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[Mental health in the aged].

The life expectancy of the world population has increased considerably and the absolute number of 65-year olds will approximately triple in the next 40 years. Since the prevalence of chronic illness and disability increases steeply with advancing age, it is to be expected that the utilization of health services and services provided for the elderly will also increase. In the developed countries about one quarter of those aged 65 and over suffer from mental disorders. An important risk factor for mental disorders of old age seems to be the subjective awareness of loneliness, combined with a quantitative deficit in social relationships. Losses in personal relationships, above all conjugal bereavement, are, in general, associated with a higher mortality, a higher risk of suicide, various physical diseases and mental disorders, in particular depression. Dementia, one of the severest disorders in late life, increases steeply with advancing age, reaching rates of 20 to 30% among those aged 85 and over. Depressive disorders are among the most frequent psychogeriatric disorders. Due to the heterogeneity of their symptomatology and differences in case identification the prevalence rates vary substantially between countries. Prospective follow-up studies have revealed the mortality risk to be markedly higher in organic than in functional mental disorders. Care of the mentally ill elderly patient is characterized by a relatively low utilization of outpatient mental health services, whereas contact with GPs becomes increasingly important in late life.