Psychiatric problems in the aged: a reconsideration.

The numerically important mental disorders found in the senescent population are reviewed from the point of view of their relationship to the process of ageing. Only two direct relationships are seen: the acute confusional states due to the age-linked decline in stress resistance; and the neurotic reactions due to the diminished capacity for rapid and adequate adjustment to the more subtle but chronic sociopsychological changes the aged individual is so frequently exposed to in our society. The chronic dementing processes of the senium, senile and arteriosclerotic dementia, are more likely to occur at an advanced age, but apparently are not the final outcome of cerebral and/or cerebrovascular ageing, although the ageing process seems to favour their phenotypical manifestation. The functional psychoses may occur at an advanced age but are not directly related to the process of ageing.