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Monday, September 11, 2023

Personality Changes Can Be Real in Older Adults

The circumstances associated with growing older often lead to personality changes. 

There’s an old trope that seniors get crankier with age, spending their days sitting at the front window so they can shout at kids to get off the lawn. Although that image is patently false, scientists have found that the circumstances of aging affect the personality of those over 60 in the same proportion as life events alter the personality of those under 30.  

What to Look for When an Older Adult’s Personality Changes  

Many personality changes in older adults are in response to life circumstances or health conditions that are fairly immutable. But it’s important to first rule out changes, especially those with a swift onset, that may be improved by health care or a change of environment. These personality changes include agitation, anxiety, nervousness, impulsiveness, and an increase in reckless behavior. Following is a list of factors and what to know.

Cognitive Decline. Many older adults with dementia will experience severe personality changes over the course of the disease. Anxiety, agitation, mood swings, depression, and listlessness may all occur.  However, it’s important to have a health care professional diagnose the disease. Sudden changes may be indicative of another, similar or totally unrelated, underlying condition. 
Depression. Good mental health is essential to reinforcing a positive outlook. Many medicines and treatments can help to lift the fog of sadness. Family and friends can offer support. Visit a doctor who specializes in depression for an assessment and care plan. 
Medication Side Effects. Seniors fill, on average, 14 to 18 prescriptions every year without counting any over-the-counter medications. It’s quite common for medications to interact, or for doctors to prescribe a dose that is unnecessarily high. Have your pharmacist double-check drug combinations and dosing, and don’t hesitate to have the doctor revisit medication and dosing if you see negative changes after starting a new medication.
Unresolved Worries. Seniors may keep anxiety and worry inside so they don’t bother their family and friends. They may not know who to talk to or feel that family members will be on their side, for instance, if driving is beginning to deteriorate or they are falling at home. Financial worries can be all-consuming, or seniors can be despondent over the loss of spouse and friends. Find a professional or family member who can listen without judgment and come up with a reasonable solution.
Loss of Hearing. Older adults may quit going out or disengage from family conversations because their hearing is poor, but they don’t want the expense or look of a hearing aid. A doctor may find impacted wax, while a hearing specialist can evaluate each ear and make recommendations. Plus, FDA-approved devices are now available over-the-counter at affordable prices. 
Loss of Vision. Obscured eyesight can happen suddenly or over a long period of time, leading to fear of falling, a reluctance to drive and inability to enjoy printed or screen material. See a vision specialist; it could be that corrective lenses or surgery could restore eyesight. 
Urinary Tract Infection (UTI). An unexpected but common cause of personality changes is an untreated UTI. A UTI can cause mood swings, agitation, forgetfulness and/or confusion, leading to misdiagnosis. UTIs can be cleared up with antibiotics prescribed by a doctor.

What is Personality?

Five measurable personality traits are commonly used by psychologists: agreeableness, conscientiousness, extroversion, openness to experience, and neuroticism. In particular, conscientiousness, extroversion, and openness to experience have been found to fall after age 60, while neuroticism climbs. 

Personality isn’t a set thing but evolves in response to external or internal circumstances. Dementia, for example, can affect personality from within, while moving away from friends or experiencing the death of a spouse are outside factors. 

Seniors are coping with major changes such as retirement, which might be a positive influence for someone with a deep social well and many activities, but a blow to another person whose friends and self-image lie with their office job. 

“What you really want to know,” Wiebke Bleidorn, a personality psychologist at the University of Zurich, told me, “is What are people’s lives like?” Did illness cause him to lose his driver’s license and keep him from getting out to see friends? Did a near-fall make her afraid to move around the house?

“We construct our world to avoid” personality change, says Brent Roberts, a psychology professor at the University of Illinois at Urbana-Champaign. When our world begins to change in ways that we can’t control, we tend to alter our personality to adapt. But the news is not entirely grim. People can react to similar events in very different ways.

Focus on What You Can Do

As they age, many older adults will begin to change their goals. They focus on what is important to them, and drill down on doing those things. They may not need more friends, just more time with those they already have. The death of a spouse may be eased by the cessation of caregiving duties. 

Loneliness, which affects 43% of Americans 60 and above, can be difficult to suspend in a population frequently dealing with the death of friends, forced changes in housing situations, and multiple health conditions. Extroversion and agreeableness can plummet when someone sits at home alone all day, with no means to change their situation. 

Senior housing, where older adults live near each other and can share social services as well as interact daily, may help shape personality in positive ways. “To the extent that we can create communities for older individuals,” Roberts says, “they would probably show a more healthy pattern of personality change.”

As we near the year (2040) when one out of five Americans will be at least age 65, we need to remember that affecting a senior’s life in a positive way can have a remarkable impact on how they view, and react to, their world.