Etiology and Types of Psychosomatic Disorders in the Elderly : From a socio-gerontological viewpoint

Abstract

With the elderly representing 9.8% of the population as of 1982,Japan can be considered to have entered the age of oldage. The graying of the nation has been bringing about sweeping changes in various aspects of society. For one thing, the number of the elderly living alone increased by 3.0% from 1971 to 1977. Whereas the number of the elderly living with their families decreased by 7.6%. The lifestyle is affected by these changes in the social structure.On the other hand, mental function in the elderly becomes diminished with aging. As a result, both reserve capacity and adaptability are lower in the elderly than in the young. The elderly are said to be liable to develop stress-induced disease because of diminished ability to cope with physical, psychosomatic and social stress. Although the elderly are more prone to psychosomatic disorder than the young for the reasons given above, this disease seems to have hardly been investigated from the standpoint of its relationship to the changes in the social structure.In the present study elderly persons with psychosomatic disorders and those without anything abnormal were compared in relation to their environmental conditions and changes in the social structure with a view to clarifying factors predisposing to psychosomatic disorders and types of the disease.The subjects of this study consisted of 107 elderly persons without physical disorders admitted to an old-age home, and of them 11 (10.3%) had complaints. The old-age home inmates (living 4 to 5 to a room) changed roommates every month. As a result of this change in the living environment the number of inmates with complaints increased to 14 (13.0%). When 78 anemic elderly inmates with physical disorders also changed roommates similarly, the number of inmates with complaints increased by 6.6%. In short, the frequency of psychosomatic disorders was higher with diseased elderly inmates than with healthy ones, when they had a change in their living environment.The effects of the changing social structure on the lifestyle of the elderly were determined in terms of personality, activities of daily living, objective of living, and CMI in three groups;elderly persons living alone, those living with their spouses adn those living with their families.The elderly living alone were generally characterized by an inactive lifestyle, distorted personality seclusion from society, loss of the objective of living, and significantly low CMI, as compared with other two groups. Further, a larger number of the elderly living alone had psychosomatic disorders of the dependent and depressive or the elusive type.These findings suggest that the phenemenon of physical and mental aging lowers the reserve capacity and adaptability of the elderly, so that they lose balance, both mentally and physically.Further, the changes in lifestyle and environment arising from the changing social struture seem to facilitate the development of psychosomatic disorders in the elderly living alone.