What causes behavior changes in older adults?


May 14, 2022

Many older people face special physical and mental health challenges which can cause behavior changes.

Did you know approximately 15% of people over the age of 60 suffer from a mental disorder? And another 5% suffer from neurological disorders? The most common conditions are dementia (a neurological disorder), depression, headache disorders, anxiety and substance abuse.

Depression – Because its symptoms can be similar to those of other diseases, depression is often missed in older adults, which may lead to unnecessary suffering or impaired daily function. Some of the symptoms of depression include changes in sleep patterns, social withdrawal, loss of appetite, anxiety, decreased concentration, restlessness, guilt, fatigue, confusion, unexplainable physical aches and pains. 

Dementia – Dementia, a progressive syndrome, in older adults presents as a deterioration in memory and thinking and is most commonly caused by Alzheimer’s disease. Contrary to common belief, this cognitive decline is not a normal part of aging and is one of the most debilitating conditions that an older adult can have. Some symptoms of dementia include difficulty communicating, forgetfulness, losing track of time, becoming lost in familiar places (such as home), wandering, repeating questions, difficulty walking, and more. 

Anxiety – Late-life anxiety is more common than both depression and dementia. Older adults who have decreased physical capabilities are at higher risk of developing anxiety due to fear
and vulnerability.

Substance Abuse – Substance abuse is a growing problem among older adults, with alcohol being the most commonly abused substance. Some reports indicate up 20% of older adults abuse some type of substance, including prescription drugs.

Causes of Mental Health Challenges

Factors such as limited mobility, increased chronic diseases, financial stressors and loss of independence often lead to social isolation and loneliness and can contribute to poor mental health in older adults. This public health issue is frequently underestimated and unrecognized. Furthermore, the social stigma associated with mental and behavioral health conditions often prevents older adults from seeking help. It is vital we all work to remove the stigma associated with mental health conditions. 

Demographics and Risk Factors

  • Non-Hispanic white males over the age of 85 are most likely to commit suicide.
  • Women are more likely than men to have substance abuse problems.
  • The majority of older adults with dementia are in low- and middle-income countries.
  • Risk factors for vascular disease, such as obesity, tobacco use, physical inactivity and diabetes are also considered risk factors for dementia.
  • Older adults with other chronic medical conditions are more likely to experience mental health issues.

Treatment and care strategies to address mental health needs of older people

Good general health and social care is important for promoting older people’s health, preventing disease and managing chronic illnesses. The mental health of older adults can be improved through promoting active and healthy ageing. Strategies include creating living conditions and environments that support wellbeing and allow people to lead a healthy life. 

Prompt recognition and treatment of mental, neurological and substance use disorders in older adults is essential. There is no medication currently available to cure dementia but much can be done to support and improve the lives of people with dementia and their caregivers and families, such as:

  • early diagnosis, in order to promote early and optimal management
  • optimizing physical and mental health, functional ability and well-being
  • identifying and treating accompanying physical illness
  • detecting and managing challenging behaviour
  • providing information and long-term support to carers


Early recognition and treatment of neuropsychiatric conditions are key to preventing a decrease in quality of life. Regular exercise can also provide positive mental health benefits.

  • Seek professional help if you, or those you care for, experience symptoms of depression, dementia or anxiety.
  • Remember that depression is treatable and does not have to lead to a decreased quality of life.
  • Stay connected with family and friends. Talk about your feelings with someone you trust.
  • Stay involved in activities you enjoy or find alternatives if those are no longer feasible


Sources: The World Health Organization’s Fact Sheets; Aging Well Texas Report: Behavioral and Mental Health Needs in Older Adults

We hope this information is helpful to you in the important work you do as a family caregiver.
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