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"Almost 10%
of the Pakistani population are 60 years and over. As life expectancy
continues to increase, this figure is also likely to increase in
the years to come. Unfortunately this will also mean that psychological
problems in the elderly will also continue to rise. For older, as
with younger people, mental health conditions are an important cause
of morbidity and premature mortality, informed Dr. Murad Moosa Khan,
Professor and Chairman Department of Psychiatry at Aga Khan University
Hospital. He was giving a presentation on "Psychological Problems
in Elderly", at Signs, Symptoms and Care - a monthly health awareness
programme, on March 6, 2004.
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| Panellist
answer questions on "Psychological Problems in Elderly" at the monthly health awareness programme Signs, Symptoms and
Care. (L to R): Dr. Ehsanullah Syed, Assistant Professor, Department
of Psychiatry, AKU; Dr. Murad M Khan, Professor and Chair, Department
of Psychiatry, AKU; Dr. Abul Faizi, Associate Professor, Department
of Psychiatry, AKU; and Dr. Shifa Naeem, Honorary Lecturer,
Department of Psychiatry, AKU. |
"The rapid pace of changes
in the family structure, which has traditionally been the main support for the
elderly, has proved upsetting for them. The break-up of the extended family,
immigration, small family sizes, limited housing and economic constraints have
very often created unhappy situations for men and women in the late years of
their lives. Many are forced to live in isolation because the large families
of previous years no longer exist and their children may have immigrated to
distant lands in search of their own livelihood. Technological and economic
changes also tend to exclude older people out of the work force. These factors
as well as illnesses which come with old age add up to create stress which often
prove overpowering for the elderly, making them prone to psychological illness
like anxiety and depression", added Dr. Murad Khan.
Dr. Murad said, "Senior
citizens cannot be equated with adults of a younger age as far as social and
medical care is concerned. Their dietary, medical and emotional needs are of
a different kind and fell into a category of their own. Similarly ageism is
defined as prejudice against older people. It is quite widespread, in its various
forms. Ageism implies that as soon as a person can be described as old they
are automatically considered of little value, a burden on society, unable to
look after themselves and slow, deaf or stupid."
"As far as neuropsychiatric
conditions, are concerned dementia and major depression are the two leading
illnesses in the elderly", informed Dr. Murad.
Dr. Murad further explained
that "Depression in the elderly is an underdiagnosed and undertreated disorder.
If all forms of depression are included, the prevalence is as high as 15% in
people over 65 years of age. Because it has an atypical symptomatology and there
is insufficient information about the disorder, patient and their relatives
are not always aware that depression is present. The symptoms are instead regarded
as part of normal ageing by family and doctors. While factors such as premorbid
personality and life experience are related to vulnerability, it is loss events
that seem to be particularly important in precipitating depression. These include
loss of independence, loss of control, loss of mobility and loss of role. Recognition
and management of these pervasive, persistent and severe depressive symptoms
which are diagnostic of depression are important and can make a considerable
contribution to improving the quality of individual's life."
"Today, treatment is available
for depression in elderly people. This includes modern psychopharmacology, cognitive
therapy and in extreme and severe cases, electro-convulsive therapy", informed
Dr. Murad.
Similarly dementia, whose
prevalence may range from 1.5% to 4% amongst the over 65s, is frequently seen
as a normal part of ageing and is not perceived as requiring medical care.
Dr. Murad advised that to
promote mental health and a sense of well-being in the senior citizens, it is
essential that social networks be encouraged to provide them opportunities for
leisure time activities, companionship with their peers and a sense of involvement
in socially useful work. For this it is important to enable them to use their
skills and capacities for the good of others so that they feel usefully engaged
and not marginalized.
Dr. Murad concluded by saying
that there is urgent need to raise awareness about mental disorders in late-life
in the community and among health professionals and to improve access to appropriate
health care for the elderly with mental illness.
Drs. Murad M Khan, Abul
Faizi, Shifa Naeem and Ehsanullah Syed participated in the question and answer
session at the end of the programme.
Aga Khan University Hospital
provides high quality services to all segments of the population. Over 70% of
the patients come from low to middle income areas.
Since the inception of the
Hospital's Patient Welfare Programme in 1986, Rs. 0.9 billion has been spent
benefiting over 175,000 needy patients. In addition, 'The Patients Behbud Society
for AKUH' receives zakat contributions and disburses to the 'mustahaqeen'.
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