Salud Mental en Personas Mayores de 60 Años

Abstract

Population ageing is associated with pathologies that emerge or persist into later life. Mental health is no such exception and although there are numerous studies that assess mental health in people over 60 years of age, there are relatively few that assess it from a multi-informant perspective. In this study we analysed the discrepancies in self-perception and the third-party perception of the mental health of older people in two age groups (60 to 75 years old and over 75 years old), discriminating by gender and place of residence, and analysed the relationships between different scales measuring psychopathology and psychosocial competences. A sample of 288 people over 60 years old, 154 women (53.47%) and 134 men (46.5%) belonging to 12 municipalities in the Region of Murcia was used, and two questionnaires belonging to the Achenbach System of Empirically Based Assessment (ASEBA) assessment instruments were used: Older Adult Self-Report (OASR) to assess psychopathological disorders in older people and the Older Adult Behavior Checklist (OABCL) instrument to ascertain the perception of the family or caregivers of mental health. Results reflect that there are different perceptions of mental health among older people about themselves and their relatives or caregivers: self-reports for empirical syndromes reached the highest prevalence for concerns (40% in the total sample), followed by anxiety/depression (28%), however, observers, while agreeing on concerns as the most prevalent 39%, ascribed the second highest prevalence to functional impairment (38%). In terms of indicators for DSM (Diagnostic and Statistical Manual of Mental Disorders) criteria, the highest self-reported incidences correspond to anxiety (61%), followed by somatic problems (23%), however, according to observers, with these same DSM criteria, the most prevalent pathology is psychotic problems (45%) ahead of anxiety (28%). In general, the incidences in self-reports (OASR) are between 19% (memory problems) and 40% (concerns) for empirical syndromes, and between 19% (dementia) and 61% (anxiety) for DSM indicators. In hetero-report (OABCL), the incidences for empirical syndromes are between 21% (memory problems) and 39% (concerns), and for DSM-oriented symptomatology, between 21% (dementia) and 45% (psychotic problems). In terms of gender differences, in general, women have higher incidences for both the OASR self-report test and for observers, OABCL. As age increases, prevalence generally increases for women, but not for men, who show lower prevalence with age for most psychopathological disorders. Acceptable reliability of the questionnaires has been found by means of the alpha coefficient. Convergence among the different measures is high for the same syndromes. Different factor analyses have been carried out based on the scree plot, finding the 7-factor analysis suitable for the analysis of empirical syndromes typical of the Murcian sample of people over 60 years old. The high incidence of psychological disorders in older people found in this research indicates the need to develop psychological intervention protocols for older people, as well as specific treatments for each gender and psychosocial risk situation, in order to address the differential mental health needs of older people.