Ageing and Mental Health
by Dr. Gerd Shneider, Medical Director, Glebe Centre, Ottawa
Keynote speech at the seniors’ mental health seminar hosted by the Ottawa Golden Oldies Seniors’ Club, 27 September 2025.
It’s a pleasure to be here and as George Burns said: **“ When you’re my age, it’s a pleasure to be anywhere!”
***I hear that ageing is pretty popular and that a lot of people are doing it! And we’ll be doing it together this afternoon!
Welcome.
When Godwin first asked to give a talk about mental health and aging, let alone becoming the keynote speaker, I said I would get back to him. I hesitated thinking about the reading I would have to do and the time it would take, then facing you, the audience and panel members too, that I didn’t want to bore – all that was scary!
However, then I realized that accepting a challenging new project was exactly what is necessary to stay stimulated and engaged in the community and learn some new material. This all contributes to good mental health! So thank you Godwin for slowing my cognitive decline.
SUMMARY
I’ll start by putting old age in context and give you some stats about longevity and that life doesn’t end at 65 or 70.
I will talk about the dementias, since that is what most people are worried about and a To-Do List to reduce risk of cognitive as well as physical decline.
Sexual health will be touched upon and the importance of humour.
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Which reminds me, I did have a BIRTHDAY last year entering another decade and a friend of mine sent me a very optimistic card that said, **“Don’t worry about old age, it doesn’t last that long!”
It really buoyed me up!
***One thing we do know for sure about old age is that no one comes out of it alive!
To illustrate we can still be creative and productive well into old age, I’d like to quote from a poem by the American poet, Henry Longfellow that he read to his 50th class reunion at 68: (Bowdoin College, Maine).
Shall we sit idly down and say
The night hath come; it is no longer day? ….
Something remains for us to do or dare;
Even the oldest trees some fruit may bear;…
For age is opportunity no less
Than youth itself, though in another dress,
And as the evening twilight fades away
The sky is filled with stars, invisible by day.
the Stars, that’s us! He was 68 when he wrote this poem. There are many examples of people being productive at a later age, some of the more well known are Immanuel Kant, Michelangelo, Picasso and even our own Leonard Cohen released his last successful album at 82 (You want it darker) : not the most optimistic-sounding title!
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I did want to spend a few minutes talking about who comprises our aging population because that is intimately related to problems associated with ageing.
The population of Canada in 2024 was 41 mill.
Presently 20% of Canadians are >65 (54% women, 46% men) : 8 million-25% by 2068. >14 million
– 2.3% are >80 (1,800,000) and 25-30% of seniours >85 are diagnosed with dementia. (860,000 are > 85)
– 0.03% are >100 (3:10,000 or 9,500 centenarians)
**George Burns at 99 said he couldn’t wait to turn 100 because he heard very few people died at that age!
He also said that he was so old, that when he was a boy, The Dead Sea was only sick
What we all want is to live long lives of quality which means good mental and physical health.
(Dr. Spock’s Vulcan greeting from Star Treck: “Live long and prosper.” )
We know that our mental health is positively related to our physical health. (Longevity apparently is 25% genes and 75% lifestyle- and we can certainly modify lifestyle)
Some parameters that promote a healthy long life and most of you know this aleady:
- Regular Physical Activity
- Good healthy diet
- Avoidance of smoking
- Management of stress
- Adequate sleep: we underestimate the importance of sleep:
- Now someone said regular naps can prevent problems in old age, especially while driving.
- Participating in social activities
- Staying mentally active and learning new skills
- Another factor in determining good health was about how people thought about and approached the idea of old age. Dr. Becca Levy in her book, Breaking the Age Code, talks about how older people with more positive perceptions of aging performed better physically and cognitively than those with more negative perceptions: they were more likely to recover from severe disability, they remembered better, they walked faster and even lived longer, she claims by 7.5 years
- Just 2 days ago I found an article on one of my medical aps about, “gerogenes”. And no, they are not blue jeans for old people! They are genes that activate certain aging processes. According to a recent literature review, biological aging is accelerated by the activation of gerogenes or slowed by suppressor genes. These gerogenes are modulated by lifestyle, environmental and psychological factors like the ones I just mentioned.
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A study of middle-aged people out of Brigham Young University looked at all kinds of life-style parameters at the start and then waited for 7 years to f/u and see what reduced your chances of dying most.
Close relationships topped them all.
Social isolation is the big public health risk of our time and up to 20% of the population suffers from loneliness
George Burns himself emphasized the importance of having a large, loving and caring family ——- in another city!
People talk of Face Time and Zoom as the next best thing to being there, but studies show that there are differences in brain activity and hormonal release with personal contact. The engagement is much greater.
I also wanted to touch on a Harvard Study of Adult Development, which took over 700 men and studied them from 1938 and followed them for 75 years. It took 2 groups, one from young men entering Harvard and the other, boys from the poorest neighbourhood in Boston. There were questionnaires and family interviews, including the children, every 2 years.
Here is the clearest message across the socio-economic spectrum: good relationships keep us happier and healthier. Loneliness kills. And the quality of relationships matters. The people who were the most satisfied at age 50, were the healthiest at age 80, both physically and mentally.
One of the main reasons postulated of why women live on average, 6-8 years longer than men is that they are more likely to groom personal relationships over a lifetime. Someone did an experiment with female baboons and discovered that it took at least 3 stable relationships to lower rates of illness and early deaths. It also lowers the rate of dementia.
The socio-economic issues of an ageing population, such as the changing ratio of caregivers to those needing care is the subject of a whole other discussion. I think of the Beatles song:
“Will you still need me,
Will you still feed me,
When I’m 104.”
I thought you might enjoy the story of Jean Calment while we’re talking about an aging population. (1875-1997 – 122 years)
The Dementias or Neurocognitive Disorders
We used to use terms like early senility, which has become MCI – mild cognitive impairment and dementia is now under neurocognitive disorders.
You’ve all heard the expression about the brain, “Use it or lose it.” The brain is like a muscle, if you don’t use it, it wastes away or atrophies.
We used to think brain development peaked some time in early adulthood before beginning its steady decline. But recently we discovered the brain’s remarkable ability to reorganize itself by forming new neural connections. This ability allows our brains to adapt to new information, environments and even injuries.
This is called, neuroplasticity, which allows our brains infinite possibilities to change. I recommend a book on the subject of neuroplasticity called “The Brain That Changes Itself” by Norman Doidge.
Common symptoms associated with normal aging are forgetting familiar names or words, greater difficulty multi-tasking . However, someone recently said old age makes us great multitaskers : Why now I can sneeze and pee at the same time.
Or, as often happens to me, going up to the third floor and forgetting what I wanted but comfort in the exercise I got getting there and back.
It takes longer to retrieve information, but the answers to questions usually come later, after a few minutes or hours. i.e. Memory is intact. Can’t emphasize enough the importance of staying mentally and socially active. We’ll say more about that later.
Recent memories and the formation of new memories are more likely to suffer with aging.
** I always enjoyed this Mark Twain quote, “The older I get, the more clearly I remember things that never happened!”
What’s not normal is repeating questions or statements within the same day or conversation, without recollection of saying the same thing before: “Now that I’m older, my memory isn’t as sharp as it used to be! Also, my memory isn’t as sharp as it used to be!”
Memory loss which other people notice when someone does not notice it in themselves.
**A seniour once told me his brain was like the Bermuda triangle: information goes in and then is never found again!
25% -30% of seniours >85 are diagnosed with dementia, of which Alzheimer’s is the most prevalent affecting 60-80% of those diagnosed with dementia.
It affects 1:10 adults of which 2/3 are women. It’s mainly caused by protein deposits called amyloid plaques and tau tangles, which destroy nerve cells.
Second most common is vascular dementia (10%) due to multiple small strokes
. Also Lewy Body characterized by hallucinations and sleep disturbances. Those are the main types of neurocognitive disorders
Note that < 4% have a genetic component
There is such a thing as ‘Cognitive Reserve’. Some people demonstrate similar brain changes as found in dementia, but don’t show signs. I’ll say more about that in a minute.
***An example of ‘cognitive reserve may be Robert F. Kennedy Jr, who said a worm ate part of his brain but he still ran for president of the United States and is now Secretary of Health and Human Services! Some Democrats would probably argue the point.
(Deaths from Alzheimer’s are 10-12 years from early symptoms but can vary from 3-20.
Some important factors in warding off dementia are:
-avoiding social isolation: loneliness is a proven risk factor for dementia. Social interaction enhances cognitive reserve.
-Stimulate your brain by learning new things: like giving a talk about aging and mental health,
-education in early life (before the age of 45) builds cognitive reserve, increasing your brain’s capacity and resilience , making you less vulnerable to dementia. (Why women >men: decades ago, women had less education)
-check hearing and get aids if required. Hearing stimulates the brain (deafness may increase social isolation),
-eyesight (cataracts or macular degeneration) Importance in getting around, driving, reading
-manage any stress (serotonin, norepinephrine and dopamine). Distress is bad, contributing to inflammation, accelerating biological aging and triggering deterioration of the immune system. Stress may activate those ‘gerogenes’.
-alcohol may play a role: limit to 1 drink a day
-You’ve heard real estate agents emphasize the most important factor in selling a house is: location, location, location.
Well, in warding off dementia one of the most important factors is : exercise, exercise, exercise: it keeps rearing its head everywhere
-sleep: during sleep, the garbage collectors come to take out the trash via the glymphatic system
-minimize diabetic risk, treat high BP, depression, manage weight, and protect your head from traumatic brain injury
-avoiding overmedication: example of Frank
To illustrate the importance of sleep and how problems can disturb our mental well being:
** 3 old men were sitting on a park bench complaining:
First man: I wish I could sleep through the night but I get up every 2 hours to pee!
Second man: You think that’s bad. I’m constipated and haven’t had a BM in 1 week!
Third man: You think you guys have problems? I sleep through the night and every morning at 7:00 I empty my bladder and have a large bowel movement.
The other 2 looked confused and asked how is that a problem?
I don’t get up until 8!
Treatments for Alzheimer’s are limited to drugs that prevent breakdown of neurotransmitters such as acetylcholine, but that just gives a 6 month reprieve in the downward curve. (donepezil {Aricept}, rivastigmine and galantamine) Some experimental drugs not yet approved in Canada, try to reduce the amyloid deposits in the brain.
SEXUAL HEALTH
A healthy sexual relationship can positively affect all aspects of your life and depends on your mental as well as your physical state. The need for intimacy is ageless. While there is a gradual slowing of sexual response time that occurs with age, some men and women continue to have intercourse even into their 80’s and 90’s!
One good question someone asked about where can single men over 65 find younger women who are interested in them:
The answer: In a bookstore under fiction!
Humour
Laughing is good for your health. Research has linked laughter to improved mental health and reduced loneliness among older adults. A book entitled, ‘Anatomy of an Illness” by Norman Cousins, illustrates how humour can alter the course of an illness. It was also published in the NEJM (New England Journal of Medicine).
A study published in The European Health Journal in 2023, found that CAD patients who watched comedy sessions benefited more than a group who watched documentaries. Laughter reduces stress by lowering stress hormone levels and improves mental well being, eases pain, relaxes muscles and strengthens the cognitive and immune systems.
As WC Fields always said: “Start the day with a smile and get it over with.”
(Video of a monk who starts laughing in the subway in NY)
Some practical Suggestions:
-Start something new: skydiving or bungie jumping – more like learn a new language, take a course especially one in which you can meet other people. I’m proud of the fact that I got my motorcycle license at 69!
-Volunteer for an organization that could use your skills.
-Choose friends that listen attentively in conversations and that give you energy
-Try meditation, Yoga,
-Walk in nature: some call it “forest bathing” and it doesn’t mean take a bath in the woods! The Japanese invented the term in the 1980’s, called shinrin-yoku and their scientists point to volatile organic compounds (phytoncydes) that are emitted by plants. By breathing them in, there is evidence that it gives the immune system a boost as well as other obvious benefits that you can look up.
-Practice Mindfulness: Focus on the present, don’t let yesterday take up too much of today, or worry about tomorrow, like the old song, “Don’t worry, Be happy.”
-Appreciate your blessings with gratitude each day
-Seek professional counselling if you feel you have overwhelming issues and are chronically unhappy.
-And finally, don’t overdose on the News, because it can be depressing.
I’d like to close with another positive poem about appreciating the present and focussing on the positive, by the American poet, William Stafford, a National Book Award winner and whose body of work has been called, “some of the finest poetry written during the second half of the 20th century. It’s called, “YES”
It could happen anytime, tornado,
earthquake, Armageddon. It could happen.
Or sunshine, love, salvation.
It could, you know. That’s why we wake
and look out – no guarantees
in this life.
But some bonuses, like morning,
like right now, like noon,
like evening
About the writer Dr. Gerd Schneider is the Medical Director of the Glebe Centre, a long-term care facility, which has a total of 5 physicians working there. He is a family physician in practice since 1973 and has worked in long term care since the mid 70’s, as well as doing a lot of obstetrics (which included attending home births) and pediatrics: “from the cradle to the grave”. He is a member of the Canadian College of Family Physicians and retired from his office in 2017. In the 1980’s he was heavily involved as an executive with Canadian Physicians for the Prevention of Nuclear War, both at the national and local levels