Why is good mental health important to older people?

• Depression is the most common mental health problem in later life. It can severely affect quality of life and may adversely affect physical health. In the UK there are currently up to 2.4 million older people with depression severe enough to impair quality of life. This number will increase to at least 3.1 million over the next 15 years unless action is taken.
• Some 18–20% of the population of Northern Ireland aged over 65 will suffer from depression, with the figures higher for women than men. Depression is under-diagnosed, and particularly so in care homes. 
• Promoting mental health and wellbeing in later life will benefit the whole of society by maintaining older people’s social and economic contributions, minimising the costs of care and improving quality of life. 

Factors affecting older people’s mental health

Older people are not a homogeneous group and mental health problems may have their origins in a number of sources. 

These include adjustment problems and socio-economic difficulties associated with retirement and changes in family circumstances, together with increased social isolation brought about by a decline in social activity, transport and mobility problems, and bereavement. 

However, physical health and mental health are inextricably linked. Good physical health is associated with good mental health, and poor physical health is associated with poor mental health.

Older people talk about health in a holistic way, combining both mental and physical aspects. Physical health is an important issue for many older people, and improving it will improve their mental health as well.

Physical activity

There is now a growing body of evidence to support the claim that regular physical activity can contribute to the promotion of good mental health and can be an effective element of an overall programme to treat some existing mental health problems.

Both aerobic and resistance type activity have been shown to enhance mood, decrease symptoms of depression and improve wellbeing, self-efficacy and quality of life, and reduce the risks of cognitive impairment. These improvements seem to occur independently of any increase in levels of fitness.

Depression

Physical activity is associated with a decreased risk of developing depression, and is an effective treatment for depression that does not appear to have any harmful side effects. The anti- depressant effect of exercise can be of the same magnitude as that found for other psychotherapeutic interventions.

For people with moderate or severe depression, physical activity is best used as an adjunct to medication and psychological therapies. 

Anxiety and stress

A single exercise session usually results in brief reduction in stress/anxiety, and regular physical activity can have a long-term effect in reducing anxiety. For certain clinical disorders, physical activity can be as effective as other non-medical treatments, such as relaxation and meditation.

Emotion and mood

Physical activity and exercise are positively associated with psychological wellbeing and mood.

A group exercise environment in which people feel a sense of achievement and mastery is associated with greater motivation and wellbeing in comparison to an environment that stresses competition. Having exercise goals that relate to personal performance and improvement is associated with moderate to high positive emotion.