Getting mental health care makes the body healthier — especially for the elderly
Taking care of our minds is an often neglected aspect of aging. What are we going to do about it?
- Studies have shown that depression can worsen in our old age.
- Other mental health concerns, too, are not only debilitating on their own but they can often make it more difficult to treat other health conditions.
- However, recent advances in how we treat mental health in the elderly are making a big difference. Here's how.
It's an unfortunate fact of life that as we grow older, our bodies stop working as well as they once did. Our muscles weaken, tying our shoes can send our backs into spasms, our hearing and vision isn't as sharp as it used to be. It's a time when taking care of yourself is more important than ever.
But we often forget that our minds, too, need to be taken care of. According to the CDC, 20% of people over 55 have some kind of mental health concern. Yet only two-thirds of this group receive treatment for their condition. Out of any other group, older men have the highest suicide rate. One study found that older patients were more likely to be diagnosed with a major depressive disorder, and that their depression grew worse with age. Older participants were more likely to have chronic depression, took longer to be in remission, and experienced depression with greater severity, according to the same study.
While mental health is enough of a concern on its own, it can also make treating physical health issues more difficult. "There is no clear-cut demarcation where behavioral health comorbidities start and where physical comorbidities end," said Dr. Joseph Conigliaro, Northwell Health's chief of general internal medicine. "When a patient with diabetes or congestive heart failure or any number of issues also has depression, anxiety, or schizophrenia, providing consistent care becomes much more challenging."
Percentage of older adults who claim they don't receive the social and emotional support they need by state, which can put individuals at risk for developing mental health conditions.
Centers for Disease Control and Prevention and National Association of Chronic Disease Directors. The State of Mental Health and Aging in America Issue Brief 1: What Do the Data Tell Us? Atlanta, GA: National Association of Chronic Disease Directors; 2008.
Bringing psychiatry to primary care
How can we better meet the mental health needs of elderly patients? In his book, Healthcare Reboot, Michael J. Dowling points to the divide between psychiatry and primary care as a major issue. "While it was true that psychiatrics went to medical school," he writes, "their subsequent clinical training was so far removed from other doctors that they tended to live in a psychiatric silo. In many ways, psychiatrists had walled themselves off from the rest of the medical profession."
A Gallup poll on the perceived honesty of various professions shows another way in which psychiatry has been pushed aside. 85%, 75%, and 70% of respondents reported that nurses, pharmacists, and medical doctors had very high ethical standards, respectively. Only 41% of respondents reported that psychiatrists had very high ethical standards.
One way to bring psychiatry back into the domain of primary care is to do just that; tighten the connections between psychiatrists and general practitioners through the collaborative care model. In this system, a behavioral health care manager and a psychiatrist are incorporated into the primary care setting. The psychiatrist serves as a consultant for the primary care physician and the behavioral health care manager, who could be a psychologist or a nurse trained in managing mental health. The primary care provider has some training in screening patients for mental health issues. Rather than refer them to a psychiatrist, they can instead point them to the behavioral health care manager. This helps normalize the relationship between mental health and primary care and can reduce the stigma associated with seeking help for mental health conditions.
A study on the use of this model for older adults suffering from depression showed resounding success — using the collaborative care model doubled the efficacy of depression treatment. Over twelve months, half of the patients reported an at least 50% reduction in their depression symptoms compared with a 19% reduction in the control group. What's more, the system saves money. For every $1 spent on implementing the collaborative care model, hospitals get $7 back over the course of four years. Today, Northwell Health and other health care organizations have incorporated psychologists and other mental health professionals in their primary care clinics to help deliver the mental health care that elderly patients need.
Virtual reality: Not just for gaming
Addressing mental health issues in the elderly doesn't just have to take place in hospitals and clinics, however. Advances in technology are blurring the lines of where treatment can happen. Rendever, for instance, is a new project by MIT graduates that uses VR to help provide the elderly with mental health treatment. VR has the potential to serve as a powerful therapeutic tool for older adults, especially those in assisted living. Often, older adults in assisted living can feel isolated and trapped in their conditions; VR offers an avenue out of those conditions. In an interview with AARP, a co-founder of Rendever related a story about an isolated former pilot flying a simulated aircraft: "All of a sudden he was sitting in a pilot seat again, and all these stories started bubbling out of him." VR technology like Rendever have been used to treat PTSD, chronic pain, phobias, depression, and drug addiction. There's even some preliminary evidence that VR could be used to keep cognitive function sharp in old age.
From the clinic to the home
One major challenge for the elderly is mobility. It's not always practical for them to travel to a clinic, psychiatrist, or psychologist. The use of "virtual visits" has become increasingly more common for health organizations. Companies like Apple and Samsung are increasingly leveraging their smartphone technologies to provide easier access to healthcare records and tackle chronic conditions. For its part, Northwell researchers have helped pioneer the use of remote intensive care units, or eICUs, to watch over multiple patients at once from a central location.
It may seem as though technology like this wouldn't be useful for psychiatric issues; in fact, the opposite is true. For the elderly, easy access to a psychiatrist may make them more likely to reach out. For patients in assisted-living facilities or unable to travel, "telepsychiatry" is sometimes the only way they can gain access to a psychiatrist.
When it comes to the health of the elderly, a broken hip or a pneumonia diagnosis can overshadow the importance of maintaining a healthy mind in one's older years. Taking care of one's physical health will always be important, especially in geriatric patients, but it doesn't make sense to focus solely on treating a physical health issue while ignoring ongoing mental health concerns. Fortunately, advances in our institutions, systems, and technology are bringing mental health issues back into the spotlight.
A study finds 1.8 billion trees and shrubs in the Sahara desert
- AI analysis of satellite images sees trees and shrubs where human eyes can't.
- At the western edge of the Sahara is more significant vegetation than previously suspected.
- Machine learning trained to recognize trees completed the detailed study in hours.
Why this matters<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNDU2MDQ1OC9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYzOTkyODg5NX0.O3S2DRTyAxh-JZqxGKj9KkC6ndZAloEh4hKhpcyeFDQ/img.jpg?width=980" id="3770d" class="rm-shortcode" data-rm-shortcode-id="3c27b79d4c0600fb6ebb82e650cabec0" data-rm-shortcode-name="rebelmouse-image" />
Area in which trees were located
Credit: University of Copenhagen<p>As important as trees are in fighting climate change, scientists need to know what trees there are, and where, and the study's finding represents a significant addition to the global tree inventory.</p><p>The vegetation Brandt and his colleagues have identified is in the Western Sahara, a region of about 1.3 million square kilometers that includes the desert, <a href="https://en.wikipedia.org/wiki/Sahel" target="_blank">the Sahel</a>, and the <a href="https://www.sciencedirect.com/topics/agricultural-and-biological-sciences/subhumid-zones" target="_blank" rel="noopener noreferrer">sub-humid zones</a> of West Africa.</p><p>These trees and shrubs have been left out of previous tabulations of carbon-processing worldwide forests. Says Brandt, "Trees outside of forested areas are usually not included in climate models, and we know very little about their carbon stocks. They are basically a white spot on maps and an unknown component in the global carbon cycle."</p><p>In addition to being valuable climate-change information, the research can help facilitate strategic development of the region in which the vegetation grows due to a greater understanding of local ecosystems.</p>
Trained for trees<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNDU2MDQ3MC9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYzNTk5NTI3NH0.fR-n1I2DHBIRPLvXv4g0PVM8ciZwSLWorBUUw2wc-Vk/img.jpg?width=980" id="e02c0" class="rm-shortcode" data-rm-shortcode-id="79955b13661dca8b6e19007935129af1" data-rm-shortcode-name="rebelmouse-image" />
Credit: Martin Brandt/University of Copenhagen<p>There's been an assumption that there's hardly enough vegetation outside of forested areas to be worth counting in areas such as this one. As a result the study represents the first time a significant number of trees — likely in the hundreds of millions when shrubs are subtracted from the overall figure — have been catalogued in the drylands region.</p><p>Members of the university's Department of Computer Science trained a machine-learning module to recognize trees by feeding it thousands of pictures of them. This training left the AI be capable of spotting trees in the tiny details of satellite images supplied by NASA. The task took the AI just hours — it would take a human years to perform an equivalent analysis.</p><p>The department's Christian Igel, a co-author, says "This technology has enormous potential when it comes to documenting changes on a global scale and ultimately, in contributing towards global climate goals. It is a motivation for us to develop this type of beneficial artificial intelligence."</p><p>"Indeed," says Brandt says, "I think it marks the beginning of a new scientific era."</p>
Looking ahead and beyond<p>The researchers hope to further refine their AI to provide a more detailed accounting of the trees it identifies in satellite photos.</p><p>The study's senior author, Rasmus Fensholt, says, "we are also interested in using satellites to determine tree species, as tree types are significant in relation to their value to local populations who use wood resources as part of their livelihoods. Trees and their fruit are consumed by both livestock and humans, and when preserved in the fields, trees have a positive effect on crop yields because they improve the balance of water and nutrients."</p><p>Ahead is an expansion of the team's tree hunt to a larger area of Africa, with the long-term goal being the creation of a more comprehensive and accurate global database of trees that grow beyond the boundaries of forests.</p>
Younger Americans support expanding the Supreme Court and serious political reforms, says new poll.
- Americans under 40 largely favor major political reforms, finds a new survey.
- The poll revealed that most would want to expand the Supreme Court, impose terms limits, and make it easier to vote.
- Millennials are more liberal and reform-centered than Generation Z.
A 2020 study published in the journal of Psychological Science explores the idea that fake news can actually help you remember real facts better.
- In 2019, researchers at Stanford Engineering analyzed the spread of fake news as if it were a strain of Ebola. The researchers adapted a model for understanding diseases that can infect a person more than once to better understand how fake news spreads and gains traction.
- A 2020 study published in the journal of Psychological Science explores the idea that fake news can actually help you remember real facts better.
- Researchers on the project explained: "These findings demonstrate one situation in which misinformation reminders can diminish the negative effects of fake-news exposure in the short term."
Previous studies on misinformation have already paved the way to a better understanding<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNDU1NzQ4NC9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYxNjE2Mjg1Nn0.hs_xHktN1KXUDVoWpHIVBI2sMJy6aRK6tvBVFkqmYjk/img.jpg?width=1245&coordinates=0%2C800%2C0%2C823&height=700" id="fc135" class="rm-shortcode" data-rm-shortcode-id="246bb1920c0f40ccb15e123914de1ab1" data-rm-shortcode-name="rebelmouse-image" alt="fake news concept of misinformation and fake news in the media" />
How does misinformation spread?
Image by Visual Generation on Shutterstock<p><strong>What is the "continued-influence" effect?</strong></p><p>A challenge in using corrections effectively is that repeating the misinformation can have negative consequences. Research on this effect (referred to as continued-influence") has shown that information presented as factual that is later deemed false can still contaminate memory and reasoning. The persistence of the continued-influence effect has led researchers to generally recommend avoiding repeating misinformation. </p><p>"Repetition increases familiarity and believability of misinformation," <a href="https://engineering.stanford.edu/magazine/article/how-fake-news-spreads-real-virus" target="_blank" rel="noopener noreferrer">the study explains</a>.</p><p><strong>What is the "familiarity-backfire" effect?</strong></p><p>Studies of this effect have shown that increasing misinformation familiarity through extra exposure to it leads to misattributions of fluency when the context of said information cannot be recalled. <a href="https://journals.sagepub.com/doi/10.1177/0956797620952797#" target="_blank" rel="noopener noreferrer">A 2017 study</a> examined this effect in myth correction. Subject rated beliefs in facts and myths of unclear veracity. Then, the facts were affirmed and myths corrected. Subjects made belief ratings again after this. The results suggested a role for familiarity but the myth beliefs remained below pre-manipulation levels. </p>
New research into fake news has uncovered something interesting about misinformation<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="ddeac998508e09fb9d1b4691d6c20d28"><iframe type="lazy-iframe" data-runner-src="https://www.youtube.com/embed/bJ5qUx1WOsg?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span><p>A 2020 study published in the journal of <a href="https://journals.sagepub.com/doi/10.1177/0956797620952797" target="_blank">Psychological Science</a> explores the idea that fake news can actually help you remember real facts better.</p><p>Fake news exposure can cause misinformation to be mistakenly remembered and believed. In two experiments, the team (led by Christopher N. Wahlheim) examined whether reminders of misinformation could do the opposite: improve memory for and beliefs in corrections to that fake news. </p><p>The study had subjects reading factual statements and then separate misinformation statements taken from news websites. Then, the subjects read statements that corrected the misinformation. Some misinformation reminders appeared before some corrections but not all. Then, subjects were asked to recall facts, indicate their belief in those recalls, and indicate whether they remembered the corrections and misinformation. </p><p>The results of the study showed that reminders increased recall and belief accuracy. These benefits were greater both when misinformation was recalled and when the subjects remembered that corrections had occurred. </p><p>Researchers on the project <a href="https://journals.sagepub.com/doi/10.1177/0956797620952797" target="_blank" rel="noopener noreferrer">explained</a>: "These findings demonstrate one situation in which misinformation reminders can diminish the negative effects of fake-news exposure in the short term.".</p><p><strong>The conclusion: fake-news misinformation that was corrected by fact-checked information can improve both memory and belief accuracy in real information.</strong></p><p>"We examined the effects of providing misinformation reminders before fake-news corrections on memory and belief accuracy. Our study included everyday fake-news misinformation that was corrected by fact-check-verified statements. Building on research using fictional, yet naturalistic, event narratives to show that reminders can counteract misinformation reliance in memory reports," <a href="https://journals.sagepub.com/doi/10.1177/0956797620952797" target="_blank" rel="noopener noreferrer">the researchers</a> explained.</p><p>"It suggests that there may be benefits to learning how someone was being misleading. This knowledge may inform strategies that people use to counteract high exposure to misinformation spread for political gain," <a href="https://www.eurekalert.org/pub_releases/2020-10/afps-rtf101620.php" target="_blank">Wahlheim said</a>.</p>
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