Although the brain literally becomes smaller as we age, basic mental abilities do not necessarily diminish. Reaction time, mental speed and efficiency, and nonverbal intelligence may decline somewhat by age 75, but understanding, vocabulary, the ability to remember information, and verbal intelligence remain the same. Although occasional forgetfulness, memory lapses, and misplacement of objects are common at any age, approximately 15% of Elders develop more serious symptoms of diminished mental capacity.

A number of physical illnesses, such as kidney disease, alcoholism, heart disease, fluid retention, diabetes, cataracts, and liver disease can cause any of the symptoms listed in the above check-off list. Through medical, neurological and psychological examination, a specific physical problem may be identified and corrected, and the psychological symptom(s) may lessen or disappear altogether.

Nearly 30% of Elders have significant symptoms of mental illness. As many as 50% of the Elders hospitalized for medical or surgical reasons develop psychiatric difficulties. Abnormal thyroid activity, drug side affects, depression or anxiety causes some of these symptoms. Nearly all of the Elders in this category can enjoy complete remission of their symptoms with the proper diagnosis and treatment. Many, however, remain symptomatic, as their condition is not identified in a timely manner.

Severe mental illness, including delusions and paranoia, affect 1 million American Elders. Many, many more suffer milder forms of mental disorders. Most of them could be treated and the symptoms lessened if an examination and diagnosis was made.

Most Elders experience untold grief and loss issues as they begin to loose their spouse and friends to illness and death. In addition, they are trying to adjust to other losses such as employment, freedom, social networks, diminished physical abilities, financial loss and other health issues. Developing effective coping strategies and reaching out to family and friends can be crucial in dealing with these difficult losses.

According to a 1992 NIH study, 25% of Elders living in Nursing Homes and Assisted Living Centers experience severe depression, with 40% suffering repeated bouts. Depression in Elders is dramatically more complex, as biological factors make them more vulnerable. Elders who become depressed are more likely to develop psychotic symptoms and hallucinations than younger people.

If any of the symptoms listed below are present, a psychiatric examination is in order and may mean the difference between a highly functioning and well adjusted Elder and one who literally waits to die.

Symptoms include:

• Finds it difficult to complete a sentence due to forgetting what words to use or what the discussion is about
  
• Misplaces important items such as money or bank records
  
• Seems confused, especially early in the morning and before bedtime
  
• Forgets how to use common items or perform simple tasks
  
• Unable to identify days, months, year or seasons
  
• Becomes disoriented when in familiar surroundings
  
• Sleeps at unusual times and is restless throughout the day
  
• Appetite dramatically decreases/ weight loss
  
• Suffers dizzy spells or severe headaches
  
• Visually displays depressed mood or sadness
  
• Lacks pleasure or interest in usual activities
  
• Feels hopeless, worthless, indecisive, irritable, or preoccupied with thoughts of death or suicide (depression)
  
• Problems in concentrating, feels exhausted, complains about aches and pains
  
• Becomes restless, trembles, or shows signs of increased muscle tension
  
• Experiences difficulty breathing, heart palpitations, or accelerated heart rate (anxiety)
  
• Has trouble swallowing, has nausea or diarrhea
  
• Has exaggerated reactions to sudden sounds, feels edgy or keyed up
  

Not always applicable to those who have been diagnosed with Dementia or Alzheimer's Disease