Mental health includes our emotional, psychological, and social well-being. It affects how we think, feel, and act as we cope with life. It also helps determine how we handle stress, relate to others, and make choices. Mental health is important at every stage of life, including as we age.

Many older adults are at risk for mental health problems. But this does not mean that mental health problems are a normal part of aging. Studies show that most older adults feel satisfied with their lives, even though they may have more illnesses or physical problems.

Sometimes, however, important life changes can make you feel uneasy, stressed, and sad. These changes could include the death of a loved one, retirement, or dealing with a serious illness. Many older adults will eventually adjust to the changes. But some people will have more trouble adjusting. This can put them at risk for mental disorders such as depression and anxiety.

It's important to recognize and treat mental disorders in older adults. These disorders don't just cause mental suffering. They can also make it harder for you to manage other health problems. This is especially true if those health problems are chronic.

Some of the warning signs of mental disorders in older adults include:

• Changes in mood or energy level
• A change in your eating or sleeping habits
• Withdrawing from the people and activities you enjoy
• Feeling unusually confused, forgetful, angry, upset, worried, or scared
• Feeling numb or like nothing matters
• Having unexplained aches and pains
• Feeling sadness or hopelessness
• Smoking, drinking, or using drugs more than usual
• Anger, irritability, or aggressiveness
• Having thoughts and memories that you can't get out of your head
• Hearing voices or believing things that are not true
• Thinking of harming yourself or others

If you think that you may have a mental health problem, get help. Talk therapy and/or medicines can treat mental disorders. If you don't know where to start, contact your primary care provider.

Nutrition is about eating a healthy and balanced diet so your body gets the nutrients that it needs. Nutrients are substances in foods that our bodies need so they can function and grow. They include carbohydrates, fats, proteins, vitamins, minerals, and water.

Good nutrition is important, no matter what your age. It gives you energy and can help you control your weight. It may also help prevent some diseases, such as osteoporosis, high blood pressure, heart disease, type 2 diabetes, and certain cancers.

But as you age, your body and life change, and so does what you need to stay healthy. For example, you may need fewer calories, but you still need to get enough nutrients. Some older adults need more protein.

Some changes that can happen as you age can make it harder for you to eat healthy. These include changes in your:

• Home life, such as suddenly living alone or having trouble getting around
• Health, which can make it harder for you to cook or feed yourself
• Medicines, which can change how food tastes, make your mouth dry, or take away your appetite
• Income, which means that you may not have as much money for food
• Sense of smell and taste
• Problems chewing or swallowing your food

To stay healthy as you age, you should:

• Eat foods that give you lots of nutrients without a lot of extra calories, such as
  • Fruits and vegetables (choose different types with bright colors)
  • Whole grains, like oatmeal, whole-wheat bread, and brown rice
  • Fat-free or low-fat milk and cheese, or soy or rice milk that has added vitamin D and calcium
  • Seafood, lean meats, poultry, and eggs
  • Beans, nuts, and seeds
• Avoid empty calories. These are foods with lots of calories but few nutrients, such as chips, candy, baked goods, soda, and alcohol.
• Pick foods that are low in cholesterol and fat. You especially want to try to avoid saturated and trans fats. Saturated fats are usually fats that come from animals. Trans fats are processed fats in stick margarine and vegetable shortening. You may find them in some store-bought baked goods and fried foods at some fast-food restaurants.
• Drink enough liquids, so you don't get dehydrated. Some people lose their sense of thirst as they age. And certain medicines might make it even more important to have plenty of fluids.
• Be physically active. If you have started losing your appetite, exercising may help you to feel hungrier.

Sometimes health issues or other problems can make it hard to eat healthy. Here are some tips that might help:

• If you are tired of eating alone, try organizing some potluck meals or cooking with a friend. You can also look into having some meals at a nearby senior center, community center, or religious facility.
• If you are having trouble chewing, see your dentist to check for problems
• If you are having trouble swallowing, try drinking plenty of liquids with your meal. If that does not help, check with your health care provider. A health condition or medicine could be causing the problem.
• If you're having trouble smelling and tasting your food, try adding color and texture to make your food more interesting
• If you aren't eating enough, add some healthy snacks throughout the day to help you get more nutrients and calories
• If an illness is making it harder for you to cook or feed yourself, check with your health care provider. He or she may recommend an occupational therapist, who can help you find ways to make it easier.

NIH: National Institute on Aging

Exercise and physical activity are good for just about everyone, including older adults. There are four main types and each type is different. Doing them all will give you more benefits.:

• Endurance, or aerobic, activities increase your breathing and heart rate. Brisk walking or jogging, dancing, swimming, and biking are examples.
• Strength exercises make your muscles stronger. Lifting weights or using a resistance band can build strength.
• Balance exercises help prevent falls
• Flexibility exercises stretch your muscles and can help your body stay limber

If you have not been active, you can start slowly and work up to your goal. How much exercise you need depends on your age and health. Check with your health care provider on what is right for you.

NIH: National Institute on Aging

Anesthesia is the use of medicines, called anesthetics, to prevent pain during surgery and other medical procedures. Medicine may be given by injection, inhalation, topical lotion, spray, eye drops, or a skin patch.

Anesthesia can cause a loss of feeling, awareness, or both. Sedation may be used with anesthesia. Unlike full anesthesia, sedation doesn't make you completely unconscious, and recovery is faster. It helps reduce pain, keep you calm, and make you less aware during procedures such as minor surgeries, endoscopies, imaging, or dental work.

Levels of sedation include:

• Minimal sedation. You are awake but more relaxed.
• Moderate sedation (conscious sedation). You may feel sleepy and not remember much, but you can still respond when spoken to or touched.
• Deep sedation. You are very drowsy and may respond only to repeated or stronger stimulation.

Anesthesia may be used for:

• Minor procedures, such as filling a tooth.
• Childbirth or procedures such as colonoscopies.
• Minor and major surgeries.

In some cases, a dentist, nurse, or doctor may give you an anesthetic. In other cases, you may need an anesthesiologist. This is a doctor who specializes in giving anesthesia.

There are several different types of anesthesia:

• Local anesthesia numbs a small area like a tooth or a cut that needs stitches. You are awake during local anesthesia.
• Regional anesthesia numbs a larger area, like an arm, a leg, or everything below the waist. You may be awake during the procedure, or you may be given sedation. It may be used during childbirth, a Cesarean delivery (C-section), or minor surgeries.
• General anesthesia affects your whole body. It feels like a deep sleep, but you do not feel anything. It is used during major surgeries, such as heart surgery, brain surgery, back surgery, and organ transplants.
• Monitored sedation makes you relaxed or sleepy. You may be able to talk, depending on the level of sedation, and you probably won't remember the procedure. It may be used for a colonoscopy or dental work.

Your overall health, medical history, the procedure you're having, and other factors will help determine the type of anesthesia you receive.

Anesthesia is generally safe. But there can be risks, especially with general anesthesia, including:

• Heart rhythm problem (arrhythmia).
• Breathing problems.
• An allergic reaction to the anesthesia.
• Temporary confusion (delirium), which can last several days in some people over the age of 60, or briefly in children after waking up from anesthesia.
• Awareness when someone is under general anesthesia. This usually means that the person hears sounds. But sometimes they can feel pain. This is rare.

Talk to your health care provider about the benefits and risks of anesthesia.

Dementia is a loss of mental functions that is severe enough to affect your daily life and activities. These functions include:

• Memory
• Language skills
• Visual perception (your ability to make sense of what you see)
• Problem solving
• Trouble with everyday tasks
• The ability to focus and pay attention

It is normal to become a bit more forgetful as you age. But dementia is not a normal part of aging. It is a serious disorder that interferes with your daily life.

The most common types of dementia are known as neurodegenerative disorders. These are diseases in which the cells of the brain stop working or die. They include:

• Alzheimer's disease, which is the most common form of dementia among older people. People with Alzheimer's have plaques and tangles in their brain. These are abnormal buildups of different proteins. Beta-amyloid protein clumps up and forms plaques in between your brain cells. Tau protein builds up and forms tangles inside the nerve cells of your brain. There is also a loss of connection between nerve cells in the brain.
• Lewy body dementia, which causes movement symptoms along with dementia. Lewy bodies are abnormal deposits of a protein in the brain.
• Frontotemporal disorders, which cause changes to certain parts of the brain:
  • Changes in the frontal lobe lead to behavioral symptoms
  • Changes in the temporal lobe lead to language and emotional disorders
• Vascular dementia, which involves changes to the brain's blood supply. It is often caused by a stroke or atherosclerosis (hardening of the arteries) in the brain.
• Mixed dementia, which is a combination of two or more types of dementia. For example, some people have both Alzheimer's disease and vascular dementia.

Other conditions can cause dementia or dementia-like symptoms, including:

• Creutzfeldt-Jakob disease, a rare brain disorder
• Huntington's disease, an inherited, progressive brain disease
• Chronic traumatic encephalopathy (CTE), caused by repeated traumatic brain injury
• HIV-associated dementia (HAD)

Certain factors can raise your risk for developing dementia, including:

• Aging. This is the biggest risk factor for dementia.
• Smoking
• Uncontrolled diabetes
• High blood pressure
• Drinking too much alcohol
• Having close family members who have dementia

The symptoms of dementia can vary, depending on which parts of the brain are affected. Often, forgetfulness is the first symptom. Dementia also causes problems with the ability to think, problem solve, and reason. For example, people with dementia may:

• Get lost in a familiar neighborhood
• Use unusual words to refer to familiar objects
• Forget the name of a close family member or friend
• Forget old memories
• Need help doing tasks that they used to do by themselves

Some people with dementia cannot control their emotions and their personalities may change. They may become apathetic, meaning that they are no longer interested in normal daily activities or events. They may lose their inhibitions and stop caring about other peoples' feelings.

Certain types of dementia can also cause problems with balance and movement.

The stages of dementia range from mild to severe. In the mildest stage, it is just beginning to affect a person's functioning. In the most severe stage, the person is completely dependent on others for care.

Your health care provider may use many tools to make a diagnosis:

• A medical history, which includes asking about your symptoms
• A physical exam
• Tests of your thinking, memory, and language abilities
• Other tests, such as blood tests, genetic tests, and brain scans
• A mental health evaluation to see whether a mental disorder is contributing to your symptoms

There is no cure for most types of dementia, including Alzheimer's disease and Lewy body dementia. Treatments may help to maintain mental function longer, manage behavioral symptoms, and slow down the symptoms of disease. They may include:

• Medicines, which may temporarily improve memory and thinking or slow down their decline. They only work in some people. Other medicines can treat symptoms such as anxiety, depression, sleep problems, and muscle stiffness. Some of these medicines can cause strong side effects in people with dementia. It is important to talk to your health care provider about which medicines will be safe for you.
• Occupational therapy to help find ways to more easily do everyday activities
• Speech therapy to help with swallowing difficulties and trouble speaking loudly and clearly
• Mental health counseling to help people with dementia and their families learn how to manage difficult emotions and behaviors. It can also help them plan for the future.
• Music or art therapy to reduce anxiety and improve well-being

Researchers have not found a proven way to prevent dementia. Living a healthy lifestyle might influence some of your risk factors for dementia.