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Marginalised and depressed: Britain’s older people

24 July 2008

Urgent action needs to be take action to curb a decline in mental health and wellbeing amongst the over 65s, according to a new report  from the institute for public policy report (ippr) published today (Thursday).

ippr highlights that older people's mental health and wellbeing has been severely neglected while young people's health and wellbeing have been the focus of many new policies and debate.  2.4 million older people are estimated to have depression which impairs their quality of life.

ippr’s report found a strong association between levels of deprivation amongst older people and poor emotional wellbeing. Although pensioner poverty has reduced overall since 1997, in 2006 /7 (the latest figures) 2.5 million people over 65 were living in poverty, up 300,000 on the previous year.

ippr's report Older People and Wellbeing  shows that another significant contributing factor to low well being in older people is the number of older people living alone. This has resulted from increases in divorce and separation, and the ageing of the population, with many women outliving their husbands. Of those living alone, 17 per cent rated themselves as ‘often/always lonely’ compared with two per cent living with others, and 80 per cent of the ‘often lonely’ lived alone. ippr argues that more needs to be done to ensure that those most at risk of depression are made the focus of community initiatives and policy priorities.

Factors identified by ippr as shaping wellbeing in older people include:

• Physical health –70 per cent of all new diagnosis of depression have been found to be a likely result of ill health. A lack of mobility can often bring about feelings of isolation due to more limited contact with friends and family.
  
• Ethnicity – poorer physical health and higher levels of poverty amongst some minority ethnic groups are risk factors for depression, although this can be mitigated by good family and religious support systems, for example among some Indian and Pakistani groups.
  
• Gender – women are more prone to some mental health problems than men particularly depression 14 per cent of women reporting these problems compared with nine per cent of men.
  
• Marital status
  • Never marrying is associated with a low prevalence of mental health issues with just eight per cent of unmarried men and four per cent of unmarried women experiencing such problems.
  • Divorce or separation increases mental health problems at least in the short term to 19 per cent of women and 17 per cent of men.
  • Marriage is associated with lower prevalence of mental health problems in men, at seven per cent, but significantly greater prevalence in women, at12 per cent.
    
• Living alone – 80 per cent of those classifying themselves as ‘often lonely’ live alone. Women over 75 are almost twice as likely to be living alone as men.
  
• Community participation – is important in promoting well being and a sense of value. Older people report their biggest neighbourhood fear as problems with traffic, while they are surprisingly less worried about teenagers, crime and drugs.
  
• Exercise – protects against mental health problems including depression giving a positive sense of wellbeing. Most health promotion campaigns are directed at children and those of working age.
  
• Volunteering – is associated with increased satisfaction, a sense of purpose and larger social networks.

The report also highlights that over the next 20 years four trends are likely to contribute to increases in older people with poor mental health and emotional wellbeing :

1. Mental health problems may be becoming more prevalent across all ages.
2. The number of older people is set to rise markedly (by 2031 nearly three million over 85s, compared with 1.2 million in 2006 and 0.6 million in 1981)
3. The number and proportion of older old people (over 85s) are increasing. Estimates indicate that by 2031 there will be nearly three million over-85s compared with 1.2 million in 2006 and around 0.6 million in 1981. People over 85 are more at risk for poor levels of well being and at higher risk of having dementia, itself a risk factor for depression.
4. A rise in the number of carers, some of whom will be older people themselves, who are at higher risk of depression than the rest of the population.

ippr examined factors which help increase wellbeing in older people. These included participation in community activities, family life, an active social life and support from partners, friends, family and religion. Being an active grandparent, an increasing role for older people, is also a protective factor for the emotional wellbeing of older people. In 2006, 58 per cent of grandparents described themselves as a friend or confidant to their grandchildren. Transport and access to important social networks like family, friends and religious groups; more access to learning, exercise and community groups; and increased financial security to reduce worries about making ends meet are other important protective factors.

ippr recommends a joined up service providing support and care for older people during and after depression 'trigger points' such as retirement, moving home, caring for a sick or elderly or following the death of a spouse or partner. ippr suggests that the a suitable approach could be based on more coordinated services, modelled on the Sure Start programme that exists for children in communities.

Jessica Allen, Head of Health and Social Care, ippr said:

“Declines in wellbeing in older people can no longer be an ignored. One million older people in the UK are socially isolated and if the issue is not addressed, this number is projected to rise to 2.2 million over the next 15 years. Politicians need to refocus their attention and get serious about improving older people’s wellbeing

“Steps must be taken to provide a community based support system which promotes emotional wellbeing. This would give support to older people and their families during potential trigger points to depression in their lives, like retirement or caring for sick partner or relative. As well as promoting wellbeing and a sense of purpose for older people, this could provide an enormous boost for society because active, happy and healthy older people can contribute huge amounts to their communities and families, from volunteering through to helping with childcare.”

ippr found that mental health problems, including depression, are also a major reason for admission to nursing and residential care and identifies a worrying lack of research on the reasons for depression in some care homes.

Ends

Notes to editors

Source: ONS 2008c

Older people and wellbeing by Jessica Allen is available from the ippr press office upon request.

This is the first in a series of four papers looking at well being in older people in the UK. In the second phase of this work ippr will be exploring ageing in other countries and cultures in more detail and assessing whether the most successful policies, services and approaches can be applied in the UK. ippr will also be asking older people themselves what they would find most helpful, particularly for those most at risk and during times of difficulty.

Contact

Dr Jessica Allen, Head of Health and Care, ippr 
020 7470 6174
j.allen@ippr.org

Catherine Bithell, Director of Communications, ippr
020 7470 6106
c.bithell@ippr.org