Mental Health Issues Among Older Adults

Mental Health Issues Among Older Adults

The older adult population is majorly affected by some serious mental health issues. One disorder that is common among this population is major neurocognitive disorder (MND). According to DSM-5-TR, MND is an old age symptom that often develops with a substantial decline of cognitive functioning unlike the previous performance of cognitive levels in reasoning, speech, memory, spatiotemporal perception, and intellectual functioning (Sadock, Sadock, & Ruiz, 2015). It is also connected to difficulties in different levels of functioning and changes in emotional behavior.

To treat MND I would select several medications. Cholinesterase is an FDA-approved drug for enhancing cognitive performance. By stopping the breakdown of acetylcholine, cholinesterase inhibitors work to prevent symptoms from getting worse or at least delaying them. Additionally, individuals with myasthenia gravis frequently use cholinesterase inhibitors (National Library of Medicine, 2006–2020). The greater activation of ACh sensors on post-synaptic membranes brought on by the higher acetylcholine concentration in the neuromuscular junction improves muscle stimulation, contractions, and strength. An off-label drug I would choose to help treat MND in older adults is donepezil. Donepezil is one of several medications categorized as cholinesterase inhibitors. It achieves this by enhancing mental performance in the brain by increasing the concentration of a specific naturally existing substance like memory, attentiveness, interaction ability and conducting daily activities. Donepezil might stop or at least slow down cognitive and memory loss in MND patients (National Library of Medicine, 2006–2020). Donepezil, however, cannot treat MND or stop the eventual decline of mental faculties. An effective nonpharmacological treatment for MND is occupational therapy. Patients can be assisted with home adjustments and be taught coping mechanisms. By doing so, they will moderate their behavior, avoid accidents, and get ready for their symptoms to worsen.

FDA-approved medicines have several benefits and risks. They evaluate a product for safety and efficacy before authorizing it. If a product has FDA approval, it has been put through the FDA assessment procedure and a rigorous quality control process. Side effects are typically not severe because the FDA weighs the advantages and disadvantages of each medication before approving it. Benefits and risks are weighed for each drug the FDA authorizes (Sadock, Sadock, & Ruiz, 2015). However, the risk is that even with the FDA’s approval of a medication no medication is “perfectly” secure. Every medication that has an impact on the body will result in some side effects.

Off-label drugs also have some benefits and risks. It may be valuable, predominantly in instances where patients have exhausted all other known choices of treatment, as in cancer or rare disease cases. Another good illustration of off-label prescribing is beta-blockers. These drugs are approved by the Food and to be used in the management of high blood pressure, but cardiologists generally agree that they should be given to patients with coronary artery disease as an ordinary of care (Sadock, Sadock, & Ruiz, 2015). Should a patient experience unfavorable side effects from using a medication off-label, there may be a greater chance of legal action. People who use drugs off-label run the risk of getting therapy that is ineffective or even harmful.

There are several clinical guidelines for the treatment of MND. ICD-10 clinical criteria should be employed for the diagnosis of MND. For an individual to be diagnosed with a major neurodevelopment disorder, he or she must meet the DSM-5 criteria classified by symptoms such as significant cognitive decline compared to previous performance level in learning, attentiveness, memory, perceptual-motor, planning, and ability to understand social issues (APA, 2016).  Also, clinicians can determine a patient’s MND causes with the help of a trustworthy, thorough background. First, they must eliminate all frequently occurring reversible causes and highly reversible causes. When the clinical features suggest a high index of suspicion of reversible MND, investigations to clear out less prevalent causes may be required.

Before confirming a moderate case of MND, doctors must rule out delirium and dementia. They should register and check to see if the applicant satisfies the diagnostic requirements for the disorder. There is a need for additional assessments if that is the case (Stewart & DeNisco, 2019). Finding the dementia syndrome underlying reason is the goal of the subsequent evaluation phase. a decline in memory, which is most noticeable when learning fresh data, though in more extreme cases, it may also affect the recollection of previously acquired information. Obtaining a trustworthy history from an informant and, if available, adding neuropsychological assessments or quantitative cognitive evaluations will help accurately confirm the decline.












American Psychiatric Association. (2016). The American Psychiatric Association Practice Guideline on The Use of Antipsychotics to Treat Agitation or Psychosis in Patients with Dementia.  https://Doi.Org/10.1176/Appi.Books.9780890426807

National Library of Medicine. (2006–2020). Drugs and lactation databaseLinks to an external site. (LactMed)

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2015). Kaplan & Sadock’s synopsis of psychiatry (11th ed.). Wolters Kluwer.

Stewart, J. G., & DeNisco, S. M. (2019). Role development for the nurse practitioner (2nd ed.)Jones & Bartlett Learning.


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