+1 (629)348-3199Opinion Article - Journal of Aging and Geriatric Psychiatry (2025) Volume 9, Issue 3
Older adult mental health: Challenges and solution
George Grossberg*
Department of School of Medicine, Saint Louis University
- *Corresponding Author:
- George Grossberg
Department of School of Medicine
Saint Louis University.
E-mail: devanand12@gmail.com
Received : 02-Aug-2025, Manuscript No. aaagp-25-202; Editor assigned : 05-Aug-2025, PreQC No. aaagp-25-202(PQ); Reviewed : 25-Aug-2025, QC No aaagp-25-202; Revised : 03-Sep-2025, Manuscript No. aaagp-25-202(R); Published : 12-Sep-2025 , DOI : 10.35841/aaagp-9.3.202
Citation: Grossberg G. Older adult mental health: Challenges and solution. J Age Geriat Psych. 2025;09(03):202.
Introduction
The intricate relationship between polypharmacy, defined as the concurrent use of multiple medications, and cognitive impairment in older adults grappling with depression is a significant area of concern. A systematic review and meta-analysis highlighted a substantial association, revealing that such medication practices notably elevate the risk of cognitive decline in this vulnerable demographic. This finding underscores the critical challenge involved in managing mental health conditions in the elderly while diligently working to minimize adverse effects stemming from complex drug regimens, thus stressing the absolute necessity for careful and regular medication reviews [1].
In the realm of dementia care, managing Behavioral and Psychological Symptoms of Dementia (BPSD) remains a complex task. One systematic review and meta-analysis specifically delved into the efficacy and safety of donepezil, a commonly prescribed medication for BPSD. The findings suggested that donepezil could offer modest improvements in these symptoms. However, it also cautioned clinicians to meticulously balance its potential benefits against the risks of adverse side effects, advocating for a highly individualized and cautious treatment approach for these delicate patients [2].
Further elaborating on pharmacological interventions for BPSD, another comprehensive systematic review and network meta-analysis evaluated a range of treatments. This study provided valuable comparative data on the efficacy and tolerability of various medications, reinforcing that while some agents might offer slight advantages, all carry inherent potential risks. This collective evidence strongly supports a careful and patient-specific strategy for therapeutic interventions [5].
Access to mental healthcare for older adults is steadily being transformed by technological advancements. A scoping review explored the burgeoning potential of telepsychiatry, demonstrating its capacity to significantly improve access to mental healthcare services for the elderly. While highlighting undeniable advantages like increased convenience and reduced travel burdens, the review also candidly addressed significant hurdles, including technological barriers and the pressing need for interventions to be specifically tailored to ensure both equitable and effective care delivery [3].
Echoing this technological focus, another scoping review investigated digital interventions tailored for mental health in older adults. This research accentuated the transformative potential of technology in delivering mental health support, encompassing a diverse array of digital tools such as specialized applications and online platforms. The review importantly identified crucial design and implementation considerations, prioritizing factors like accessibility and user-friendliness, to ensure these interventions genuinely cater to the unique needs of the elderly population [7].
The global public health crisis, specifically the COVID-19 pandemic, exerted a profound and often detrimental impact on older adults, especially those living with serious mental illness. A dedicated review meticulously examined these effects, outlining how the pandemic severely exacerbated existing vulnerabilities. This led to a marked increase in social isolation, significantly reduced access to essential care services, and an overall worsening of mental health outcomes for this population. This critical analysis unequivocally underscored the urgent need for robust, integrated, and flexible support systems that can effectively respond during future public health emergencies [4].
Beyond pharmacological approaches, non-pharmacological interventions are gaining significant traction in managing mental health and cognitive challenges in older adults. Cognitive Behavioral Therapy (CBT), for instance, was the subject of a systematic review and meta-analysis specifically investigating its effectiveness in treating depression and anxiety among older adults. The conclusive findings positioned CBT as a highly valuable non-pharmacological intervention, demonstrably yielding significant improvements in symptoms and presenting a promising pathway for mental health support in this demographic [6].
Similarly, for individuals living with dementia, managing agitation without medication is a priority. A systematic review and meta-analysis evaluating non-pharmacological interventions for agitation in dementia found that diverse non-drug strategies, including behavioral therapies, music therapy, and sensory stimulation, proved effective in reducing agitation. This research strongly advocates for their role as first-line treatments, primarily to minimize the adverse effects typically associated with pharmacological options [8].
Furthermore, physical activity has emerged as a key factor in cognitive health. Another systematic review and meta-analysis explored the efficacy of various exercise interventions on cognitive function in older adults experiencing mild cognitive impairment (MCI). The compelling results indicated that different forms of exercise, with multicomponent training showing particular promise, could significantly enhance cognitive abilities. This highlights physical activity as an accessible and crucial strategy for maintaining brain health in this population [9].
While medications offer benefits, their risks, especially in the elderly, cannot be overlooked. A systematic review and meta-analysis diligently investigated the correlation between antidepressant use and the heightened risk of falls in older adults. The findings revealed that specific antidepressants, notably tricyclic antidepressants and Selective Serotonin Reuptake Inhibitors (SSRIs), are indeed associated with an elevated risk of falls. This crucial insight strongly emphasizes the necessity for extremely careful medication selection and rigorous risk assessment practices when treating geriatric patients, aiming to prevent these prevalent and often serious adverse events [10].
Conclusion
Research highlights various mental health aspects in older adults, addressing both challenges and interventions. A significant concern is polypharmacy, which is associated with cognitive impairment, particularly in older adults experiencing depression. This underscores the need for thorough medication reviews to mitigate adverse drug effects. Similarly, managing Behavioral and Psychological Symptoms of Dementia (BPSD) often involves pharmacological treatments, such as donepezil, which offer modest benefits but require careful consideration of potential side effects and individualized care approaches. General pharmacological treatments for BPSD also come with inherent risks, necessitating a cautious strategy. The COVID-19 pandemic exacerbated mental health issues for older adults with serious mental illness, increasing isolation and hindering access to essential care. This situation emphasized the crucial need for integrated and flexible support systems during public health emergencies. Non-pharmacological strategies offer valuable alternatives. Cognitive Behavioral Therapy (CBT) effectively reduces symptoms of depression and anxiety in older adults. For individuals with dementia, non-drug interventions like behavioral therapies, music therapy, and sensory stimulation are effective in managing agitation, often serving as preferred first-line treatments. Furthermore, exercise, particularly multicomponent training, has shown promise in improving cognitive function for older adults with mild cognitive impairment, reinforcing the role of physical activity in brain health. Technology is emerging as a critical tool, with telepsychiatry enhancing access to mental healthcare for the elderly, though challenges like technological barriers persist. Digital interventions, including apps and online platforms, are also being explored to deliver mental health support, requiring careful design for accessibility and user-friendliness. While these interventions are vital, it's also important to acknowledge risks associated with medication, such as the increased fall risk linked to certain antidepressants in older adults, necessitating careful prescription practices
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