
==== Front
Ther Adv Psychopharmacol
Ther Adv Psychopharmacol
TPP
sptpp
Therapeutic Advances in Psychopharmacology
2045-1253
2045-1261
SAGE Publications Sage UK: London, England

10.1177/20451253241278557
10.1177_20451253241278557
Geriatric Psychiatry and Brain Health in Old Age
Editorial
Geriatric psychiatry and brain health in old age
https://orcid.org/0000-0002-3770-4074
Tampi Rajesh R. Department of Psychiatry, Creighton School of Medicine, Creighton University Education Building, 7710 Mercy Road, Suite 601, Omaha, NE 68124-237, USA
Department of Psychiatry, Yale School of Medicine, 300 George St #901, New Haven, CT 06511, USA
Conceptualization Writing – original draft Writing – review & editing
Karp Jordan F. Writing – review & editing Department of Psychiatry, College of Medicine – Tuscon, University of Arizona, Tucson, AZ, USA

rajesh.tampi@gmail.com
17 9 2024
2024
14 204512532412785575 7 2024
31 7 2024
© The Author(s), 2024
2024
SAGE Publications Ltd unless otherwise noted. Manuscript content on this site is licensed under Creative Commons Licenses
https://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
cover-dateJanuary-December 2024
typesetterts1
==== Body
pmcBy 2030, one in six people across the world will be ⩾60 years old. 1 In real numbers, this global older cohort will increase in size from 1 billion in 2020 to 1.4 billion by 2030 and then 2.1 billion by 2050. At the same time, the number of people ⩾80 years old will triple in size, up to 426 million. It is estimated that approximately 14% of adults ⩾60 have a neuropsychiatric disorder, and these disorders account for 10.6% of the total years lived with disability for this age group. 2 Common neuropsychiatric disorders among older adults include anxiety disorders, mood disorders, substance use disorders, neurocognitive disorders, especially due to Alzheimer’s disease (AD), and delirium.3,4

Despite being common and causing significant difficulties, psychiatric disorders are often undiagnosed and untreated in late life. 5 It has been noted that when compared to younger individuals, older individuals are less likely to receive a psychiatric diagnosis, have fewer visits with a psychiatrist, and receive less psychotherapy, but have greater rates of psychotropic medication visits (121.4 per 100 population vs 56.8 per 100 population). 6 Furthermore, it is more common for non-psychiatrists to prescribe most of the psychotropic medications for older people with one study finding that among older adults, only 5%, 4%, 17%, and 13% of the visits for antidepressants, anxiolytics, antipsychotics, and mood stabilizers, respectively, were with a psychiatrist. 7 Inadequate assessment and management of common psychiatric disorders can worsen outcomes among older patients including both decreased quality of life and increased morbidity and mortality.5,8

To educate professionals on the best practices in caring for older adults with neuropsychiatric conditions, Therapeutic Advances in Psychopharmacology has assembled a special collection of articles titled “Geriatric Psychiatry and Brain Health in Old Age.” 9 This collection includes five articles on relevant topics in geriatric psychiatry including alcohol use disorder, treatments for anxiety, depression, delirium, and the management of multi-morbidity among older adults. These articles were prepared by experts in geriatric psychiatry and include the latest information available on these topics in their respective manuscripts.

In the first article, Schroder et al. investigated the frequency and characteristics of potentially serious alcohol–medication interactions, potentially inappropriate medications (PIMs), and potential drug–drug interactions (pDDIs) in a population of older patients with alcohol use disorder over a 10-year period using a retrospective monocentric cohort study design. 10 The investigators identified that these patients are frequently exposed to potentially serious alcohol–medication interactions, PIMs, and pDDIs, especially with regard to cardiovascular and psychotropic drugs. In the second article, Stahl et al. 11 prepared a scoping review of the literature on the types and efficacy of psychosocial interventions for improving antidepressant pharmacotherapy adherence among depressed and anxious older adults using the PRISMA-ScR guidelines. The investigators identified that there are effective interventions for improving antidepressant medication adherence among depressed older adults but there is a lack of such interventions for anxious older people. In the third manuscript, Srifuengfung et al. provide a comprehensive guide to optimize medication management in older adults with depression in the outpatient setting. 12 In addition, the authors also describe appropriate medications for managing anxiety, insomnia, allergy, overactive bladder, psychosis, and muscle spasms in depressed older patients.

In the fourth article in the special issue, Faeder et al. provide narrative literature on nonpharmacologic and pharmacologic approaches to prevent and treat delirium among older adults. 13 The authors also critically review whether antipsychotics should be used among older adults with delirium. In the fifth and final article in this collection, Carlson and Yarns discuss the important topic of medical and psychiatric multimorbidity among older adults. 14

We hope that the readers find the information provided in this special collection of articles useful in providing the latest evidence-based care for their patients. Early detection and appropriate treatment of neuropsychiatric disorders among older adults will help improve their quality of life, and minimize the morbidity and mortality due to these disorders.

None.

Declarations

ORCID iD: Rajesh R. Tampi https://orcid.org/0000-0002-3770-4074

Ethics approval and consent to participate: Not applicable.

Consent for publication: Not applicable.

Author contributions: Rajesh R. Tampi: Conceptualization; Writing – original draft; Writing – review & editing.

Jordan F. Karp: Writing – review & editing.

Funding: The authors received no financial support for the research, authorship, and/or publication of this article.

Competing interests: The authors declare that there is no conflict of interest.

Availability of data and materials: Not available.
==== Refs
References

1 World Health Organization. Aging and health, https://www.who.int/news-room/fact-sheets/detail/ageing-and-health (2022, accessed 2 July 2024).
2 World Health Organization. Mental health of older adults, https://www.who.int/news-room/fact-sheets/detail/mental-health-of-older-adults#:~:text=According%20to%20the%20Global%20Health,adults%20are%20depression%20and%20anxiety (2023, accessed 2 July 2024).
3 Reynolds K Pietrzak RH El-Gabalawy R , et al . Prevalence of psychiatric disorders in U.S. older adults: findings from a nationally representative survey. World Psychiatry 2015; 14 : 74–81.25655161
4 2024 Alzheimer’s Disease Facts and Figures. Alzheimer’s association, https://www.alz.org/media/documents/alzheimers-facts-and-figures.pdf (2024, accessed 2 July 2024).
5 de Mendonça Lima CA Ivbijaro G . Mental health and wellbeing of older people: opportunities and challenges. Ment Health Fam Med 2013; 10 : 125–127.24427178
6 Maust DT Kales HC Blow FC. Mental health care delivered to younger and older adults by office-based physicians nationally. J Am Geriatr Soc 2015; 63 : 1364–1372.26140422
7 Maust DT Oslin DW Marcus SC. Effect of age on the profile of psychotropic users: results from the 2010 National Ambulatory Medical Care Survey. J Am Geriatr Soc 2014; 62 : 358–364.24417590
8 Lehmann SW Ellison JM Sakauye K , et al . Raising the bar on geriatric mental health competency training, https://www.psychiatrictimes.com/view/raising-bar-geriatric-mental-health-competency-training (2020, accessed 4 July 2024).
9 Therapeutic Advances in Psychopharmacology. Geriatric psychiatry and brain health in old age, https://journals.sagepub.com/topic/collections-tpp/tpp-1_geriatric_psychiatry_and_brain_health_in_old_age/tpp (2024, accessed 4 July 2024).
10 Schröder S Westhoff MS Pfister T , et al . Drug safety in older patients with alcohol use disorder: a retrospective cohort study. Ther Adv Psychopharmacol. Epub ahead of print 21 Feb 2024. DOI: 10.1177/20451253241232563.
11 Stahl ST Kincman J Karp JF , et al . Psychosocial interventions to improve adherence in depressed and anxious older adults prescribed antidepressant pharmacotherapy: a scoping review. Ther Adv Psychopharmacol. Epub ahead of print 20 Nov 2023. DOI: 10.1177/20451253231212322.
12 Srifuengfung M Pennington BRT Lenze EJ. Optimizing treatment for older adults with depression. Ther Adv Psychopharmacol. Epub ahead of print 18 Nov 2023. DOI: 10.1177/20451253231212327.
13 Faeder M Hale E Hedayati D , et al . Preventing and treating delirium in clinical settings for older adults. Ther Adv Psychopharmacol. Epub ahead of print 8 Sep 2023. DOI: 10.1177/20451253231198462.
14 Carlson DM Yarns BC. Managing medical and psychiatric multimorbidity in older patients. Ther Adv Psychopharmacol. Epub ahead of print 30 Aug 2023. DOI: 10.1177/20451253231195274.
