Behavioral Changes in Elderly: Mental Health or Aging?

Q: Behavioral Changes in Elderly: Mental Health or Aging?

Hello, DD： Grandma's change in temperament, inconsistent statements, and declining memory are likely symptoms of brain pathology, most commonly seen in dementia. <br>Please take Grandma to a neurologist or psychiatrist for evaluation and treatment. <br>Wishing Grandma a speedy re

It is unclear whether it is a psychological disorder or symptoms of aging?

Hello Doctor: My grandmother is 80 years old.
She has always had a bit of a temper, but recently her condition has worsened.
She often gets angry for no apparent reason, and it lasts for a long time.
For example, after going out for a walk or waking up from a nap, she can suddenly become inexplicably angry, and this can last for over an hour.
Additionally, she sometimes describes the same event differently, which feels like a mental bombardment for the family.
Recently, her memory has also declined, but it hasn't yet affected her daily life.
She has a history of proteinuria (managed with medication), high cholesterol (medication causes dizziness, so she manages it through diet), and elevated blood calcium levels (also not treated with medication).
I would like to ask the doctor what possible issues could be causing these symptoms.
Thank you.

DD, 30~39 year old female. Ask Date: 2018/01/01

Dr. Liang Yinpan reply Geriatrics

Hello, DD: Grandma's change in temperament, inconsistent statements, and declining memory are likely symptoms of brain pathology, most commonly seen in dementia.
Please take Grandma to a neurologist or psychiatrist for evaluation and treatment.
Wishing Grandma a speedy recovery.
Liang Yin-Pan, Geriatrics Department, Changhua Hospital, January 4, 2018.

Reply Date: 2018/01/01

More Info

Understanding behavioral changes in elderly individuals can be quite complex, as these changes can stem from a variety of factors, including mental health issues, cognitive decline, and the natural aging process. In your grandmother's case, her recent behavioral changes, including increased irritability, mood swings, and memory issues, warrant a closer examination.

Firstly, it is essential to consider the possibility of underlying mental health conditions. Depression and anxiety are common among older adults and can manifest in various ways, including irritability and mood swings. In some cases, these emotional disturbances can be mistaken for personality traits or simply attributed to aging. However, when these behaviors become more pronounced or disruptive, as you described, it may indicate a need for further evaluation.

Another significant concern is the potential for cognitive decline, such as mild cognitive impairment (MCI) or dementia. Memory issues, especially when accompanied by changes in behavior and mood, can be indicative of these conditions. Dementia, for instance, can lead to confusion, irritability, and difficulty in communication, which may explain the discrepancies in her recounting of events. It is crucial to differentiate between normal age-related memory changes and more serious cognitive issues that may require intervention.

Additionally, your grandmother's physical health conditions, such as proteinuria, high cholesterol, and elevated blood calcium levels, could also contribute to her behavioral changes. Chronic health issues can lead to discomfort, pain, or even medication side effects that may affect mood and cognitive function. For instance, medications for high cholesterol can sometimes cause dizziness, which might lead to frustration or irritability. It is essential to review her current medications with her healthcare provider to ensure they are not contributing to her mood changes.

Given the complexity of these symptoms, I recommend that you take your grandmother to a healthcare professional, preferably a geriatrician or a psychiatrist specializing in elderly care. They can conduct a comprehensive assessment that includes a physical examination, a review of her medical history, and possibly cognitive testing. This evaluation will help determine whether her symptoms are due to a mental health disorder, cognitive decline, or a combination of factors.

In the meantime, there are several strategies you can employ to help manage her behavior and improve her quality of life. Encouraging her to engage in social activities, physical exercise, and cognitive stimulation can be beneficial. Activities such as puzzles, reading, or even simple conversations can help keep her mind active. Additionally, maintaining a consistent daily routine can provide a sense of stability and predictability, which may help reduce anxiety and irritability.

It is also important to approach her with empathy and understanding. When she exhibits irritability, try to remain calm and avoid escalating the situation. Validate her feelings and provide reassurance, as this can help her feel more secure and understood. If she is open to it, consider involving her in discussions about her health and well-being, empowering her to express her needs and preferences.

In conclusion, while your grandmother's symptoms may be related to aging, they could also indicate underlying mental health or cognitive issues that require attention. A thorough evaluation by a healthcare professional is essential to determine the appropriate course of action. In the meantime, providing support, understanding, and engaging her in meaningful activities can help improve her overall well-being.

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