Frequent Mental Distress - Ages 65+

Frequent Mental Distress - Ages 65+ in United States

United States

Frequent mental distress is an indicator of health-related quality of life and the burden of mental illness in a population. It aims to capture the population experiencing persistent, and likely severe, mental health issues, defined by 14 or more days of self-reported poor mental health in the past month. There is a strong relationship between the 14-day period and clinically diagnosed mental disorders, such as depression and anxiety. 

Frequent mental distress is associated with health conditions and risk factors for poor health, including diabetes, hypertension, smoking, obesity, physical inactivity and insufficient sleep.

The prevalence of frequent mental distress is higher among:

• Older women than older men. 
• American Indian/Alaska Native older adults compared with white older adults. Multiracial, Hispanic and Black older adults also have a high prevalence. 
• Older adults with less than a high school education compared with those with higher levels of education; college graduates have the lowest prevalence. 
• Older adults with an annual household income less than $25,000 compared with those with higher levels of income.

The odds of frequent mental distress are nearly 3 times higher among older adults with activity limitations (due to chronic conditions, physical disabilities or mental or emotional problems) compared with older adults without activity limitations; and 2 times higher among older adults who reported that health care cost was a barrier to seeing a doctor compared with older adults without cost barriers.

Although some poor mental health days or occasional short periods of mental distress may be unavoidable, more prolonged and severe episodes are treatable and preventable through time-efficient screening procedures, early interventions and quality care. The National Institutes of Health provide resources for older adults who have depression, as well as information for older adults suffering from other mental health issues. The American Psychological Association recognizes the unique needs of older adults and has several resources available through its Committee on Aging, including information on geropsychology.

Healthy People 2030 has objectives to increase the proportion of adults with depression and adults with serious mental illness who receive treatment.

Dwyer-Lindgren, Laura, Johan P. Mackenbach, Frank J. van Lenthe, and Ali H. Mokdad. 2017. “Self-Reported General Health, Physical Distress, Mental Distress, and Activity Limitation by US County, 1995-2012.” Population Health Metrics 15 (1): 16. https://doi.org/10.1186/s12963-017-0133-5.

Leggett, Amanda, and Steven H. Zarit. 2014. “Prevention of Mental Disorder in Older Adults: Recent Innovations and Future Directions.” Generations 8 (3): 45–52. https://pubmed.ncbi.nlm.nih.gov/26290620/.

Liu, Yong, Janet B. Croft, Anne G. Wheaton, Geraldine S. Perry, Daniel P. Chapman, Tara W. Strine, Lela R. McKnight-Eily, and Letitia Presley-Cantrell. 2013. “Association between Perceived Insufficient Sleep, Frequent Mental Distress, Obesity and Chronic Diseases among US Adults, 2009 Behavioral Risk Factor Surveillance System.” BMC Public Health 13 (1): 84. https://doi.org/10.1186/1471-2458-13-84.

Segev, Zuzana, Ahmed A. Arif, and James E. Rohrer. 2012. “Activity Limitations and Healthcare Access as Correlates of Frequent Mental Distress in Adults 65 Years and Older: A Behavioral Risk Factor Surveillance Study—2008.” Journal of Primary Care and Community Health 3 (1): 17–22. https://doi.org/10.1177/2150131911412380.

Shih, Margaret, and Paul A. Simon. 2008. “Health-Related Quality of Life among Adults with Serious Psychological Distress and Chronic Medical Conditions.” Quality of Life Research 17 (4): 521–28. https://doi.org/10.1007/s11136-008-9330-9.

Slabaugh, S. Lane, Mona Shah, Matthew Zack, Laura Happe, Tristan Cordier, Eric Havens, Evan Davidson, Michael Miao, Todd Prewitt, and Haomiao Jia. 2016. “Leveraging Health-Related Quality of Life in Population Health Management: The Case for Healthy Days.” Population Health Management 20 (1): 13–22. https://doi.org/10.1089/pop.2015.0162.