Item 3: Meadows Institute Slide Deck — original pdf
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Mental Health and Aging Roshni Koli, MD Chief Medical Officer Meadows Institute The Meadows Institute works at the intersection of policy and programs. We create mental health solutions and support implementation, and we shape and help enact policy. | 2 Shape mental health policy STATE AND NATIONAL POLICY Extract lessons learned and proof points The work of the Meadows Institute Enact mental health policy SOLUTIONS Develop, implement, scale, and finance evidence- based solutions in local, state, and national systems OUR VALUES Collaboration and partnership Data-driven and evidence-based Innovation Nonpartisanship Stewardship Background | 3 • In 2023, 17% of Americans were aged 65 or older,1 and by 2040, that proportion is projected to rise to over 22%.2 • Over 90% of older adults reported having at least one chronic medical condition, and nearly 80% reported having two or more.3 • 16% of older adults also have a mental health condition or a substance use disorder.4 • Fewer than half of older adults with a mental health condition, and approximately 10% of those with a substance use disorder, receive treatment.4 • Mental health symptoms in older adults frequently overlap with physical illnesses or age-related changes.”5 Suicide Mortality Among Adults (18+) and Older Adults (65+) | 4 In 2024, there were 10,496 deaths from suicide by adults 65 years old or older. *Deaths occurring in 2024 are considered provisional and are subject to change as final mortality data are finalized and certified. Substance Use Disorder in Older Adults | 5 • In 2023, approximately 7% of older adults (65+) had a substance use disorder.4 • Alcohol misuse is the most common SUD in older adults.4 • SUD is often difficult to recognize and may be mistaken for dementia, anxiety, or depression.6 • Only 18% of Substance Use Treatment Programs are designed for older adults.6 • Physiological changes in older adults alter the way in which substances are metabolized, often increasing the risk of medication interactions, falls, injuries, and cognitive decline.7 Dementia | 6 • Texas is at the epicenter of the crisis. Currently, over 500,000 Texans suffer from some form of Dementia.8 We have the third highest number of Alzheimer’s cases in the country and the second-highest number of Alzheimer’s-related deaths. • One of several identified barriers in health care for Texans with Alzheimer's Disease and Related Dementias is insufficient coordination of dementia care between specialists and PCPs.8 • Depression and dementia are deeply linked. A 2024 meta-analysis of 26 studies found that people with depression have an 82% higher risk of developing dementia14 | 9 Aging Texas Well Strategic Plan 2024-2025 4 M's Framework of an Age-Friendly Health System | 10 Thank You! Roshni Koli, MD: rkoli@mmhpi.org References | 12 1. U.S. Census Bureau. (2024, December). American Community Survey 2019-2023 5-year estimates. https://www.census.gov/data/developers/data-sets/acs- 5year.2023.html 2. U.S. Census Bureau. (2023, November). 2023 National Population Projections Tables: Main Series. https://www.census.gov/data/tables/2023/demo/popproj/2023- summary-tables.html 3. Watson KB, Wiltz JL, Nhim K, Kaufmann RB, Thomas CW, Greenlund KJ. Trends in Multiple Chronic Conditions Among US Adults, By Life Stage, Behavioral Risk Factor Surveillance System, 2013–2023. Prev Chronic Dis 2025;22:240539. DOI: https://doi.org/10.5888/pcd22.240539 4. Substance Abuse and Mental Health Services Administration (SAMHSA) data analysis system (DAS), specifically the National Survey on Drug Use and Health: 2-year restricted use data (2022-2023). https://datatools.samhsa.gov/das 5. Supportive Care. (2025, October). How Psychiatric Diagnoses May Present Differently in Senior Populations. https://www.thesupportivecare.com/blog/how-psychiatric- diagnoses-may-present-differently-in-senior-populations 6. Jaqua EE, Nguyen V, Scherlie N, Dreschler J, Labib W. Substance Use Disorder in Older Adults: Mini Review. Addict Health. 2022 Jan;14(1):62-67. doi: 10.22122/ahj.v14i1.1311. PMID: 35573758; PMCID: PMC9057647. 7. Abrams, Z. (2025, January). Treating substance misuse in older adults. Monitor on Psychology, 56(1). https://www.apa.org/monitor/2025/01/substance-misuse-older- adults 8. Texas Department of State Health Services. Texas State Plan for Alzheimer's Disease 2024-2028 As Required by Texas Health and Safety Code, Sections 99A.001 and 99A.004. Texas Health and Human Services. https://www.dshs.texas.gov/sites/default/files/CHI-Alzheimers/Docs/Reports/Texas-State-Plan-Alzheimers-Report- 2024-2028.pdf 9. The Meadows Institute. (2025). National, state, and county-level mental health prevalence estimates, 2023. For more information, see: https://data.mmhpi.org/MMHPI- Prevalence-Methods.pdf 10. Substance Abuse and Mental Health Services Administration. (2025). 2023 National Survey on Drug Use and Health: Model-based prevalence estimates – Total U.S. https://www.samhsa.gov/data/data-we-collect/nsduh-national-survey-drug-use-and-health/state-releases 11. West Health – Gallup, 2024 12. Reynolds et al., 2022 13. Substance Abuse and Mental Health Services Administration (SAMHSA) data analysis system (DAS), specifically the National Survey on Drug Use and Health: 2-year restricted use data (2022-2023). 14. Fernández Fernández, R., Martín, J. I., & Antón, M. A. M. (2024). Depression as a Risk Factor for Dementia: A Meta-Analysis. The Journal of Neuropsychiatry and Clinical Neurosciences, 36(2), 101–109. https://doi.org/10.1176/appi.neuropsych.20230043 United States Adult and Older Adult Mental Health and Substance Use Disorder Prevalence (2023) | 13 All Adults (18+) Older Adults (65+) Population % Population % Total Population1 258,500,000 100% 56,000,000 100% Mental Health Condition9 Major Depressive Disorder 26,800,000 10% 4,750,000 Generalized Anxiety Disorder 13,500,000 5% 3,000,000 Substance Use Disorders4,10 Any Substance Use Disorder 46,700,000 Alcohol-Related Substance Use Disorders 28,600,000 18% 11% 4,100,000 2,450,000 8% 5% 7% 4%