Mental Health Issues in Old Age

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Mental Health Issues in Old Age
Osvaldo P. Almeida Unit of Geriatric
Psychiatry University of Western Australia
Royal Perth Hospital
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Mental Health Issues in Old Age

• Dementia and cognitive impairment
• Depression and other mood disorders
• Self-harm behaviour suicide
• Substance use (smoking, benzodiazepines,
  alcohol)
• Psychiatric morbidity in other medical
  conditions
• Other (schizophrenia and other paranoid
  disorders, etc.)

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Mental Health Issues in Old Age
Dementia and cognitive impairment

• Physical activity for AD MCI (FABS-NHMRC)
• Predictors of cognitive decline in MCI
  (PEPERS-NHMRC)
• Promoting physical activity in GP (Clear
  Mind-Healthway)
• Smoking (Healthy Brain Ageing-NHMRC)
• Homocysteine cognitive decline (NHMRC)
• Testosterone estradiol (Raine NHMRC)

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Mental Health Issues in Old Age
Depression

• Promoting physical activity in GP (Clear
  Mind-Healthway)
• Smoking (Healthy Brain Ageing-NHMRC)
• Homocysteine and treatment resistance
  (Neurosciences)
• DEPS-GP (NHMRC)
• Testosterone estradiol (Raine NHMRC)

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Mental Health Issues in Old Age
Self-Harm Behaviour Suicide

• Guidebook (DHA, Commonwealth)
• DEPS-GP (NHMRC)

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Mental Health Issues in Old Age
Self-Harm Behaviour Suicide

• Guidebook (DHA, Commonwealth)
• DEPS-GP (NHMRC)

- Clustered randomised trial 2 years of
follow-up - 500 GPs WA, SA, Vic, NSW, QLD -
50,000 adults aged 60 or over - Intervention
audit individualised feedback - Outcomes of
interest - incidence of suicide attempt -
incidence of completed suicide - prevalence of
depression (DSM-IV) - prevalence of suicide
ideation (DSI-SS) - management of
depression Investigators OPA, Jon Pfaff, Rob
Goldney, John Snowdon, Brian Draper, Gerard
Byrne, Jane Pirkis, Ngaire Kerse, Ian Wilson,
Nigel Stocks, Leon Flicker, Nicola Lautenschlager
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Mental Health Issues in Old Age
Substance Use

• Clear Mind Project (AERF Healthway)
• Healthy Brain and Ageing (NHMRC)

Psychiatric Morbidity in Other Medical Conditions

• Stroke, depression and personality (Rotary)
• Congestive heart failure (UWA)

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Mental Health Issues in Old Age
Future Direction

• Increasing focus on early intervention
  prevention
• Expand multidisciplinary collaborations
• Strengthen collaborations able to produce new
  relevant information about potentially modifiable
  risk factors for psychiatric morbidity in later
  life