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Why Do Some Older Patients Suffer From Depression

Posted On: Dec 24, 2019

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Although depression is widespread among older adults, it is less frequent than in younger individuals. However, depression in the elderly has a different set of effects as compared to the other age groups1. Knowing how it impacts this demographic of people can help them and their caregivers to be proactive.

Depression is a serious mental health disorder, which results in feelings of sadness, loss, frustration, and anger interfering with the daily life of the individual. It requires immediate treatment to prevent the risk of disabilities and suicidal tendencies, which are relatively higher in older adults. As per the reports of CDC, nearly 7 million older adults (aged 65 and above) are affected by depression. Also, 16% of suicide-related deaths during 2004 are attributed to older adults with depression.

Why do older people get depressed?

In older adults, complications associated with their aging process can increase the risk of developing depression. Some of the common complications include chronic medical conditions, isolation, immobility, financial problems, divorce or widowhood, deaths of friends and loved ones, approaching death, loss of independence, retirement or relocation. Alcohol or drug abuse can also make them more prone to develop the condition.

Challenges in identifying depression in older adults

It is quite difficult to detect depression in older adults. The most common reason is that the symptoms of depression such as fatigue, loss of appetite, difficulty with sleeping, etc. also can occur as a part of the normal aging process. Thus, family members usually ignore these symptoms.

It can be confusing for the health care providers to differentiate whether the symptoms are due to depression or if they are a result of any physical illness, which is common in this age. Therefore, specially trained mental health specialists are involved in diagnosing and treating depression in this population.

Impact of depression in older adults

Suicidal tendencies due to depression and the associated cases of death are higher in older individuals as compared to the other population groups. Compared to women, men are at a higher risk, of which the cases are mostly due to widowhood and divorce.

The prognosis is also worse among the survivors of depression who are old. The health care cost invested on older patients with depression is higher than in younger individuals.

In older adults with depression, the risk of cognitive impairment and dementia are also very high. Their functional ability is also highly impaired, and they seem to be more anxious than other groups of affected individuals.

Fatigue, sleep disturbance, hopelessness, loss of interest in life, and psychomotor retardation are also predominant with late-life depression as compared to the depression that occurs in other age groups. Older women with depression have a higher incidence of appetite disturbance while older men are found to be more agitated.

Prevention is better than cure!

Interventions are available for preventing depression in older adults with promising results. Psychosocial activities focused on the older adults’ needs, and abilities have a meaningful outcome on preventing depression in this group of individuals. Certain preventive measures of depression in older adults include:

Exercise: Aerobic exercise, and not resistance exercise, can significantly reduce the symptoms of depression.

Educational classes: Classroom or home-based mind-body wellness programs and courses, along with relaxation training, problem-solving, communication, cognitive restructuring, behavioral treatment for nutrition, exercise, and insomnia, and instructions on mind-body relationships can significantly reduce depression.

Interpersonal therapy: This can prevent an increase in the depressive symptoms.

Problem-solving therapy: This therapy is effective with improvement in depressive symptoms along with functional and emotional well-being.

As the population of the elderly is increasing worldwide, it is important to identify their problems and provide immediate treatment. Depression being more devastating in the later stages of life for this population group, families, and health care providers should pay additional attention. This can help to improve their quality of life.

References

  1. Hasin DS, Goodwin RD, Stinson FS, Grant BF. Epidemiology of major depressive disorder: Results from the National Epidemiologic Survey on Alcoholism and Related Conditions. Arch. Gen.Psychiatr.2005;62:1097–106.
  2. https://www.cdc.gov/aging/pdf/cib_mental_health.pdf

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