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PRESIDENT’S
MESSAGE

Mental Health in Our Elderly:

Personal Anecdotes

By Rodolfo “Rudy” Molina, MD, MACR, FACP, 2021 BCMS President

With aging comes changes that we are not pre- tempts at multitasking for forgetfulness. We are
pared for. It’s not as though we have done it be- all guilty of multitasking. How many times have
fore, readjusting our current aging process by you walked into a room or opened a cabinet
experience. Rather, our physician experience with drawer and forgot the purpose of the action? That
aging comes as witnesses to our patients, parents is because we are thinking about one, two, three,
or both. This month’s topic covers mental health, maybe four or five things that we need to do. We
and I thought I would provide just a few words are still thinking of our last task when we find
on my experience dealing with it, specifically in ourselves in the middle of completing our first
the elderly. I’m reminded by some of the lyrics in thought. I tell my patients that no one does mul-
the song “Sunrise, Sunset,” which state, “I don’t titasking well, despite their convictions that they
remember growing older,” and that is exactly how were good at it when they were younger. The
I feel as I near retirement. other major source of loss of memory is lack of
The World Health Organization defines health sleep or poor sleep hygiene, which is associated
as “a state of complete physical, mental, and social with increased pain and forgetfulness. Once we
well-being and not merely the absence of disease identify the problem and address it, they feel a lot
or infirmity.” It is reported that one in five older better about themselves.
adults experience a mental health concern. The Another recurrent topic in my office that cre-
most common mental illnesses reported are anx- ates both anxiety and depression is patronization
iety and depression. An under-reported mental by patients’ children. I assure them that their chil-
health problem is loneliness. Dealing with issues dren’s actions are born out of love and concern.
such as depression, anxiety and loneliness among Love and concern are what I consider two sides
others can lead to suicide. The highest rate of sui- of the same coin. How can we not love one an-
cides in this country are in the elderly, with those other without a “protective” concern as part of
aged 85 and older having the highest suicide rate. that love? I had one gentleman in his late 80s ex-
Risk factors for suicide include not just those press his frustration to me about his adult chil-
three mentioned, but also include a previous sui- dren characterizing them as “all wanting to be his
cide attempt, substance abuse, family history of doctor.” I merely told him that he would feel
suicide, chronic pain, physical illness, declining much worse if they didn’t care about him at all,
physical function and impaired cognitive func- which made him pause and think. On a personal
tion. Recognizing these risk factors is key to suc- note, my children are all medical doctors, so I will
cessfully preventing suicide. It is also known that just wait my turn to experience the same.
most of these mental health issues respond well This month, as mentioned, we dedicate our
to therapy. I bring up this topic because it is im- magazine to discuss the topic of mental health,
portant to know and understand. I am fortunate and I hope you will enjoy reading the excellent
to say that suicide in my elderly patients has been work presented in it.
a rare occurrence in my 40+ years in practice.
In my practice, the biggest concern expressed Rodolfo “Rudy” Molina, MD, MACR, FACP is
to me from the elderly is loss of memory. I find it the 2021 President of the Bexar County Medical
interesting, since most are confusing their at- Society.

8 SAN ANTONIO MEDICINE • October 2021