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Healthy Aging: Keeping Mentally Fit as You Age

Today, thoughts of aging gracefully have been replaced by efforts to age successfully. As we age and look forward to longer life expectancies than past generations, we strive to age with good health. How do we do this? By eating nutritiously. Limiting alcohol. Keeping physically active. Staying connected with our friends and family. Seeking medical treatment when necessary. These are the right steps toward healthy aging. And with good health, we can enjoy life and pursue new dreams and endeavors as we age.

Good health includes both physical and mental well-being. And the two go hand in hand. A healthy mind contributes to a healthy body. The mind, like the body, benefits from low blood pressure, low cholesterol, nourishing food, a healthy weight, and physical activity.

There are many healthy lifestyle choices we can make to keep our bodies healthy and avoid illness and disability. There are additional steps we can take to help preserve healthy minds.

What changes in mental abilities can we expect as we age? What’s normal?
As we age, we can expect certain changes in our bodies and minds. We may not see and hear as well as we did in our 20s. We may not be able to remember recent events or details as well or as quickly as we did in our 30s. Beginning in our 30s, our brain’s weight, the network of nerves, and its blood flow begin to decrease. Our brains adapt, however, and grow new patterns of nerve endings.

While certain changes in our mental abilities are inevitable as we age, much remains the same. We retain our intellect. Our ability to change and be flexible remains. Old dogs can learn new tricks. We just might need a little more time. We keep our ability to grow intellectually and emotionally.

What can I do to keep my mind healthy?
For the last several years, new research has emerged that shows there are many things we can do to keep our minds healthy. Many of the same things we do to keep our bodies healthy contribute to healthy minds. Physical activity and a diet that helps lower cholesterol levels and blood pressure also helps to keep our minds healthy by allowing our bodies to deliver oxygen-rich blood to our brains. In addition, activities that stimulate our minds, like crossword puzzles, reading, writing, and learning new things, help to keep our brains healthy. Staying engaged with the people around us and our communities plays an equally big part in staying mentally fit.

Following are some specific recommendations to keep a healthy mind and ward off mental health problems.

Be physically active. The benefits are numerous. Being physically active helps prevent bone density loss, maintain balance, and ward off illnesses (like heart disease, stroke, and some cancers). For some, illness and disability can bring on or contribute to mental illness. For example, those who live with diabetes, cancer, and heart disease can also suffer from depression.

Regular physical activity helps to:

  • Maintain and improve memory
  • Maintain and improve mental ability
  • Prevent dementia (impaired intellectual functioning) including Alzheimer’s disease
  • Make us happy and prevent and alleviate depression
  • Improve energy levels

How does exercise do all that? Physical activity—whether it’s walking, running, swimming, dancing (we have a lot of choices)—helps to:

  • Decrease heart rate
  • Decrease blood pressure
  • Decrease blood cholesterol
  • Strengthen the heart and increase the flow of oxygen to the brain
  • Improve reaction time
  • Improve mobility

If you are thinking about starting an exercise program, talk first with your doctor. Start slowly, take proper precautions (for example, walk in well-lit areas in sturdy shoes), and have fun. Remember, you don’t have to be athletic to benefit from regular physical activity.

Exercise Resources

Keep blood pressure down. Blood pressure below 120/80 mmHg is considered healthy and helps reduce the risk of stroke, which is tied to dementia including Alzheimer’s disease. High blood pressure damages blood vessels, which increases one’s risk of stroke, kidney failure, heart disease, and heart attack. Nearly two-thirds of adults over age 65 have high blood pressure, 140/90 mmHg or higher. Those with blood pressure between 120/80 mmHg and 139/89 mmHg are considered to have prehypertension, which means that while the blood pressure is not too high, they are likely to develop it in the future. To reduce or keep blood pressure at a healthy level, keep your weight down, don’t smoke, exercise regularly, eat a healthy diet, and limit salt, alcohol and caffeine.

Blood Pressure Resources

Keep your cholesterol levels low. High blood cholesterol is a risk factor for heart disease as well as dementia. The higher your blood cholesterol level, the greater your chance of disease and illness. An excess of cholesterol (a fat-like substance) in your blood can build up on the walls of your arteries. This causes them to harden and narrow, which slows down and can block blood flow. A blood cholesterol level of less than 200 mg/dL is considered healthy, 200-239 mg/dL is borderline high, and 240 mg/dL and above is high. Heredity, age, and gender can affect cholesterol levels. Cholesterol rises with age and women’s levels tend to rise beginning after menopause. Healthy changes to diet, weight, and physical activity can help improve blood cholesterol levels.

Cholesterol Resources

Eat your vegetables… and more. We’ve heard it all our lives, the good advice to eat our vegetables. The same diet that can help us stay strong and healthy provides the nutrition necessary for a healthy brain. It starts with a diet rich in fruits and vegetables, whole grains, and nonfat dairy products. Experiment and find out how you best like to eat the good things that your entire body needs. There’s an endless variety to suit every taste.

Some specific dietary recommendations for a healthy brain:

Folate is a B vitamin found in foods such as spinach and asparagus. Folic acid is the synthetic form used in supplements and fortified foods. Folate is necessary for the health of our cells, and helps to prevent anemia and changes to DNA (the building blocks of cells) that could lead to cancer. Folate is also necessary to maintain normal levels of homocysteine, an amino acid in the blood. Good sources of folate and folic acid include fortified breakfast cereals, dark-green leafy vegetables, asparagus, strawberries, beans, and beef liver.

The vitamins E and C are important antioxidants found in foods that help guard against cell damage and may reduce the risk of cancer and heart disease. While there’s no conclusive evidence, vitamins E and C may help boost mental ability and prevent dementia.

For adults, the recommended dietary allowance (RDA) of vitamin E is 15 milligrams per day from foods. Foods naturally rich in vitamin E include nuts, such as almonds, vegetable oils, seeds, wheat germ, spinach, and other dark-green leafy vegetables.

The RDA of vitamin C for adults is 75 milligrams per day for women and 90 milligrams per day for men. Vitamin C is found in oranges, grapefruits, asparagus, Brussels sprouts, broccoli, bell peppers, collard greens, cabbage, cauliflower, kale, potatoes, spinach, and turnip greens.

Nutrition Resources

Monitor your medication use. Be sure to read labels and carefully follow your physician’s instructions. Some medications come with certain precautions such as avoiding alcohol or not combining with other medications, even over-the-counter drugs and herbal remedies. Some memory loss, some forms of dementia, and other problems of the brain can be traced back to harmful drug combinations or inappropriate drug use.

Drink moderately. If you don’t drink, don’t start. If you do drink, limit yourself to no more than one drink a day if you are over the age of 65 and do not have a drinking problem. One drink is 12 ounces of beer, 1.5 ounces of distilled spirits, or 5 ounces of wine.

Medication and Alcohol Use Resources

  • As You Age… A Guide to Aging, Medicines, and Alcohol from the U.S. Food and Drug Administration and the Substance Abuse and Mental Health Services Administration: asyouage.samhsa.gov

Give up smoking. If you are a smoker, don’t wait until you are debilitated by a serious disease before considering quitting. Smoking significantly increases one’s chance of having a stroke and developing lung and other cancers, emphysema, chronic bronchitis, chronic obstructive pulmonary disease (COPD), heart attacks, and peripheral vascular disease.

According to the American Lung Association, when an older person quits smoking, circulation improves immediately and lungs begin to heal. After one year, the additional risk of heart disease caused by smoking is cut almost in half, and the risk of stroke, lung disease, and cancer decreases.

Quitting Smoking Resources

Maintain a healthy weight. People who are obese or overweight are at increased risk for heart disease, high blood pressure, diabetes, arthritis-related disabilities, and some cancers. The health risks of being overweight include high blood pressure, high cholesterol, heart disease, and stroke. Being underweight also carries risks including poor memory and decreased immunity. Ask your health care provider how much you should weigh and for suggestions on reaching that weight. Whatever your weight, a healthy diet and regular exercise will only improve your overall health.

Healthy Weight Resources

Take care of your teeth by brushing and flossing and seeing your dentist regularly. Recent studies have linked chronic inflammation caused by gum disease to a number of health problems, including Alzheimer’s disease and heart disease. So, take care of your teeth not only to maintain a dazzling smile and the ability to chew your favorite foods but also to ward off disease.

Oral Health Care Resources

Keep mentally fit. Just as we exercise our bodies to keep them in working order, so must we exercise our brains to stay mentally agile and adept. It’s the use-it-or-lose-it theory. By engaging in mentally stimulating activities, we can maintain our brain functions as we age. We can continue to grow new connections among the billions of brain cells we possess by learning new things. This activity may help to ward off dementia like Alzheimer’s disease. So, work out your brain daily. Stimulate new areas of your brain and grow more connections among brain cells by intellectually challenging yourself. Solve a puzzle, learn a new musical instrument, read a challenging book, play a board or card game, attend a lecture or play, or write a short story.

Mental Fitness Resources
Alzheimer’s Association, Maintain Your Brain: www.alz.org/maintainyourbrain/overview.asp

AARP Games and Puzzles: www.aarp.org/fun/puzzles

Memory Fitness Institute: www.memoryfitnessinstitute.org/default.asp

Reduce stress. Just as stress can wear our bodies down and increase blood pressure and the risk of heart disease, it can also affect the way we think, our moods, and ability to remember. In fact, the hormones our bodies release when we are under stress may shrink the brain, affecting memory and learning. Stress can also cause or contribute to depression and anxiety.

  • To deal with stress, first identify its causes and determine what changes you can make to avoid it. For example, if rush-hour traffic is causing you stress, time your driving or change your route to avoid heavy traffic. If party planning and gift buying during the holidays overwhelm you, simplify and concentrate on those aspects you really look forward to, like getting together with friends and family.
  • Talk it out. Sometimes talking through your stress with a friend or therapist, or even writing in a journal, helps to put things in perspective.
  • Relax. Whether it’s by taking walks, playing golf, hitting a tennis ball, or meditating, find ways to release your stress and take a break.
  • Get moving. Physical activity on most days of the week helps our bodies keep mental stress in check.
  • Give yourself a break. If you must live with a stressful situation, take mini-vacations. Whether it’s 20 minutes or several days, take time to relax and enjoy the things and people you find pleasurable.

Stress Reduction Resources

Protect your brain. A history of head injury or loss of consciousness can affect the health of your brain. Falls are the leading cause of brain injury in the elderly, according to the Brain Injury Association of America. Takes steps to protect your head and the precious matter inside.

  • To avoid falls, exercise regularly to improve your balance.
  • Clear your home of hazards like clutter on the floor. Make sure you have proper lighting.
  • In the car, wear your seatbelt. Ask someone else to drive in situations where you are not as comfortable as you once were, such as nighttime driving or driving in bad weather.
  • On your bike, wear a helmet.
  • When walking or running, wear proper shoes with good support and stay in well-lit areas.
  • If your balance seems a bit unsteady, talk to your doctor about any medications you may be taking.

Head Protection Resources

Stay socially connected. The support we receive from our friends, family, and colleagues helps maintain our mental health. Studies have shown that those who are engaged with family and community groups take longer to show the symptoms of Alzheimer’s disease than those who are socially isolated. So stay or become connected. Join a book club or a volunteer group and interact with the world around you.

Look on the bright side. A positive outlook and emotions contribute to a healthy mind and body. Focus on the good in the world and the activities and people that make you happy.

Stay connected spiritually. If nurturing your spiritual side has had meaning for you, keep up that aspect of your life. Those with a strong faith often find support and comfort from their beliefs and their community. So whatever your religious or spiritual beliefs, stay connected. This connection can help prevent and relieve depression and may guard against dementia.

How can I help my memory?

  • Don’t expect to remember everything. In today’s busy world, we’re all overloaded with information. When necessary, use lists, calendars, reminders, and other memory aides. For example, write down appointments on your calendar and keep a list of chores in your pocket.
  • Develop routines to help you remember. Take medicines the same time every day. Leave your keys in the same place.
  • Visual memory tends to be better than auditory memory. That is, it’s easier to remember what we see than what we hear. Using both at the same time will enhance memory. For example, if you need to pick up fruit at the grocery store, picture blueberries in the produce isle.
  • Associating stories with new things or ideas is also helpful.
  • Increasing attention improves learning and memory. When learning something new, limit the distractions (turn off the TV and choose a quiet room), and focus your attention.
  • More time helps learning and recall. Allow yourself additional time and have patience.

What’s not normal as we get older? What might indicate an illness?
While some forgetfulness is normal in older age, persistent memory loss is not. And because we experience more loss as we age (family members who move away, the death of loved ones), we are bound to experience more sadness. However, prolonged periods of sadness or depression are not normal as we age.

If you experience any of the following warning signs listed below, or notice that an older relative or friend is experiencing any of these, seek help. Older adults can first start by talking to friends or loved ones, and find help from their family physician, internist, psychiatrist, or geriatric psychiatrist, to name just a few professionals who can provide assistance.

Warning Signs
The following are not normal characteristics of aging and can indicate an illness. Discuss these symptoms with your physician.

  • Depressed mood or sadness lasting longer than two weeks
  • Unexplained crying spells
  • Loss of interest or pleasure in the things and people that were previously enjoyable
  • Jumpiness or tiredness, lethargy, fatigue, or loss of energy
  • Irritability, quarrelsomeness
  • Loss or increase in appetite or weight change
  • Sleep change such as insomnia (not being able to sleep) or sleeping more than usual
  • Feelings of worthlessness, inappropriate guilt, hopelessness, helplessness
  • Decreased ability to think, concentrate, or make decisions
  • Repeated thoughts of death or suicide, suicide attempts—Seek help from a medical professional immediately.
  • Aches and pains, constipation, or other physical problems that cannot otherwise be explained
  • Confusion and disorientation
  • Memory loss, loss of recent, short-term memory
  • Social withdrawal
  • Trouble handling finances, working with numbers, paying the bills
  • Change in appearance, standard of dress
  • Problems maintaining the home, the yard

What might trigger or contribute to mental illness?

  • Physical disability
  • Physical illness
    • With diseases of the heart and lungs, the brain may not get enough oxygen, which affects mental ability and behavior.
    • Diseases of the adrenal, thyroid, pituitary, or other glands can affect emotions, perceptions, memory, and thought processes
  • A change in environment such as moving into a new home
  • Loss or illness of a loved one
  • A combination of medications
    • On average, older adults take more medications than others. Because our metabolism slows down as we age, drugs can remain longer in an older person and reach toxic levels more quickly
  • Drug-alcohol interactions can cause confusion, mood changes, symptoms of dementia
  • Alcohol or drug abuse and misuse
  • Poor diet
    • Dental problems can contribute to a poor diet. Some older adults may avoid foods that are difficult to chew.

If I suspect a problem, what should I do?

  • Talk with your physician. Explain how you feel and describe what is not normal for you. Have a list of all medications, and vitamin, mineral, and herbal supplements.
  • Talk to a trusted friend, family member, or spiritual advisor.

Talking with Your Doctor, Pharmacist, or Other Health Care Providers

  • Have a list of all medications, herbal remedies, and vitamin, mineral and herbal supplements.
  • Don’t be shy or embarrassed. Explain how you feel.
  • Ask questions. Take a list and pencil if necessary.
  • Remind your doctors and pharmacist about your medical history.
  • Ask for advice and instructions in clear writing, free of medical jargon.
  • Ask for a follow-up visit if all your questions cannot be answered during your appointment.
  • If you have questions once at home, don’t hesitate to phone your doctor.

General Resources

Geriatric Mental Health Foundation:
www.GMHFonline.org
7910 Woodmont Avenue, Suite 1050, Bethesda, MD 20814
Phone: (301) 654-7850

American Association for Geriatric Psychiatry:
www.AAGPonline.org
7910 Woodmont Avenue, Suite 1050, Bethesda, MD 20814
Phone: (301) 654-7850

Alzheimer’s Association:
www.alz.org
225 N. Michigan Avenue, Floor 17, Chicago, IL 60601-7633
Phone: (800) 272-3900 and (312) 335-8700

Alzheimer’s Disease Education and Referral Center:
www.alzheimers.org
PO Box 8250, Silver Spring, MD 20907-8250
Phone: (800) 438-4380

American Psychiatric Association:
www.psych.org
1000 Wilson Boulevard, Suite 1825, Arlington, VA 22209-3901
Phone: (703) 907-7300

Depression & Bipolar Support Alliance:
www.dbsalliance.org
730 N. Franklin Street, Suite 501, Chicago, IL 60610-7224
Phone: (800) 826-3632 and (312) 642-0049

Families for Depression Awareness:
www.familyaware.org
300 Fifth Avenue, Waltham, MA 02451
Phone: (781) 890-0220

National Center for Chronic Disease Prevention and Health Promotion, Healthy Aging:
www.cdc.gov/aging/health_issues.htm

National Alliance for the Mentally Ill:
www.nami.org
Colonial Place Three, 2107 Wilson Boulevard, Suite 300, Arlington, VA 22201-3042
Phone: (703) 524-7600 and (800) 950-NAMI (6264)

National Institute on Aging (NIA):
www.nih.gov/nia
Building 31, Room 5C27, 31 Center Drive, MSC 2292, Bethesda, MD 20892
Phone: (301) 496-1752

National Institute of Mental Health (NIMH):
www.nimh.nih.gov
Public Information and Communications Branch, 6001 Executive Boulevard, Room 8184, MSC 9663, Bethesda, MD 20892-9663
Phone: (301) 443-4513 and (866) 615-6464

National Mental Health Association:
www.nmha.org
2001 N. Beauregard Street, 12th Floor, Alexandria, VA 22311
Phone: (703) 684-7722

NIH SeniorHealth.gov:
nihseniorhealth.gov

Philadelphia Mental Health and Aging Resource Guide:
www.mhaging.org/guide
Mental Health/Aging Advocacy Project, Mental Health Association of SE PA, 1211 Chestnut Street, Philadelphia, PA 19107
Phone: (215) 751-1800, ext. 266

Real Men. Real Depression.:
menanddepression.nimh.nih.gov
National Institute of Mental Health, Public Information and Communications Branch, 6001 Executive Boulevard, Room 8184, MSC 9663, Bethesda, MD 20892-9663
Phone: (301) 443-4513 and (866) 615-6464

The information presented here is for general information only. It is NOT a substitute for the knowledge, skill, and judgment of qualified health care professionals. If you have any mental health or medical questions or concerns, please consult a physician, psychiatrist, geriatric psychiatrist, or other health care professional.

Geriatric Mental Health Foundation
The Geriatric Mental Health Foundation was established by the American Association for Geriatric Psychiatry to raise awareness of psychiatric and mental health problems and issues affecting older adults, eliminate the stigma of mental illness and treatment, promote healthy aging strategies, and increase access to quality mental health care for older adults.

The Foundation’s vision for America’s aging population includes:

  • Increased public awareness of the importance of mental health in the aging population;
  • Removal of stigmas for those seeking mental health services;
  • Increased access to quality mental health care for older adults; and
  • Promotion of healthy aging strategies for all older adults, family caregivers, and others devoted to the overall health of our communities.

To achieve this vision, the Foundation’s mission is to raise awareness of psychiatric and mental health problems and issues affecting older adults. The Foundation focuses on public education targeted to the health care consumer and family caregiver about mental health promotion, and illness prevention and treatment. The Foundation develops programs to enhance communication and foster broad collaboration between the aging and mental health research community, mental health care providers, and the general public.

Older Adults & Mental Health Brochure Series
This publication is part of a series of brochures published by the Geriatric Mental Health Foundation to provide information about the mental health of the elderly. Other GMHF brochures include:

  • A Guide to Mental Wellness in Older Age: Recognizing and Overcoming Depression (A Depression Recovery Toolkit)
  • Depression in Late Life: Not a Natural Part of Aging
  • Depression in Late Life (in Spanish)—Depresión Tardía: No Es Una Parte Natural Del Envejecimiento
  • Coping with Depression and the Holidays
  • Alzheimer’s Disease: Understanding the Most Common Dementing Disorder
  • Alzheimer’s Disease (in Spanish)—Enfermedad de Alzheimer: Entendiendo Acerca de la Demencia Más Común
  • Caring for the Alzheimer’s Disease Patient: How You Can Provide the Best Care and Maintain Your Own Well-Being
  • Substance Misuse and Abuse Among Older Adults

To view brochures online, visit www.GMHFonline.org/gmhf/consumer. Order from the website or call 301-654-7850.

Find a Geriatric Psychiatrist
A geriatric psychiatrist is a medical doctor with special training in the diagnosis and treatment of mental illnesses that may occur in older adults. These include, but are not limited to, dementia, depression, anxiety, alcohol and substance abuse/misuse, and late-life schizophrenia.

The Geriatric Mental Health Foundation can provide the names of geriatric psychiatrists. Visit www.GMHFonline.org or call 301-654-7850.

© 2005 Geriatric Mental Health Foundation
7910 Woodmont Avenue
Suite 1050
Bethesda, MD 20814
301-654-7850
www.GMHFonline.org
info@GMHFonline.org