Many older adults in Ireland remained undiagnosed or inadequately treated, with serious consequences for their wellbeing and independence, according to findings from the longitudinal study Ageing (TILDA) at Trinity College Dublin.
Drawing on 14 years of longitudinal data from over 8,000 adults aged 50 and older, the new report has highlighted widespread unmet need in key areas such as cardiovascular disease prevention, falls and fracture care, osteoporosis treatment, chronic pain, and mental health.
It said depression in later life was underdiagnosed, under-treated, and often not reported at all. It also drew attention to the vital role of family carers, many of whom, it said, were older adults themselves providing more than 50 hours of care each week. This level of caregiving was associated with poorer mental health, particularly among women.
The report pointed out that the fact that Ireland was one of the fastest ageing countries in Europe, with the population aged 65 and over projected to double by 2051 would place increasing pressure on public services particularly health and social care and would require significant planning and adaptation.
Regius Professor Rose Anne Kenny, Principal Investigator of TILDA, said what made their latest findings so compelling was that the majority of the issues they had identified, like untreated hypertension, high cholesterol, chronic pain, and depression, were largely modifiable. “These are not inevitable aspects of ageing – they are challenges we can address with the right health and social care systems in place. This study shines a light on where immediate, evidence-based action can transform outcomes for older adults in Ireland.”
Key Findings
Loneliness
Loneliness has emerged as a persistent and powerful factor influencing the health and wellbeing of older adults. The study tracked how loneliness has affected older adults in Ireland over 14 years, including the impact of the COVID-19 pandemic.
- Loneliness scores more than doubled during the pandemic, however levels and frequency of loneliness returned to pre-pandemic levels by the latest report.
- Despite being quite static over time, a significant proportion of older adults experienced loneliness and this experience was associated with poorer health outcomes including functional limitations, poorer self-rated health, and a higher number of depressive symptoms.
Unmet Need
The study explored the scale of undiagnosed and poorly managed health conditions among older adults, representing missed opportunities for prevention and intervention, with serious implications for wellbeing and health system efficiency.
- A significant proportion of older adults remained undiagnosed or under-treated for key conditions including hypertension, hypercholesterolaemia, diabetes, osteoporosis, depression, and chronic pain.
- Thirty six per cent of older adults had undiagnosed hypertension and 45% had undiagnosed high cholesterol based on clinical thresholds.
- While 12% of older adults had clinically significant depressive symptoms, fewer than half received appropriate treatment, and over 45% had not reported their symptoms to any healthcare provider.
4Ms Framework
Using the 4Ms—Mobility, Medications, Mentation, and What Matters— the study offers a comprehensive view of how ageing affects older adults over time.
- Ageing is non-linear and multidimensional: while mobility and cognitive function decline, Quality of Life (QoL) can initially improve before declining in later years.
- Evidence supports the male–female health–survival paradox: women live longer but experience more health-related decline.
Caring
The study examined the emotional and mental health impacts of caregiving, and made the case for stronger policy supports to reduce caregiver strain and improve wellbeing.
Carers who provided more than fifty hours of care each week reported poorer mental health and reduced overall well-being, highlighting the emotional strain of high-intensity caregiving.
- Among these caregivers, women in particular were more likely to report increased symptoms of depression, pointing to a gendered impact of prolonged caregiving responsibilities.
