Aging Late Life Mood Disorders amp Suicidebull David Shraberg MDbull Medical Director ndash Ridge Hospital

bull Integrity Geriatric Unit and Services

bull ECT Service

bull Assistant Professor of Psychiatry

bull Department of Psychiatry - University of Kentucky Medical School

Senium root for senile senior and senator

bull Arbitrarily at 65 years old with three life-stage subgroups bull Young-old (approximately 65ndash74)

bull Middle-old (ages 75ndash84)

bull Old-old (over age 85)

Chapter 13 Aging and the ElderlyIntroduction to Sociology ndash 1st Canadian EditionAuthorsWilliam Little and Little William

What is Old Age- ie The ldquoSeniumrdquo

Todayrsquos young-old age group is generally happier healthier and financially better off than the young-old of previous generations

GompertzLaw of

Mortality

Chances of dementia doubles every 5 years after the age of 65

Chance of dying doubles every 8 years after we reach adulthood

Is Aging a Disease or Phase of

Life

Disease Argument

bull Law of Entropy

bull Energy Consumption Issues

bull DNA Damage

Max Life expectancy 125 years

Aging Population

bull Today ~16

bull 1900 4

Phase of Life - ie Erik Erikson

Physical Cognitive (The Aging Brain) amp

Emotional Aging

bull Neurological amp Major Complaints

Physical Changes Include

bull Incontinence

bull Polypharmacy

bull Falls

bull Frailty

bull Dementia amp Cognitive Changes

Conditions of Aging Top 5

Major Changes in The Brain

Prefrontal Atrophy

bull Setting Goals

bull What to Focus on

Changes in Executive Functions Including

Decrease in White Matter Integrity

bull Processing speed

bull Multitasking

bull Working Memory

bull Decrease in hippocampi

bull Decrease in episodic memory

Ischemic Changes Impacting

Memory with Age

Semantic Memory Crystalized Intelligence and Procedural Memory Remains intact-

Unless Dementia sets in

Some memory is Normally Impacted by Age Including

Fluid Processing of Facts

Emotional Aging

Multifactorial Roles of

bull Neurotransmitters

bull Genetics

bull Epigenetics

bull Lifestyle

bull Diet

bull Exercise

bull Social Outlets

bull Chance

bull Temperament

bull Personality

What is the Purpose of Life OR Is There One

ldquoStoicismrdquoCicero

ldquoExistentialismrdquoSimone de BeauvoirAnd In Between

Abrahamic Religionsbull Judaismbull Christianitybull Islambull Other World Viewsbull Eschatology ndash Hindu Buddhism Etc

Cicero

1 Good Old Age begins in Youth

2 Old age can be a wonderful part of life

3 There are proper seasons in life

4 Older people have much to teach the young

5 Old age need not deny us an active life but we need to accept limitations

6 The mind is a muscle that must be exercised

7 Older people must stand up for themselves

8 Sex is highly overrated

9 Cultivate your own garden

10 Death is not to be Feared

Healthy Aging

Hippocampus Exercise Physically amp Mentally

Socialize

Interact with Hobbies amp Community

Spirituality

Healthy Diet

Moderation - including alcohol

Recognize depression in self or partner- more psychomotor than emotive

bull Withdrawn Poor Appetite Slowed Down

bull Rule out Medical Causes

Depression Dementia amp Depressive Pseudodementia

The Greatest

Fear Losing Your Mind amp Self Dementia

bull Alzheimerrsquos Disease

bull Vascular

bull Lewy Body

bull Frontal- Temporal

Dementia over 65

bull Lack of Exercise

bull Poor Diet

bull Smoking

bull Excessive Drinking

bull Untreated Clinical Depression

bull Genetic

bull Intelligence

bull Occupation (Nunrsquos Study)

bull History of TBI

bull Poverty

Risk Factors for Dementia

Lowering Risk Factors

Controlling Blood Pressure

Good Health Maintenance

Lucky Genes

Glass of Cabernet or Resveratrol Daily

Cup of Caffeine a Day

Exercise Brain amp Body

Travel

Have a Partner andor Socialize

Diet- particularly high in Anti-Oxidants ( Mediterranean)

Depression amp Suicide with Aging

Why Do Older Adults Commit

Suicide

There is no one factor that causes someone to commit suicide however there are a number issues

bull The biggest commonality in older adults is clinical depression Many see depression as an inevitable part of getting older as one copes with declining health and the loss of loved ones However while feeling ldquodownrdquo is normal clinical depression at any age is not It is medically treatable and should not just be accepted something that doctors are very keen to stress

Common risk factors surrounding elder suicide includebull The recent death of a spouse family member or friend

bull Illness

bull The fear of a prolonged illness

bull Social isolation and feelings of loneliness

bull Major life changes particularly retirement

bull Common suicide warning signs in an older adult include (but are not limited to)

bull Insomnia

bull Weight loss

bull Feelings of guilt

bull Feelings of purposelessness

bull Feelings of being a burden

bull Dramatic changes in regular routines

bull Refusing social activities

bull Giving away prized possessions

Senium root for senile senior and senator

bull Arbitrarily at 65 years old with three life-stage subgroups bull Young-old (approximately 65ndash74)

bull Middle-old (ages 75ndash84)

bull Old-old (over age 85)

Chapter 13 Aging and the ElderlyIntroduction to Sociology ndash 1st Canadian EditionAuthorsWilliam Little and Little William

What is Old Age- ie The ldquoSeniumrdquo

Todayrsquos young-old age group is generally happier healthier and financially better off than the young-old of previous generations

GompertzLaw of

Mortality

Chances of dementia doubles every 5 years after the age of 65

Chance of dying doubles every 8 years after we reach adulthood

Is Aging a Disease or Phase of

Life

Disease Argument

bull Law of Entropy

bull Energy Consumption Issues

bull DNA Damage

Max Life expectancy 125 years

Aging Population

bull Today ~16

bull 1900 4

Phase of Life - ie Erik Erikson

Physical Cognitive (The Aging Brain) amp

Emotional Aging

bull Neurological amp Major Complaints

Physical Changes Include

bull Incontinence

bull Polypharmacy

bull Falls

bull Frailty

bull Dementia amp Cognitive Changes

Conditions of Aging Top 5

Major Changes in The Brain

Prefrontal Atrophy

bull Setting Goals

bull What to Focus on

Changes in Executive Functions Including

Decrease in White Matter Integrity

bull Processing speed

bull Multitasking

bull Working Memory

bull Decrease in hippocampi

bull Decrease in episodic memory

Ischemic Changes Impacting

Memory with Age

Semantic Memory Crystalized Intelligence and Procedural Memory Remains intact-

Unless Dementia sets in

Some memory is Normally Impacted by Age Including

Fluid Processing of Facts

Emotional Aging

Multifactorial Roles of

bull Neurotransmitters

bull Genetics

bull Epigenetics

bull Lifestyle

bull Diet

bull Exercise

bull Social Outlets

bull Chance

bull Temperament

bull Personality

What is the Purpose of Life OR Is There One

ldquoStoicismrdquoCicero

ldquoExistentialismrdquoSimone de BeauvoirAnd In Between

Abrahamic Religionsbull Judaismbull Christianitybull Islambull Other World Viewsbull Eschatology ndash Hindu Buddhism Etc

Cicero

1 Good Old Age begins in Youth

2 Old age can be a wonderful part of life

3 There are proper seasons in life

4 Older people have much to teach the young

5 Old age need not deny us an active life but we need to accept limitations

6 The mind is a muscle that must be exercised

7 Older people must stand up for themselves

8 Sex is highly overrated

9 Cultivate your own garden

10 Death is not to be Feared

Healthy Aging

Hippocampus Exercise Physically amp Mentally

Socialize

Interact with Hobbies amp Community

Spirituality

Healthy Diet

Moderation - including alcohol

Recognize depression in self or partner- more psychomotor than emotive

bull Withdrawn Poor Appetite Slowed Down

bull Rule out Medical Causes

Depression Dementia amp Depressive Pseudodementia

The Greatest

Fear Losing Your Mind amp Self Dementia

bull Alzheimerrsquos Disease

bull Vascular

bull Lewy Body

bull Frontal- Temporal

Dementia over 65

bull Lack of Exercise

bull Poor Diet

bull Smoking

bull Excessive Drinking

bull Untreated Clinical Depression

bull Genetic

bull Intelligence

bull Occupation (Nunrsquos Study)

bull History of TBI

bull Poverty

Risk Factors for Dementia

Lowering Risk Factors

Controlling Blood Pressure

Good Health Maintenance

Lucky Genes

Glass of Cabernet or Resveratrol Daily

Cup of Caffeine a Day

Exercise Brain amp Body

Travel

Have a Partner andor Socialize

Diet- particularly high in Anti-Oxidants ( Mediterranean)

Depression amp Suicide with Aging

Why Do Older Adults Commit

Suicide

There is no one factor that causes someone to commit suicide however there are a number issues

bull The biggest commonality in older adults is clinical depression Many see depression as an inevitable part of getting older as one copes with declining health and the loss of loved ones However while feeling ldquodownrdquo is normal clinical depression at any age is not It is medically treatable and should not just be accepted something that doctors are very keen to stress

Common risk factors surrounding elder suicide includebull The recent death of a spouse family member or friend

bull Illness

bull The fear of a prolonged illness

bull Social isolation and feelings of loneliness

bull Major life changes particularly retirement

bull Common suicide warning signs in an older adult include (but are not limited to)

bull Insomnia

bull Weight loss

bull Feelings of guilt

bull Feelings of purposelessness

bull Feelings of being a burden

bull Dramatic changes in regular routines

bull Refusing social activities

bull Giving away prized possessions

GompertzLaw of

Mortality

Chances of dementia doubles every 5 years after the age of 65

Chance of dying doubles every 8 years after we reach adulthood

Is Aging a Disease or Phase of

Life

Disease Argument

bull Law of Entropy

bull Energy Consumption Issues

bull DNA Damage

Max Life expectancy 125 years

Aging Population

bull Today ~16

bull 1900 4

Phase of Life - ie Erik Erikson

Physical Cognitive (The Aging Brain) amp

Emotional Aging

bull Neurological amp Major Complaints

Physical Changes Include

bull Incontinence

bull Polypharmacy

bull Falls

bull Frailty

bull Dementia amp Cognitive Changes

Conditions of Aging Top 5

Major Changes in The Brain

Prefrontal Atrophy

bull Setting Goals

bull What to Focus on

Changes in Executive Functions Including

Decrease in White Matter Integrity

bull Processing speed

bull Multitasking

bull Working Memory

bull Decrease in hippocampi

bull Decrease in episodic memory

Ischemic Changes Impacting

Memory with Age

Semantic Memory Crystalized Intelligence and Procedural Memory Remains intact-

Unless Dementia sets in

Some memory is Normally Impacted by Age Including

Fluid Processing of Facts

Emotional Aging

Multifactorial Roles of

bull Neurotransmitters

bull Genetics

bull Epigenetics

bull Lifestyle

bull Diet

bull Exercise

bull Social Outlets

bull Chance

bull Temperament

bull Personality

What is the Purpose of Life OR Is There One

ldquoStoicismrdquoCicero

ldquoExistentialismrdquoSimone de BeauvoirAnd In Between

Abrahamic Religionsbull Judaismbull Christianitybull Islambull Other World Viewsbull Eschatology ndash Hindu Buddhism Etc

Cicero

1 Good Old Age begins in Youth

2 Old age can be a wonderful part of life

3 There are proper seasons in life

4 Older people have much to teach the young

5 Old age need not deny us an active life but we need to accept limitations

6 The mind is a muscle that must be exercised

7 Older people must stand up for themselves

8 Sex is highly overrated

9 Cultivate your own garden

10 Death is not to be Feared

Healthy Aging

Hippocampus Exercise Physically amp Mentally

Socialize

Interact with Hobbies amp Community

Spirituality

Healthy Diet

Moderation - including alcohol

Recognize depression in self or partner- more psychomotor than emotive

bull Withdrawn Poor Appetite Slowed Down

bull Rule out Medical Causes

Depression Dementia amp Depressive Pseudodementia

The Greatest

Fear Losing Your Mind amp Self Dementia

bull Alzheimerrsquos Disease

bull Vascular

bull Lewy Body

bull Frontal- Temporal

Dementia over 65

bull Lack of Exercise

bull Poor Diet

bull Smoking

bull Excessive Drinking

bull Untreated Clinical Depression

bull Genetic

bull Intelligence

bull Occupation (Nunrsquos Study)

bull History of TBI

bull Poverty

Risk Factors for Dementia

Lowering Risk Factors

Controlling Blood Pressure

Good Health Maintenance

Lucky Genes

Glass of Cabernet or Resveratrol Daily

Cup of Caffeine a Day

Exercise Brain amp Body

Travel

Have a Partner andor Socialize

Diet- particularly high in Anti-Oxidants ( Mediterranean)

Depression amp Suicide with Aging

Why Do Older Adults Commit

Suicide

There is no one factor that causes someone to commit suicide however there are a number issues

bull The biggest commonality in older adults is clinical depression Many see depression as an inevitable part of getting older as one copes with declining health and the loss of loved ones However while feeling ldquodownrdquo is normal clinical depression at any age is not It is medically treatable and should not just be accepted something that doctors are very keen to stress

Common risk factors surrounding elder suicide includebull The recent death of a spouse family member or friend

bull Illness

bull The fear of a prolonged illness

bull Social isolation and feelings of loneliness

bull Major life changes particularly retirement

bull Common suicide warning signs in an older adult include (but are not limited to)

bull Insomnia

bull Weight loss

bull Feelings of guilt

bull Feelings of purposelessness

bull Feelings of being a burden

bull Dramatic changes in regular routines

bull Refusing social activities

bull Giving away prized possessions

Is Aging a Disease or Phase of

Life

Disease Argument

bull Law of Entropy

bull Energy Consumption Issues

bull DNA Damage

Max Life expectancy 125 years

Aging Population

bull Today ~16

bull 1900 4

Phase of Life - ie Erik Erikson

Physical Cognitive (The Aging Brain) amp

Emotional Aging

bull Neurological amp Major Complaints

Physical Changes Include

bull Incontinence

bull Polypharmacy

bull Falls

bull Frailty

bull Dementia amp Cognitive Changes

Conditions of Aging Top 5

Major Changes in The Brain

Prefrontal Atrophy

bull Setting Goals

bull What to Focus on

Changes in Executive Functions Including

Decrease in White Matter Integrity

bull Processing speed

bull Multitasking

bull Working Memory

bull Decrease in hippocampi

bull Decrease in episodic memory

Ischemic Changes Impacting

Memory with Age

Semantic Memory Crystalized Intelligence and Procedural Memory Remains intact-

Unless Dementia sets in

Some memory is Normally Impacted by Age Including

Fluid Processing of Facts

Emotional Aging

Multifactorial Roles of

bull Neurotransmitters

bull Genetics

bull Epigenetics

bull Lifestyle

bull Diet

bull Exercise

bull Social Outlets

bull Chance

bull Temperament

bull Personality

What is the Purpose of Life OR Is There One

ldquoStoicismrdquoCicero

ldquoExistentialismrdquoSimone de BeauvoirAnd In Between

Abrahamic Religionsbull Judaismbull Christianitybull Islambull Other World Viewsbull Eschatology ndash Hindu Buddhism Etc

Cicero

1 Good Old Age begins in Youth

2 Old age can be a wonderful part of life

3 There are proper seasons in life

4 Older people have much to teach the young

5 Old age need not deny us an active life but we need to accept limitations

6 The mind is a muscle that must be exercised

7 Older people must stand up for themselves

8 Sex is highly overrated

9 Cultivate your own garden

10 Death is not to be Feared

Healthy Aging

Hippocampus Exercise Physically amp Mentally

Socialize

Interact with Hobbies amp Community

Spirituality

Healthy Diet

Moderation - including alcohol

Recognize depression in self or partner- more psychomotor than emotive

bull Withdrawn Poor Appetite Slowed Down

bull Rule out Medical Causes

Depression Dementia amp Depressive Pseudodementia

The Greatest

Fear Losing Your Mind amp Self Dementia

bull Alzheimerrsquos Disease

bull Vascular

bull Lewy Body

bull Frontal- Temporal

Dementia over 65

bull Lack of Exercise

bull Poor Diet

bull Smoking

bull Excessive Drinking

bull Untreated Clinical Depression

bull Genetic

bull Intelligence

bull Occupation (Nunrsquos Study)

bull History of TBI

bull Poverty

Risk Factors for Dementia

Lowering Risk Factors

Controlling Blood Pressure

Good Health Maintenance

Lucky Genes

Glass of Cabernet or Resveratrol Daily

Cup of Caffeine a Day

Exercise Brain amp Body

Travel

Have a Partner andor Socialize

Diet- particularly high in Anti-Oxidants ( Mediterranean)

Depression amp Suicide with Aging

Why Do Older Adults Commit

Suicide

There is no one factor that causes someone to commit suicide however there are a number issues

bull The biggest commonality in older adults is clinical depression Many see depression as an inevitable part of getting older as one copes with declining health and the loss of loved ones However while feeling ldquodownrdquo is normal clinical depression at any age is not It is medically treatable and should not just be accepted something that doctors are very keen to stress

Common risk factors surrounding elder suicide includebull The recent death of a spouse family member or friend

bull Illness

bull The fear of a prolonged illness

bull Social isolation and feelings of loneliness

bull Major life changes particularly retirement

bull Common suicide warning signs in an older adult include (but are not limited to)

bull Insomnia

bull Weight loss

bull Feelings of guilt

bull Feelings of purposelessness

bull Feelings of being a burden

bull Dramatic changes in regular routines

bull Refusing social activities

bull Giving away prized possessions

Physical Cognitive (The Aging Brain) amp

Emotional Aging

bull Neurological amp Major Complaints

Physical Changes Include

bull Incontinence

bull Polypharmacy

bull Falls

bull Frailty

bull Dementia amp Cognitive Changes

Conditions of Aging Top 5

Major Changes in The Brain

Prefrontal Atrophy

bull Setting Goals

bull What to Focus on

Changes in Executive Functions Including

Decrease in White Matter Integrity

bull Processing speed

bull Multitasking

bull Working Memory

bull Decrease in hippocampi

bull Decrease in episodic memory

Ischemic Changes Impacting

Memory with Age

Semantic Memory Crystalized Intelligence and Procedural Memory Remains intact-

Unless Dementia sets in

Some memory is Normally Impacted by Age Including

Fluid Processing of Facts

Emotional Aging

Multifactorial Roles of

bull Neurotransmitters

bull Genetics

bull Epigenetics

bull Lifestyle

bull Diet

bull Exercise

bull Social Outlets

bull Chance

bull Temperament

bull Personality

What is the Purpose of Life OR Is There One

ldquoStoicismrdquoCicero

ldquoExistentialismrdquoSimone de BeauvoirAnd In Between

Abrahamic Religionsbull Judaismbull Christianitybull Islambull Other World Viewsbull Eschatology ndash Hindu Buddhism Etc

Cicero

1 Good Old Age begins in Youth

2 Old age can be a wonderful part of life

3 There are proper seasons in life

4 Older people have much to teach the young

5 Old age need not deny us an active life but we need to accept limitations

6 The mind is a muscle that must be exercised

7 Older people must stand up for themselves

8 Sex is highly overrated

9 Cultivate your own garden

10 Death is not to be Feared

Healthy Aging

Hippocampus Exercise Physically amp Mentally

Socialize

Interact with Hobbies amp Community

Spirituality

Healthy Diet

Moderation - including alcohol

Recognize depression in self or partner- more psychomotor than emotive

bull Withdrawn Poor Appetite Slowed Down

bull Rule out Medical Causes

Depression Dementia amp Depressive Pseudodementia

The Greatest

Fear Losing Your Mind amp Self Dementia

bull Alzheimerrsquos Disease

bull Vascular

bull Lewy Body

bull Frontal- Temporal

Dementia over 65

bull Lack of Exercise

bull Poor Diet

bull Smoking

bull Excessive Drinking

bull Untreated Clinical Depression

bull Genetic

bull Intelligence

bull Occupation (Nunrsquos Study)

bull History of TBI

bull Poverty

Risk Factors for Dementia

Lowering Risk Factors

Controlling Blood Pressure

Good Health Maintenance

Lucky Genes

Glass of Cabernet or Resveratrol Daily

Cup of Caffeine a Day

Exercise Brain amp Body

Travel

Have a Partner andor Socialize

Diet- particularly high in Anti-Oxidants ( Mediterranean)

Depression amp Suicide with Aging

Why Do Older Adults Commit

Suicide

There is no one factor that causes someone to commit suicide however there are a number issues

bull The biggest commonality in older adults is clinical depression Many see depression as an inevitable part of getting older as one copes with declining health and the loss of loved ones However while feeling ldquodownrdquo is normal clinical depression at any age is not It is medically treatable and should not just be accepted something that doctors are very keen to stress

Common risk factors surrounding elder suicide includebull The recent death of a spouse family member or friend

bull Illness

bull The fear of a prolonged illness

bull Social isolation and feelings of loneliness

bull Major life changes particularly retirement

bull Common suicide warning signs in an older adult include (but are not limited to)

bull Insomnia

bull Weight loss

bull Feelings of guilt

bull Feelings of purposelessness

bull Feelings of being a burden

bull Dramatic changes in regular routines

bull Refusing social activities

bull Giving away prized possessions

Major Changes in The Brain

Prefrontal Atrophy

bull Setting Goals

bull What to Focus on

Changes in Executive Functions Including

Decrease in White Matter Integrity

bull Processing speed

bull Multitasking

bull Working Memory

bull Decrease in hippocampi

bull Decrease in episodic memory

Ischemic Changes Impacting

Memory with Age

Semantic Memory Crystalized Intelligence and Procedural Memory Remains intact-

Unless Dementia sets in

Some memory is Normally Impacted by Age Including

Fluid Processing of Facts

Emotional Aging

Multifactorial Roles of

bull Neurotransmitters

bull Genetics

bull Epigenetics

bull Lifestyle

bull Diet

bull Exercise

bull Social Outlets

bull Chance

bull Temperament

bull Personality

What is the Purpose of Life OR Is There One

ldquoStoicismrdquoCicero

ldquoExistentialismrdquoSimone de BeauvoirAnd In Between

Abrahamic Religionsbull Judaismbull Christianitybull Islambull Other World Viewsbull Eschatology ndash Hindu Buddhism Etc

Cicero

1 Good Old Age begins in Youth

2 Old age can be a wonderful part of life

3 There are proper seasons in life

4 Older people have much to teach the young

5 Old age need not deny us an active life but we need to accept limitations

6 The mind is a muscle that must be exercised

7 Older people must stand up for themselves

8 Sex is highly overrated

9 Cultivate your own garden

10 Death is not to be Feared

Healthy Aging

Hippocampus Exercise Physically amp Mentally

Socialize

Interact with Hobbies amp Community

Spirituality

Healthy Diet

Moderation - including alcohol

Recognize depression in self or partner- more psychomotor than emotive

bull Withdrawn Poor Appetite Slowed Down

bull Rule out Medical Causes

Depression Dementia amp Depressive Pseudodementia

The Greatest

Fear Losing Your Mind amp Self Dementia

bull Alzheimerrsquos Disease

bull Vascular

bull Lewy Body

bull Frontal- Temporal

Dementia over 65

bull Lack of Exercise

bull Poor Diet

bull Smoking

bull Excessive Drinking

bull Untreated Clinical Depression

bull Genetic

bull Intelligence

bull Occupation (Nunrsquos Study)

bull History of TBI

bull Poverty

Risk Factors for Dementia

Lowering Risk Factors

Controlling Blood Pressure

Good Health Maintenance

Lucky Genes

Glass of Cabernet or Resveratrol Daily

Cup of Caffeine a Day

Exercise Brain amp Body

Travel

Have a Partner andor Socialize

Diet- particularly high in Anti-Oxidants ( Mediterranean)

Depression amp Suicide with Aging

Why Do Older Adults Commit

Suicide

There is no one factor that causes someone to commit suicide however there are a number issues

bull The biggest commonality in older adults is clinical depression Many see depression as an inevitable part of getting older as one copes with declining health and the loss of loved ones However while feeling ldquodownrdquo is normal clinical depression at any age is not It is medically treatable and should not just be accepted something that doctors are very keen to stress

Common risk factors surrounding elder suicide includebull The recent death of a spouse family member or friend

bull Illness

bull The fear of a prolonged illness

bull Social isolation and feelings of loneliness

bull Major life changes particularly retirement

bull Common suicide warning signs in an older adult include (but are not limited to)

bull Insomnia

bull Weight loss

bull Feelings of guilt

bull Feelings of purposelessness

bull Feelings of being a burden

bull Dramatic changes in regular routines

bull Refusing social activities

bull Giving away prized possessions

Memory with Age

Semantic Memory Crystalized Intelligence and Procedural Memory Remains intact-

Unless Dementia sets in

Some memory is Normally Impacted by Age Including

Fluid Processing of Facts

Emotional Aging

Multifactorial Roles of

bull Neurotransmitters

bull Genetics

bull Epigenetics

bull Lifestyle

bull Diet

bull Exercise

bull Social Outlets

bull Chance

bull Temperament

bull Personality

What is the Purpose of Life OR Is There One

ldquoStoicismrdquoCicero

ldquoExistentialismrdquoSimone de BeauvoirAnd In Between

Abrahamic Religionsbull Judaismbull Christianitybull Islambull Other World Viewsbull Eschatology ndash Hindu Buddhism Etc

Cicero

1 Good Old Age begins in Youth

2 Old age can be a wonderful part of life

3 There are proper seasons in life

4 Older people have much to teach the young

5 Old age need not deny us an active life but we need to accept limitations

6 The mind is a muscle that must be exercised

7 Older people must stand up for themselves

8 Sex is highly overrated

9 Cultivate your own garden

10 Death is not to be Feared

Healthy Aging

Hippocampus Exercise Physically amp Mentally

Socialize

Interact with Hobbies amp Community

Spirituality

Healthy Diet

Moderation - including alcohol

Recognize depression in self or partner- more psychomotor than emotive

bull Withdrawn Poor Appetite Slowed Down

bull Rule out Medical Causes

Depression Dementia amp Depressive Pseudodementia

The Greatest

Fear Losing Your Mind amp Self Dementia

bull Alzheimerrsquos Disease

bull Vascular

bull Lewy Body

bull Frontal- Temporal

Dementia over 65

bull Lack of Exercise

bull Poor Diet

bull Smoking

bull Excessive Drinking

bull Untreated Clinical Depression

bull Genetic

bull Intelligence

bull Occupation (Nunrsquos Study)

bull History of TBI

bull Poverty

Risk Factors for Dementia

Lowering Risk Factors

Controlling Blood Pressure

Good Health Maintenance

Lucky Genes

Glass of Cabernet or Resveratrol Daily

Cup of Caffeine a Day

Exercise Brain amp Body

Travel

Have a Partner andor Socialize

Diet- particularly high in Anti-Oxidants ( Mediterranean)

Depression amp Suicide with Aging

Why Do Older Adults Commit

Suicide

There is no one factor that causes someone to commit suicide however there are a number issues

bull The biggest commonality in older adults is clinical depression Many see depression as an inevitable part of getting older as one copes with declining health and the loss of loved ones However while feeling ldquodownrdquo is normal clinical depression at any age is not It is medically treatable and should not just be accepted something that doctors are very keen to stress

Common risk factors surrounding elder suicide includebull The recent death of a spouse family member or friend

bull Illness

bull The fear of a prolonged illness

bull Social isolation and feelings of loneliness

bull Major life changes particularly retirement

bull Common suicide warning signs in an older adult include (but are not limited to)

bull Insomnia

bull Weight loss

bull Feelings of guilt

bull Feelings of purposelessness

bull Feelings of being a burden

bull Dramatic changes in regular routines

bull Refusing social activities

bull Giving away prized possessions

Emotional Aging

Multifactorial Roles of

bull Neurotransmitters

bull Genetics

bull Epigenetics

bull Lifestyle

bull Diet

bull Exercise

bull Social Outlets

bull Chance

bull Temperament

bull Personality

What is the Purpose of Life OR Is There One

ldquoStoicismrdquoCicero

ldquoExistentialismrdquoSimone de BeauvoirAnd In Between

Abrahamic Religionsbull Judaismbull Christianitybull Islambull Other World Viewsbull Eschatology ndash Hindu Buddhism Etc

Cicero

1 Good Old Age begins in Youth

2 Old age can be a wonderful part of life

3 There are proper seasons in life

4 Older people have much to teach the young

5 Old age need not deny us an active life but we need to accept limitations

6 The mind is a muscle that must be exercised

7 Older people must stand up for themselves

8 Sex is highly overrated

9 Cultivate your own garden

10 Death is not to be Feared

Healthy Aging

Hippocampus Exercise Physically amp Mentally

Socialize

Interact with Hobbies amp Community

Spirituality

Healthy Diet

Moderation - including alcohol

Recognize depression in self or partner- more psychomotor than emotive

bull Withdrawn Poor Appetite Slowed Down

bull Rule out Medical Causes

Depression Dementia amp Depressive Pseudodementia

The Greatest

Fear Losing Your Mind amp Self Dementia

bull Alzheimerrsquos Disease

bull Vascular

bull Lewy Body

bull Frontal- Temporal

Dementia over 65

bull Lack of Exercise

bull Poor Diet

bull Smoking

bull Excessive Drinking

bull Untreated Clinical Depression

bull Genetic

bull Intelligence

bull Occupation (Nunrsquos Study)

bull History of TBI

bull Poverty

Risk Factors for Dementia

Lowering Risk Factors

Controlling Blood Pressure

Good Health Maintenance

Lucky Genes

Glass of Cabernet or Resveratrol Daily

Cup of Caffeine a Day

Exercise Brain amp Body

Travel

Have a Partner andor Socialize

Diet- particularly high in Anti-Oxidants ( Mediterranean)

Depression amp Suicide with Aging

Why Do Older Adults Commit

Suicide

There is no one factor that causes someone to commit suicide however there are a number issues

bull The biggest commonality in older adults is clinical depression Many see depression as an inevitable part of getting older as one copes with declining health and the loss of loved ones However while feeling ldquodownrdquo is normal clinical depression at any age is not It is medically treatable and should not just be accepted something that doctors are very keen to stress

Common risk factors surrounding elder suicide includebull The recent death of a spouse family member or friend

bull Illness

bull The fear of a prolonged illness

bull Social isolation and feelings of loneliness

bull Major life changes particularly retirement

bull Common suicide warning signs in an older adult include (but are not limited to)

bull Insomnia

bull Weight loss

bull Feelings of guilt

bull Feelings of purposelessness

bull Feelings of being a burden

bull Dramatic changes in regular routines

bull Refusing social activities

bull Giving away prized possessions

What is the Purpose of Life OR Is There One

ldquoStoicismrdquoCicero

ldquoExistentialismrdquoSimone de BeauvoirAnd In Between

Abrahamic Religionsbull Judaismbull Christianitybull Islambull Other World Viewsbull Eschatology ndash Hindu Buddhism Etc

Cicero

1 Good Old Age begins in Youth

2 Old age can be a wonderful part of life

3 There are proper seasons in life

4 Older people have much to teach the young

5 Old age need not deny us an active life but we need to accept limitations

6 The mind is a muscle that must be exercised

7 Older people must stand up for themselves

8 Sex is highly overrated

9 Cultivate your own garden

10 Death is not to be Feared

Healthy Aging

Hippocampus Exercise Physically amp Mentally

Socialize

Interact with Hobbies amp Community

Spirituality

Healthy Diet

Moderation - including alcohol

Recognize depression in self or partner- more psychomotor than emotive

bull Withdrawn Poor Appetite Slowed Down

bull Rule out Medical Causes

Depression Dementia amp Depressive Pseudodementia

The Greatest

Fear Losing Your Mind amp Self Dementia

bull Alzheimerrsquos Disease

bull Vascular

bull Lewy Body

bull Frontal- Temporal

Dementia over 65

bull Lack of Exercise

bull Poor Diet

bull Smoking

bull Excessive Drinking

bull Untreated Clinical Depression

bull Genetic

bull Intelligence

bull Occupation (Nunrsquos Study)

bull History of TBI

bull Poverty

Risk Factors for Dementia

Lowering Risk Factors

Controlling Blood Pressure

Good Health Maintenance

Lucky Genes

Glass of Cabernet or Resveratrol Daily

Cup of Caffeine a Day

Exercise Brain amp Body

Travel

Have a Partner andor Socialize

Diet- particularly high in Anti-Oxidants ( Mediterranean)

Depression amp Suicide with Aging

Why Do Older Adults Commit

Suicide

There is no one factor that causes someone to commit suicide however there are a number issues

bull The biggest commonality in older adults is clinical depression Many see depression as an inevitable part of getting older as one copes with declining health and the loss of loved ones However while feeling ldquodownrdquo is normal clinical depression at any age is not It is medically treatable and should not just be accepted something that doctors are very keen to stress

Common risk factors surrounding elder suicide includebull The recent death of a spouse family member or friend

bull Illness

bull The fear of a prolonged illness

bull Social isolation and feelings of loneliness

bull Major life changes particularly retirement

bull Common suicide warning signs in an older adult include (but are not limited to)

bull Insomnia

bull Weight loss

bull Feelings of guilt

bull Feelings of purposelessness

bull Feelings of being a burden

bull Dramatic changes in regular routines

bull Refusing social activities

bull Giving away prized possessions

Cicero

1 Good Old Age begins in Youth

2 Old age can be a wonderful part of life

3 There are proper seasons in life

4 Older people have much to teach the young

5 Old age need not deny us an active life but we need to accept limitations

6 The mind is a muscle that must be exercised

7 Older people must stand up for themselves

8 Sex is highly overrated

9 Cultivate your own garden

10 Death is not to be Feared

Healthy Aging

Hippocampus Exercise Physically amp Mentally

Socialize

Interact with Hobbies amp Community

Spirituality

Healthy Diet

Moderation - including alcohol

Recognize depression in self or partner- more psychomotor than emotive

bull Withdrawn Poor Appetite Slowed Down

bull Rule out Medical Causes

Depression Dementia amp Depressive Pseudodementia

The Greatest

Fear Losing Your Mind amp Self Dementia

bull Alzheimerrsquos Disease

bull Vascular

bull Lewy Body

bull Frontal- Temporal

Dementia over 65

bull Lack of Exercise

bull Poor Diet

bull Smoking

bull Excessive Drinking

bull Untreated Clinical Depression

bull Genetic

bull Intelligence

bull Occupation (Nunrsquos Study)

bull History of TBI

bull Poverty

Risk Factors for Dementia

Lowering Risk Factors

Controlling Blood Pressure

Good Health Maintenance

Lucky Genes

Glass of Cabernet or Resveratrol Daily

Cup of Caffeine a Day

Exercise Brain amp Body

Travel

Have a Partner andor Socialize

Diet- particularly high in Anti-Oxidants ( Mediterranean)

Depression amp Suicide with Aging

Why Do Older Adults Commit

Suicide

There is no one factor that causes someone to commit suicide however there are a number issues

bull The biggest commonality in older adults is clinical depression Many see depression as an inevitable part of getting older as one copes with declining health and the loss of loved ones However while feeling ldquodownrdquo is normal clinical depression at any age is not It is medically treatable and should not just be accepted something that doctors are very keen to stress

Common risk factors surrounding elder suicide includebull The recent death of a spouse family member or friend

bull Illness

bull The fear of a prolonged illness

bull Social isolation and feelings of loneliness

bull Major life changes particularly retirement

bull Common suicide warning signs in an older adult include (but are not limited to)

bull Insomnia

bull Weight loss

bull Feelings of guilt

bull Feelings of purposelessness

bull Feelings of being a burden

bull Dramatic changes in regular routines

bull Refusing social activities

bull Giving away prized possessions

Healthy Aging

Hippocampus Exercise Physically amp Mentally

Socialize

Interact with Hobbies amp Community

Spirituality

Healthy Diet

Moderation - including alcohol

Recognize depression in self or partner- more psychomotor than emotive

bull Withdrawn Poor Appetite Slowed Down

bull Rule out Medical Causes

Depression Dementia amp Depressive Pseudodementia

The Greatest

Fear Losing Your Mind amp Self Dementia

bull Alzheimerrsquos Disease

bull Vascular

bull Lewy Body

bull Frontal- Temporal

Dementia over 65

bull Lack of Exercise

bull Poor Diet

bull Smoking

bull Excessive Drinking

bull Untreated Clinical Depression

bull Genetic

bull Intelligence

bull Occupation (Nunrsquos Study)

bull History of TBI

bull Poverty

Risk Factors for Dementia

Lowering Risk Factors

Controlling Blood Pressure

Good Health Maintenance

Lucky Genes

Glass of Cabernet or Resveratrol Daily

Cup of Caffeine a Day

Exercise Brain amp Body

Travel

Have a Partner andor Socialize

Diet- particularly high in Anti-Oxidants ( Mediterranean)

Depression amp Suicide with Aging

Why Do Older Adults Commit

Suicide

There is no one factor that causes someone to commit suicide however there are a number issues

bull The biggest commonality in older adults is clinical depression Many see depression as an inevitable part of getting older as one copes with declining health and the loss of loved ones However while feeling ldquodownrdquo is normal clinical depression at any age is not It is medically treatable and should not just be accepted something that doctors are very keen to stress

Common risk factors surrounding elder suicide includebull The recent death of a spouse family member or friend

bull Illness

bull The fear of a prolonged illness

bull Social isolation and feelings of loneliness

bull Major life changes particularly retirement

bull Common suicide warning signs in an older adult include (but are not limited to)

bull Insomnia

bull Weight loss

bull Feelings of guilt

bull Feelings of purposelessness

bull Feelings of being a burden

bull Dramatic changes in regular routines

bull Refusing social activities

bull Giving away prized possessions

The Greatest

Fear Losing Your Mind amp Self Dementia

bull Alzheimerrsquos Disease

bull Vascular

bull Lewy Body

bull Frontal- Temporal

Dementia over 65

bull Lack of Exercise

bull Poor Diet

bull Smoking

bull Excessive Drinking

bull Untreated Clinical Depression

bull Genetic

bull Intelligence

bull Occupation (Nunrsquos Study)

bull History of TBI

bull Poverty

Risk Factors for Dementia

Lowering Risk Factors

Controlling Blood Pressure

Good Health Maintenance

Lucky Genes

Glass of Cabernet or Resveratrol Daily

Cup of Caffeine a Day

Exercise Brain amp Body

Travel

Have a Partner andor Socialize

Diet- particularly high in Anti-Oxidants ( Mediterranean)

Depression amp Suicide with Aging

Why Do Older Adults Commit

Suicide

There is no one factor that causes someone to commit suicide however there are a number issues

bull The biggest commonality in older adults is clinical depression Many see depression as an inevitable part of getting older as one copes with declining health and the loss of loved ones However while feeling ldquodownrdquo is normal clinical depression at any age is not It is medically treatable and should not just be accepted something that doctors are very keen to stress

Common risk factors surrounding elder suicide includebull The recent death of a spouse family member or friend

bull Illness

bull The fear of a prolonged illness

bull Social isolation and feelings of loneliness

bull Major life changes particularly retirement

bull Common suicide warning signs in an older adult include (but are not limited to)

bull Insomnia

bull Weight loss

bull Feelings of guilt

bull Feelings of purposelessness

bull Feelings of being a burden

bull Dramatic changes in regular routines

bull Refusing social activities

bull Giving away prized possessions

Lowering Risk Factors

Controlling Blood Pressure

Good Health Maintenance

Lucky Genes

Glass of Cabernet or Resveratrol Daily

Cup of Caffeine a Day

Exercise Brain amp Body

Travel

Have a Partner andor Socialize

Diet- particularly high in Anti-Oxidants ( Mediterranean)

Depression amp Suicide with Aging

Why Do Older Adults Commit

Suicide

There is no one factor that causes someone to commit suicide however there are a number issues

bull The biggest commonality in older adults is clinical depression Many see depression as an inevitable part of getting older as one copes with declining health and the loss of loved ones However while feeling ldquodownrdquo is normal clinical depression at any age is not It is medically treatable and should not just be accepted something that doctors are very keen to stress

Common risk factors surrounding elder suicide includebull The recent death of a spouse family member or friend

bull Illness

bull The fear of a prolonged illness

bull Social isolation and feelings of loneliness

bull Major life changes particularly retirement

bull Common suicide warning signs in an older adult include (but are not limited to)

bull Insomnia

bull Weight loss

bull Feelings of guilt

bull Feelings of purposelessness

bull Feelings of being a burden

bull Dramatic changes in regular routines

bull Refusing social activities

bull Giving away prized possessions

Depression amp Suicide with Aging

Why Do Older Adults Commit

Suicide

There is no one factor that causes someone to commit suicide however there are a number issues

bull The biggest commonality in older adults is clinical depression Many see depression as an inevitable part of getting older as one copes with declining health and the loss of loved ones However while feeling ldquodownrdquo is normal clinical depression at any age is not It is medically treatable and should not just be accepted something that doctors are very keen to stress

Common risk factors surrounding elder suicide includebull The recent death of a spouse family member or friend

bull Illness

bull The fear of a prolonged illness

bull Social isolation and feelings of loneliness

bull Major life changes particularly retirement

bull Common suicide warning signs in an older adult include (but are not limited to)

bull Insomnia

bull Weight loss

bull Feelings of guilt

bull Feelings of purposelessness

bull Feelings of being a burden

bull Dramatic changes in regular routines

bull Refusing social activities

bull Giving away prized possessions

Why Do Older Adults Commit

Suicide

There is no one factor that causes someone to commit suicide however there are a number issues

bull The biggest commonality in older adults is clinical depression Many see depression as an inevitable part of getting older as one copes with declining health and the loss of loved ones However while feeling ldquodownrdquo is normal clinical depression at any age is not It is medically treatable and should not just be accepted something that doctors are very keen to stress

Common risk factors surrounding elder suicide includebull The recent death of a spouse family member or friend

bull Illness

bull The fear of a prolonged illness

bull Social isolation and feelings of loneliness

bull Major life changes particularly retirement

bull Common suicide warning signs in an older adult include (but are not limited to)

bull Insomnia

bull Weight loss

bull Feelings of guilt

bull Feelings of purposelessness

bull Feelings of being a burden

bull Dramatic changes in regular routines

bull Refusing social activities

bull Giving away prized possessions

Treatment of

Depression in Old Age

Anti-Depressants Low amp Slow

ECT ( viz ldquoPride Studyrdquo) Extreme cases or life-threatening depression with failure to thrive

Non- Semantic Therapies

bull Cognitive Therapy

bull Grief Counseling when indicated

bull Agency services

bull Senior Citizenrsquos Center etc

The Eriksonian Struggle Later in Life

vs

Every suicidal person may have a homicidal component but they are turning anger and rage inward

May cause some to latch onto a fixed idea which relieves and answers the ragehellip An ldquoOtherrdquo or group as an enemy

IntegrityDespairamp Rage

Disorders with Overvalued

Ideas

A solitary abnormal belief that is neither delusional nor obsessional in nature but which is preoccupying to the extent of dominating the sufferers life

Disorders conforming to his definition are well documented though their recognition as such has been variable and they may not be as rare as is often thought

As well as sharing a distinctive phenomenology the conditions develop in similar settings and carry a uniformly poor prognosis Their pathogenesis is obscure and difficult to account for in conventional terms

bull McKenna PJ

The Eriksonian Struggle Later in Life

vs

Every suicidal person may have a homicidal component but they are turning anger and rage inward

May cause some to latch onto a fixed idea which relieves and answers the ragehellip An ldquoOtherrdquo or group as an enemy

IntegrityDespairamp Rage

Disorders with Overvalued

Ideas

A solitary abnormal belief that is neither delusional nor obsessional in nature but which is preoccupying to the extent of dominating the sufferers life

Disorders conforming to his definition are well documented though their recognition as such has been variable and they may not be as rare as is often thought

As well as sharing a distinctive phenomenology the conditions develop in similar settings and carry a uniformly poor prognosis Their pathogenesis is obscure and difficult to account for in conventional terms

bull McKenna PJ

Disorders with Overvalued

Ideas

A solitary abnormal belief that is neither delusional nor obsessional in nature but which is preoccupying to the extent of dominating the sufferers life

Disorders conforming to his definition are well documented though their recognition as such has been variable and they may not be as rare as is often thought

As well as sharing a distinctive phenomenology the conditions develop in similar settings and carry a uniformly poor prognosis Their pathogenesis is obscure and difficult to account for in conventional terms

bull McKenna PJ

Wernickersquos Overvalued

Idea -Relieve the

Rage

Imagined Failure in Life ndash leads to rage

To relieve or answer rage- may morph into an extreme overvalued belief

Overvalued Belief becomes Obsessive and Addictive

Needs Relief through Violence or Domination

bull Neo- Nazis

bull KKK

bull Worship amp mindless following of a cult leader or ethos (Hitler etc)

This May manifest in ldquolone wolvesrdquo or Groups

Serenity vs Despair in

Aging

Suicide

Homicide

Angry Man

bull With an extremely overvalued belief

Oslo Mass Murders

Anders Behring Breivik

Neo- Nazis

White Supremacists

Suicide Bombers

Assorted Terrorist

True Acceptance of what Life has Given you Leads to Wisdom Leads to Serenity

Life is a journey with an End in sight

Try to leave the world with more than you came into it

PEACE LOVE AND GEROTRANSCENDENCE

Born January 20th 1896Died March 9th 1996Occupation Comedian

Serenity vs Despair in

Aging

Suicide

Homicide

Angry Man

bull With an extremely overvalued belief

Oslo Mass Murders

Anders Behring Breivik

Neo- Nazis

White Supremacists

Suicide Bombers

Assorted Terrorist

True Acceptance of what Life has Given you Leads to Wisdom Leads to Serenity

Life is a journey with an End in sight

Try to leave the world with more than you came into it

PEACE LOVE AND GEROTRANSCENDENCE

Born January 20th 1896Died March 9th 1996Occupation Comedian

True Acceptance of what Life has Given you Leads to Wisdom Leads to Serenity

Life is a journey with an End in sight

Try to leave the world with more than you came into it

PEACE LOVE AND GEROTRANSCENDENCE

Born January 20th 1896Died March 9th 1996Occupation Comedian

Life is a journey with an End in sight

Try to leave the world with more than you came into it

PEACE LOVE AND GEROTRANSCENDENCE

Born January 20th 1896Died March 9th 1996Occupation Comedian