OCD in older adults

Have you sometimes noticed people doing the same things again and again or having irrational thoughts without any specific reason? For example, folding the same shirt multiple times or repeatedly rearranging their cutlery? While this may seem like a normal case of stress, nervousness, or habit (in most cases, it is!), sometimes these ‘‘rituals’’ become obsessive and uncontrollable. At that point, it develops into obsessive-compulsive disorder or OCD.

According to the ADAA, OCD is prevalent in about 2.5 million adults in the United States. Though it is believed that this disorder is less prevalent among the elderly, still it is not non-existent.

In this blog, we will discuss OCD in older adults, its symptoms, causes, and how to stop it from worsening. So, if you are an older adults and want to stay up to date about OCDs, you’re at the right place!

What does OCD look like in old age?

Obsessive-compulsive disorder (OCD) is an anxiety-triggering disorder that causes intrusive thoughts and repetitive behaviors that are difficult to resist. While it’s not a common condition in the elderly, it’s certainly something you should know about if any of your elderly loved one is diagnosed with it.

In older adults, OCD may present itself in various ways. Some common manifestations of OCD in old age are:

1. Continuation of lifelong symptoms

Individuals who have had OCD throughout their lives may continue to experience the same symptoms in old age, although the intensity and frequency might change. Obsessions and compulsions that were present earlier in life may persist, sometimes with a shift in focus to age-related concerns.

2. Late-onset OCD

In some cases, OCD symptoms may first appear in old age. Late-onset OCD is less common but can be triggered by factors such as neurodegenerative diseases, stroke, brain injury, or increased stress related to aging, illness, or caregiving responsibilities.

3. Cognitive decline and memory issues

As people age, they may experience cognitive decline and memory problems that can exacerbate OCD symptoms. For example, older adults with memory issues might repeatedly check if they turned off appliances or locked doors due to forgetfulness, which can intensify their anxiety and compulsive behaviors.

4. Increased isolation

Older adults with OCD may become more isolated as they age, due to factors such as retirement, the loss of a spouse or friends, and difficulty engaging in social activities. This isolation can contribute to worsening OCD symptoms, as individuals have fewer distractions and more time to focus on their obsessions and compulsions.

5. Comorbid conditions

Older adults with OCD may also have other mental health conditions, like depression or anxiety. Additionally, they may experience aging-related physical health issues, such as chronic pain or mobility limitations. These comorbid conditions can interact with and exacerbate OCD symptoms.

6. Anger issues

Study suggests that about 50% of OCD patients experience anger issues or aggressive behavior. However, anger issues in the elderly can arise from various factors such as declining physical health, cognitive decline, or social isolation. Identifying and addressing the hidden cause through appropriate interventions, including therapy, medication, or lifestyle changes, is necessary to help manage anger and promote healthy aging.

OCD signs & symptoms in older adults

OCD in old age can be more subtle than in younger individuals, so it is essential to recognize the signs and symptoms to treat it. Here are some of the symptoms of obsessive-compulsive disorder in older adults:

Excessive washing and cleaning
Constantly checking on things, such as locking doors or turning off appliances
Intense fear of contamination or germs
Compulsive counting, arranging, or organizing objects
Repeating specific words, phrases, or prayers
Avoidance of triggering situations
Hoarding unnecessary items
Preoccupation with orderliness and symmetry
Intrusive and unwanted thoughts, images, or impulses
Feeling compelled to perform rituals or routines to relieve anxiety
Difficulty discarding items, even if they have no value
Significant distress or impairment in social, occupational, or other areas of functioning due to the symptoms

What causes OCD in older adults?

Many older adults with OCD have suffered from the condition for decades. In some cases, it’s possible that their symptoms were present in childhood but went undiagnosed. For others, OCD may have developed later in life due to changes in brain chemistry or stressors such as illness, trauma, or grief. Though the exact cause of obsessive-compulsive disorder is unknown, the following could be some of the possible factors contributing to OCD in seniors.

1. Trauma

Research has shown that older adults are 3.62 times more likely to develop OCD after Post Traumatic Stress Disorder (PTSD) due to unexpected events like the passing of a loved one, divorce, etc. It is likely due to an increased risk of depression and anxiety following such events.

2. Age-related brain changes

The brain undergoes many changes as we age, including decreased dopamine levels and reduced connectivity between certain regions of the brain. These changes can cause the brain to misfire and become overly active at times, causing obsessive thoughts and compulsive rituals that are difficult to resist.

3. Stress

Stress is a major contributing factor for all mental health disorders, including OCD. When stressed out about something, our brains become highly active as they work through whatever problem is causing us stress. This increased activity can make it difficult to focus on anything else. It can lead to obsessive thinking or compulsive behavior as we try to deal with our stress in some way or another.

How to stop OCD from getting worse for the elderly?

Diagnosing and treating OCD in older adults can be challenging, as symptoms may be mistaken for age-related cognitive decline, memory issues, or other mental health conditions. In addition, treatment options may need modification for older adults, considering their unique needs and potential side effects of medications. However, below are some steps to stop OCD from worsening in elderly individuals:

1. Establish a daily routine

Creating a consistent daily routine can help elderly individuals with OCD feel more in control and reduce anxiety. This routine can include regular mealtimes, exercise, socialization, and relaxation activities.

2. Encourage social interaction

Isolation can exacerbate OCD symptoms. Encourage elderly individuals to maintain social connections with friends and family or participate in community activities. This can help enhance their emotional well-being and provide a support network.

3. Promote relaxation techniques

Teach elderly individuals with OCD relaxation techniques such as deep breathing exercises, progressive muscle relaxation, or mindfulness meditation. These methods can help reduce anxiety and stress, which can trigger or worsen OCD symptoms.

4. Provide a supportive environment

Create a supportive and understanding environment for elderly individuals with OCD. Encourage open communication and express empathy towards their struggles, while also setting boundaries to prevent enabling their compulsions.

5. Encourage physical activity

Regular exercise can help manage anxiety and improve overall mental health. Encourage elderly individuals with OCD to engage in physical activities that they enjoy and are appropriate for their fitness level.

6. Monitor medication

If an elderly individual with OCD is prescribed medication, ensure they are taking it as directed and report any side effects to their healthcare provider. Regular check-ups with a healthcare expert can aid in tracking the medication’s efficacy and making required changes.

7. Seek professional help

Speaking to a mental health professional who specializes in OCD to develop a tailored treatment plan. This may include cognitive-behavioral therapy (CBT), exposure and response prevention (ERP), or medications such as selective serotonin reuptake inhibitors (SSRIs).

Conclusion

Managing OCD in elderly individuals can be difficult, yet with appropriate treatment and assistance, a satisfying life can be achieved. We hope this blog has given you valuable information about OCD in older adults and has inspired you to take action if you or a loved one is struggling with this condition.

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FAQs

Is OCD a symptom of dementia?

OCD is not a symptom of dementia. While both conditions can impact mental health, and dementia may cause OCD to worsen, they are two separate disorders.

Does OCD affect life expectancy?

While OCD may not directly affect life expectancy, it impacts an individual’s quality of life, mental health, and overall well-being. It can potentially lead to other health issues or complications that might have an indirect effect on life expectancy.