Psychological Assessment of the Elderly (Medicine in Old Age})

One of the major social phenomena of the end of this century and the beginning of the next, is the ageing of the population of the developed nations and of developing countries, who will face a similar challenge early next century. The number of people in the middle-aged groups who provide most of the care is declining relative to the very elderly population, and very old people have an especially high prevalence of disabling disorders, including dementia and also often live alone in substandard accommodation and relative poverty. This psychological assessment of the elderly focuses attention on the task of describing and measuring diseases, disabilities and the needs of old people. The authors feel there is a need for better planning and efficiency within the existing medical and social services and a need to evaluate the various new treatment strategies for mental illness in old age, especially the dementias. The measurement of these problems enables those concerned to test hypotheses about the classification of diseases, their outcome and the effects of treatment. This collection of selective essays includes contributions on three major methodological issues - what is "normal" in old age, the place of longitudinal (as against cross-sectional) studies, and the correlation between clinical ratings and pathology. Their fundamental aim was to help patients, and to ground this work in a clinical situation a chapter on psychological approaches to treatment is included. The conclusions found from this study state that the ideal instrument to measure the psychological state of an old person would measure a wide range of functions: cognition, mood, other aspects of mental state and behaviour in the social context. The structure of the instrument would also allow these elements to be analyzed separately and would be short, valid, reliable, sensitive and easily administered by any professional with the minimum of training.