Creighton Conversations: Mental health needs of older adults

A 2024 report by the nonprofit FAIR Health found that between 2019 and 2023, the age group that experienced the largest percentage increase in mental health diagnoses was seniors, age 65 and older – with a 57.4% spike.

The finding is not surprising to Rajesh Tampi, MD, professor and chair in the Department of Psychiatry in the Creighton School of Medicine and the Bhatia Family Endowed Chair in Psychiatry, who has authored more than 250 publications on psychiatry and geriatric psychiatry and, in 2024, received the American Association for Geriatric Psychiatry’s Diversity Award for innovation and sensitivity in serving elderly minorities or underserved populations. Creighton magazine talked with Tampi about this growing crisis.

What is the concern?

Dementia is a growing problem in the U.S. and globally. For the first time in the history of the world, we have more people over the age of 65 than under the age of 5, and by 2034-2035, we will have more people above the age of 65 than under the age of 18. We are an aging society. Because of improvements in healthcare, people are living longer, but not necessarily living better. Soon, all baby boomers, people born between 1946 and 1964, will be enrolled in Medicare, and 1 in 5 will have a diagnosable mental illness. Our healthcare systems are not geared to take care of this increase in the geriatric population. My goal is to empower people to take control of their lives, developing healthy strategies toward a healthy brain. We talk about heart health. I think it’s also time that we talk about the brain.

What factors affect mental health in seniors?

There are social determinants of health, nonmedical factors, including income, race, education, living environments and loneliness, that significantly impact health and longevity, including cognitive and functional decline.

Many people are also inaccurately diagnosed, receive the wrong medications and have limited access to care. The gap in care is greater in racial and ethnic minority groups, including Blacks and Hispanics, and women are also disproportionately affected and represent a higher number of patients and caregivers.

Is it the same worldwide?

People are living longer all over the world. American society has its own issues, though. Obesity has gone up. Our families are small and intergenerational relationships are not there. Many older adults are living by themselves without any extended family and support. These are all risk factors for cognitive decline and functional decline. Human beings are social animals. Isolation becomes a problem.

What can we do?

Families and immediate support systems can encourage people to follow a healthy lifestyle. Many of these things you can do by simple lifestyle modifications, such as exercising, eating healthily, not drinking alcohol and not smoking. Prevention is always better than cure.

People 65 and older can do other things that impact cognition. Planning ahead in your life is very important. We all go through different phases, so make sure that you’re financially stable, take care of your health, continue to educate yourself as much as possible and stay connected to things that give you meaning. And learn a new skill. If you’re getting older, that doesn’t mean that you cannot learn new things. So, pick up a new hobby, watch different kinds of movies, read new books, do puzzles and travel.

What about overcoming loneliness?

With access to 5G networks and devices, people are more connected than ever before, but are doing more things isolated, separated from people. If you can, at least sometimes, do connected activities to get human connection, such as talk with friends and family on Zoom, participate in group activities or exercise, attend a church or prayer meeting, even psychotherapy. Get a pet, too, if you’re able to do that.

What advice do you give to medical residents caring for older adults?

Every interaction, even if it’s for two seconds, is a human interaction. Be respectful of everybody. Hear what people have to say. Listen to understand. If a human being is coming to us in trouble and pouring out their heart, we need to respect that. It’s all about how we can help another human being. We all have a shelf life. What we leave behind is a legacy of who we were and the little things that we have done.

There are many ways of improving your quality of life, and that’s what I am working on training the next generation of physician leaders. It’s not always about medicine. There’s not always a pill. We have to work together to make sure we can care for these individuals and help improve the cognitive health of older adults. We have a personal, family, health system and societal responsibility.