Mental Health in Older Age

Older people are particularly vulnerable to social isolation and loneliness owing to loss of friends and family, mobility and income. Loneliness has been described as an unwelcome feeling of lack or loss of companionship, marked by a discrepancy between the contact people have and what they desire ( Estimates suggest that around 20% of those aged 65 and over experience mild loneliness with a further 8-10% experiencing intense loneliness, which would equate to around 36,400 older people experiencing mild loneliness in Devon, and a further 14,500 to 18,200 experiencing intense loneliness (

According to the English Longitudinal Study of Ageing (ELSA) people aged 80 and older were the most vulnerable to loneliness, with women more likely to report feeling lonely than men. There is a socio-economic gradient to loneliness with higher levels in more deprived areas. Whilst wealth is an important determinant of life satisfaction, its effect declines over the age of 75. Contact with children generally reduces loneliness, although having children but not feeling close to any of them is associated with higher rates of loneliness than being childless. People without friends report the highest rates of loneliness. ( – see chapter 10)

Cacioppo and Patrick (Loneliness: Human Nature and the Need for Social Connection, 2008) highlighted five ways in which severe loneliness can adversely affect health:

  • Increasing self-destructive habits (overeating, smoking, excessive alcohol use etc.)
  • Increasing stress levels
  • Self-imposed isolation and failure to seek emotional support
  • The effect on immune and cardiovascular systems and
  • Difficulty in sleeping, negative impact on metabolic, neural and hormonal regulations

The most common mental health conditions in older people are depression and dementia. Depression affects proportionately older people than any other demographic group, because older people face more events and situations that may trigger depression: physical illness, debilitating physical conditions, bereavement, poverty and isolation. The majority of people who have depression make a full recovery after appropriate treatment, and older people are just as responsive to treatment as younger people. Communities and support services can help older people address some of the causes of depression such as social isolation, financial problems, or difficulties with their accommodation.