Written by Ron Sterling, M.D. and Published in Northwest Prime Time Magazine
by Ron Sterling, M.D. -- March 2006
If you or a friend or relative are experiencing significant changes in social styles or personality characteristics, those changes are likely related to something that is not part of the natural aging process. Many studies have clearly shown that normal aging processes do not have significant effects on brain functions, including memory. No matter how old you are, if you notice significant changes in memory, personality, or social styles, it likely means something is wrong.
Generally, studies have shown that as people age, they don't change that much from their earlier personality or behavior styles, but may actually display "more of the same." That is, if they tended to be rude, blunt or inconsiderate, they might become even more rude, blunt and inconsiderate. Similarly, if they were well-mannered, considerate and kind, they might become even more considerate and kind.
Significant social disinhibition, or increased irritability, rudeness, and impulse control problems are always indicators that something is not right. What might cause these symptoms? The answer depends on which symptom is the most signficant, how often the behavior is displayed, and the age of the person. Increased rudeness, without any other symptoms of an impulse control problem, can be a manifestation of a psychological or physiological change.
Older adults have a wide array of psychological reactions to getting older. Some are so challenged by it that they become overtly angrier. They may have difficulty dealing with or accepting certain aspects of the aging process, such as changes in appearance, lifestyle, health, finances, or social interactions. Physiological changes that might bring about isolated rudeness without other associated symptoms such as generalized increased irritability, impulse control problems, depression, or memory deficits, are very rare, and would likely have been evident much earlier in a person's life (such as in Tourette's Disorder).
Significantly increased irritability can be associated with a sleeping disorder, depression, burnout (chronic stress), a grieving process, psychosis, bipolar illness, and certain dementias. Such irritability could produce rude and callous behavior. Questions that would help to diagnose whether the irritability is related to one of those symptom-complexes are easy to ask. They should be asked and answered before you conclude that someone is just an inconsiderate, cranky person. Lewy-body and frontotemporal dementias can sometimes produce personality and behavioral changes before any memory impairment becomes noticeable.
I hope this is helpful. The idea that older adults are somehow crankier than their younger counterparts would generally be thought of as an "ageist" stereotype. There are many studies that show that this is just not true. If you would like to read more about ageism, please visit www.AgePride.org. -- Best wishes, Dr. Ron.
Ron Sterling, M.D. is a 64 year-old General and Geriatric Psychiatrist with a private practice in Seattle. He invites you to e-mail him at with any questions about mental wellness or emotional, relationship, or aging concerns. He is the only person who reads e-mail sent to Dr. Ron. Please be assured that your questions and identities are completely confidential and protected. For more information about Dr. Ron and for resources related to senior mental health, please go to SeniorMentalHealth.org. The content offered through Mind Matters is for information only and is not intended for medical, psychiatric, or psychological diagnosis or treatment. Never disregard professional advice or delay seeking it because of something you have read in this column. Read our Disclaimer. If you wish to understand more about Dr. Sterling's potential biases in health care advocacy, please check his Conflicts of Interest Disclosure Statement
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RON STERLING, M.D.
General Psychiatry with Specialization in Adult Attention Deficit Disorder
Updated October 7, 2007
Copyright 2000-2007. Ron Sterling, M.D. All Rights Reserved.
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