There is no mental disorder that is inevitable in old age. Most older people describe their overall well-being as good. Hence there is such a thing as “normal” ageing in terms of mental (as well as physical) health. Nevertheless, as in all age groups, mental disorder is not uncommon in older people and there are some disorders that become more prevalent as age increases.

About 5% of the general population over 65 years suffer from severe cognitive impairment with a further 5% showing mild changes, which may progress with time. Dementia refers to a global impairment of mental function which follows a chronic and progressive course. The symptoms and signs have usually been present for at least 6 months. The impairment of mental function is commonly associated with a deterioration in emotional control, social behaviour, motivation and the ability to perform activities of daily living (ADLs). These “non-cognitive” features of dementia, which are often the most upsetting aspects for family carers and friends, tend now to be referred to as Behavioural and Psychological Symptoms in Dementia (BPSD). Dementia is related to progressive cerebral degeneration, which may be caused by a variety of pathological processes, such as Alzheimer’s disease, vascular dementia and dementia with Lewy bodies.


Old age psychiatry handout (not just dementia)

Link to blog posts featuring dementia

Internal video resources
“A woman who couldn’t remember.”

“She couldn’t remember…”: Delirium

Cognitive testing with the MMSE

External links
— Wikipedia articles on dementia, Alzheimer’s, multi-infarct dementia and dementia with Lewy Bodies
— A Royal College of Psychiatrists podcast on “Alcohol-related dementia: a 21st-century silent epidemic?
— Royal College of Psychiatrists leaflet on Alzheimer’s and dementia
— A BBC video where Claudia Hammond and guests look at the best ways around the world to improve the lives of people with dementia and those who care for them
— Dementia Gateway has a number of videos relating to a range of issues in dementia including use of the Mental Capacity Act