Abstract Body

Older persons represent a large, and the fastest growing, segment of the global population. Women form the majority of older persons with global demographic data consistently showing that women tend to live longer than men, especially at advanced ages. Older women also make substantial contributions to our societies and economies, including as informal caregivers, volunteers and community leaders. Ageing, however, is not gender-neutral and inequality and discrimination experienced by women during their lifespan is often exacerbated in older age. For example, older women are at a higher risk of living in poverty and of facing barriers in accessing basic rights such as health, adequate housing, and protection from violence, abuse and neglect. Yet, the specific challenges created by the intersection between age and gender often remain invisible and understudied. This also applies to people living in Europe. And elderly women with mental disorders face a triple stigma: suffering from mental disorders, being a woman, being old. The presentation emphasises the UN-decade of healthy ageing with fight against ageism, and a paper of the WHO and IPA on the topic of this presentation.

Abstract Body

The treatment of sleep disorders in older people requires knowledge of the changes in sleep in old age. In the case of multimorbid older people, pharmacological aspects such as interactions must also be taken into account. Sleep in old age is characterised by a lower depth of sleep and more frequent awakenings. The duration of sleep corresponds to that in middle adulthood. In multimorbid older people, sleep is often chronically impaired by pain and/or obstructive breathing disorders. Many medications can have a negative effect on sleep. This applies to cortisone, for example. Antipsychotics can also worsen sleep by worsening nocturnal myoclonia. Ideally, sleep disorders should first be addressed non-pharmacologically. For benzodiazepines, preparations with a short half-life should be chosen. An algorithm is presented.

References:
Gulia KK, Kumar VM. Sleep disorders in the elderly: a growing challenge. Psychogeriatrics 2018;18(3):155-165.

Samara MT, Huhn M, Chiocchia V, Schneider-Thoma J, Wiegand M, Salanti G, Leucht S. Efficacy, acceptability, and tolerability of all available treatments for insomnia in the elderly: a systematic review and network meta-analysis. ActaPsychiatr Scand. 2020;142(1):6-17.

Abstract Body

For many old people with mental health problems, access to psychotherapeutic and psychiatric help is often difficult. This is partly because going to a psychiatrist is still stigmatised, especially among the older generation. On the other hand, therapists with an interest in and competence for older people are often not sufficiently available even in the well-supplied western countries. In this situation, digitalisation offers various opportunities. Basically, the internet is a good way to promote health literacy. Classic psychoeducation can certainly be offered on the internet. And psychotherapy can also be administered with the help of the internet. Especially in the COVID-19 pandemic, the possibilities of internet-based therapies, for example Zoom or other techniques, were practised. This means that people with limited mobility can also receive therapy over long distances. This technology also makes it possible, for example, for the migrant population to receive therapy in their national language. All these possibilities are under development, but may become routine in the future. With the help of the digital possibilities, it is possible to organise helper conference. The professional exchange between relatives, family doctors, psychiatrists and other people in the help system can be easily organised in this way. The method also saves travel time, which is often not reimbursed in the health systems.