
  (800) 222-4225 TTY

• American Psychiatric Association
  Mental Health of the Elderly
  1400 K Street, N.W.
  Washington, DC 20005

• American Geriatrics Society
  (800) 247-4779

Additional Sources: American Psychiatric Association, National Institute on Aging, American Geriatrics Society, National Institute of Mental Health, The AMA Family Medical Guide, The AMA Encyclopedia of Medicine

Brian Pace, M.A., Writer
Richard M. Glass, M.D., Editor

(JAMA. 2000; 283:2886)

Published in JAMA: June 7, 2000