Mental health disorders in the elderly: prevention strategies, diagnostic challenges, and management protocols

Abstract

Background: Mental health disorders in older adults—including depression, anxiety, dementia, late-onset psychosis, substance use disorders, and delirium—remain a major and growing global health concern. These conditions are commonly missed or undertreated due to atypical symptom presentation, coexisting physical illnesses, ageist assumptions in clinical settings, and stressors like bereavement, isolation, and institutional living.

Objective: This study aimed to build an integrated framework covering prevention, early detection, accurate diagnosis, and evidence-based treatment for six major psychiatric conditions in adults aged 60 and older, drawing on geriatric psychiatry, neuropsychology, pharmacology, multidisciplinary teamwork, and person-centred care principles.

Methods: The research combined a systematic review of 25 studies (2010–2024) across major databases, evaluated using the GRADE framework, with retrospective analysis of clinical data from 290 patients (aged 60–94) treated at 10 geriatric psychiatry units in seven countries, using interrupted time-series methods to assess pre- and post-implementation outcomes.

Results: Findings showed the framework reduced depression rates by 30–40%, delayed dementia onset by 2–4 years, raised diagnostic accuracy by 38.6%, achieved treatment response rates of 68–82%, cut inpatient costs by 34.2%, and lowered diagnostic errors by 42.3%.

Conclusion: The authors conclude that coordinated, evidence-based multidisciplinary care meaningfully improves outcomes and efficiency in elderly mental health services, and recommend expanding workforce capacity and care coordination system-wide.