11 - Mental health of the ageing immigrant population

Summary

Summary More than 8% of people aged 65 and over in the UK are immigrants. Concentrated in deprived inner-city areas, their numbers are rising rapidly, with the ageing of those arriving after the Second World War. Cultural, language and educational differences cause problems in studying this group's mental health. Idioms of distress may affect presentation, help-seeking behaviour and acceptability of treatment. Older people from Black and minority ethnic groups may be vulnerable to depression because of socioeconomic deprivation, immigrant status and old age, but studies are contradictory and may use inappropriate screening instruments. Relatively few consider immigrant status and dementia. Uncontrolled hypertension could relate to higher dementia rates in Black immigrants which are not reflected in the country of origin. No genetic risk has been found. There is potential for prevention in this population.

This chapter concerns the mental health of people aged 65 and over who have moved from their country of birth – the older immigrant population. In the UK, although the absolute numbers of older people from Black and minority ethnic groups are relatively small, there is a greater concentration in deprived inner-city areas. Numbers are also increasing rapidly, as those who immigrated to the UK after the Second World War reach retirement age. This is evident from the exponential increase, particularly in England and Wales, of people over 65 who come from an ethnic minority, from 3% in the 1991 census to 8.2% in 2001 (Shah et al, 2005). Estimates based on 2004 data suggest that 11 860 individuals from Black and minority ethnic groups in the UK have dementia (King's College London & London School of Economics, 2007), and between 33 559 and 52 980 have depression (Shah, 2008). The prevalence of dementia and depression in older people is generally similar or higher in those from minority ethnic groups than in the indigenous population (Bhatnagar & Frank, 1997). A systematic review of dementia in African–Caribbean people living in Britain found an excess prevalence in comparison with White British peers. Of the 11 papers assessed, all except one found a statistically significant increase in prevalence in the African–Caribbean population (Adelman et al, 2009).