Psychological Stressors and Burden of Medical Conditions in Older Adults: A Psychosomatic Approach

Article excerpt

Objective: In geriatric practice, the impact of psychological distress on health status has been undermined due to ageism, atypical presentation and less tendency to report negative affect among elderly people. Few studies have examined the impact of psychological stressors on medical burden in older adults. The current study has investigated the correlation of psychological distress and burden of medical conditions in a sample of older people .

Method: A convenient study sample of 120 elderly subjects was recruited from the places where there was greater chance for the elderly people to attend. Data were collected by a trained research assistant using perceived stress scale, cumulative illness rating scale, geriatric depressive scale and a demographic questionnaire.

Results: Our participants perceived more level of stress than the average for their age. In the current study, the burden of medical condition was significantly correlated with the level of perceived stress(r = .197, p = .044). Moreover, in regression analysis, perceived stress was the strongest predictor for physical health morbidity (R2 =.049, significant f= .03).

Conclusions: The result of this study suggested that the psychological stressors contribute to poor health outcome in older adults ; the area that is usually overlooked due to ageism and its physiological related changes. The medical practitioners should consider the psychological distress as a part of etiological factors implicating in health morbidity among their aged patients.

Key words: Frail elderly, Psychological Resilience, Psychological stressors, Psychosomatic medicine

Iran J Psychiatry 2009; 4:107-111

Psychological stressors set in motion physiological changes in the body, which arise both physiological and behavioral reactions increasing susceptibility to mental and physical illnesses. There has been a growing interest in the relationship between psychological stressors and physical health status; and various physiological, emotional and behavioral reactions have been attributed to stress. Researches conducted in different populations have supported the association between stressors and medical morbidity or health service utilization (1, 2). Psychological stressors have been implicated in physiological changes that increase susceptibility to physical illnesses. Even minor daily experience is associated with higher cortisol level and its medical outcome (3). In addition to physiological processes, exposure to stressors could result in maladaptive behavioral patterns as adaptive responses such as bad sleep, tendency to substance use, decreased activity and poor compliance to medical orders. In psycho geriatric practice, the effect of psychological stressors on physical health status has been undermined due to ageism, atypical presentation and less tendency to report negative effect among elderly people. Previous studies have been inconsistent about the extent to which mental distress predict more burden of medical conditions in elderly population. In one study conducted by Prakash and colleagues, stressful life events were associated with poor mental and physical health in a group of old persons (4). Thompson et al, found a positive correlation between mental rumination about past negative experiences and immune dysfunction; they also noted that these subjects had more tendency to use health services (5, 6). The results of a prospective study which recruited 8205 persons who were aged over 65, showed that disability as a chronic stressor predicted increased risk of gastrointestinal bleeding. In contrast to the general assumption, older adults express less reaction to stressors than younger adults. There is some evidence that older people are more prone to experience negative affect and higher stress reactivity than the younger adults (1, 7). In a survey comparing autonomic reaction to work-related stress, authors concluded that recovery from stress in older adults was insufficient compared to the younger adults (8). …