Getting older is a normal part of living. “Our brain function changes, and we’re not as agile in our reasoning or verbal agility,” says Vineeth John, MD.
“As we age, we still learn, just at a slower rate and less efficiently,” explains John. “We may have trouble with recall and retrieval even though our IQ and vocabulary remain the same.”
Appropriately addressing behavioral issues of an aging population will become increasingly important as Texas and the rest of the nation enter the third decade of the 21st century. Today, Texas has an estimated 4 million residents age 65 and older. That number will nearly double to 7.5 million by 2040.
Older adults can have emotional or behavioral symptoms that are not connected to mental or neurological disorders, John explains. For example, pain resulting from illnesses and injuries can lead to depression in an older individual, but that does not mean the person suffers from clinical depression.
Discussions with patients about brain-related aging require helping them distinguish between healthy aging and pathological aging, according to Antonio Teixeira, MD, PhD. “If you have psychiatric problems, your brain is at risk of developing cognitive impairment and dementia. People sometimes avoid psychiatric tests out of fear of learning they have these conditions. This makes it difficult to help the patient delay the onset of a condition or take safety measures.”
“Specialized expertise in geriatric psychiatry helps us navigate symptoms and treat conditions appropriately,” says John, who teaches residents at McGovern Medical School at UTHealth to connect with the whole person. “I want to help them understand that geriatric psychiatry is seeing the patient as a person whose depression may be caused by frailty or loneliness or a heart that is failing, and not always from a neurological condition.”
As part of their commitment to help older adults with healthy aging, John and Teixeira collect clinical data to address health problems without prescribing medications. Polypharmacy— the use of multiple medications—is common for older patients and may lead to negative outcomes, such as falls, dangerous drug reactions, and death. Many times, older adults have more than one medical specialist because they have more than one issue, and confusion about medication names can add to the problem.
Practicing medicine is more than writing prescriptions. “It involves not only diagnosing and explaining, but also listening,” explains Teixeira, adding that patients should adopt healthy habits such as eating healthy, getting adequate sleep, limiting alcohol consumption, and eliminating cigarette consumption. “It’s never too late to embrace good habits.”
Carmel B. Dyer, MD, leads UTHealth Consortium on Aging, of which John and Teixeira are members. She has been a champion of educating future and established doctors to look at the individual needs of the patient based on their unique situation. This is particularly true in terms of medications.
“We want to make sure no one is on medication they don’t need. Lifestyle modifications help,” says Dyer. “It’s a discussion between physician and
patient to determine what will be most efficient.”