Mental health problems of aging and the aged.

The rapid increase in admission rates to mental hospitals in many countries in recent decades threatens to create serious problems. These may be to some extent remediable in that social factors are important in deciding the chances of admission to hospital, as well as the frequency of suicide, which reaches a peak among the aged in most countries. All communities possess valuable assets in the form of existing links between the aged and their families which may be lost by indiscriminate community planning. Although some psychological decline is inevitable during senescence, it is becoming clear that much that once passed for the ineluctable effects of mental and physical aging is due to disease that may be ameliorated or cured. The relationship between mental and physical health is particularly close in old age, and the effective treatment of the aged person with a psychiatric disorder demands the full resources of general medicine as well as psychiatry. For successful rehabilitation a full community service for the aged and proper integration of the work of the family doctor with that of preventive and hospital services are essential. The possibilities of prevention can be enhanced by fostering physical well-being and healthy adjustment during earlier stages of life, as well as by ascertaining, and remedying as far as possible, the mental and physical disorders of the aged in the early stages of their development. There is great scope for biological, medical and sociological research to define reasons for the wide variations in mental and physical well-being in old age.