Depression Articles

What is elderly depression? This article will define elderly depression and how it differs or compares to other types of depression. Keep reading to learn the causes, symptoms, and treatment options for elderly depression. Keep reading to see if you're at risk of elderly depression.

The landscape of depression for the elderly has some special features that are worthy of notice. Depression is common, but not normal, for people in the senior population. Sometimes referred to as “late-life depression,” elderly depression affects an estimated 6 million people, and it may be startling to learn that 90% go untreated. The percentage of elderly who are depressed is higher among those who are in the hospital, and higher still for those who require healthcare in their homes. This article will review the causes and risks, symptoms, effects, and treatment and other specific features of depression in the elderly - those aged 65 and up.

Contrary to what some believe, depression is not a natural and expected part of aging. Of course people who age will experience bereavement and loss, and have temporary “low” periods, but these normal responses to normal, but sad, events of life are technically depression. The field is further complicated by the fact that many elderly have a condition that does not meet all the criteria for major depressive disorder but appear to be depressed. It is common to refer to this condition as minor depression or subsyndromal depression. Subsyndromal depression puts people at a greater risk of developing major depression.

Causes and Risks of Elderly Depression

Not only does depression in elderly individuals coexist with other illnesses, but other illnesses can, not surprisingly, increase the risk of depression. Risks for depression include:

• certain medications or medication combinations, such as those often used to treat hypertension
• certain attributes, such as being female and being unmarried
• not having a supportive social network
• certain medical conditions, such as atrial fibrillation, bypass surgery, cancer, dementia, diabetes, hip fracture, hypertension, insomnia, macular degeneration, and stroke
• family history of major depression
• chronic or severe pain
• personal history of depression or suicide attempt(s)
• substance abuse
• recent loss of a loved one
• retirement or other change in community status
• having to move out of one’s home
• experiencing other stressful life events

Symptoms of Elderly Depression

One of the problems with identifying depression in the elderly is that symptoms can be mistaken with other illnesses and disorders that the person may have. Some conditions with which symptoms of depression have been confused are Alzheimer’s disease, arthritis, cancer, dementia, heart disease, Parkinson’s disease, stroke, and thyroid disorders.

Symptoms may include the following:

• memory issues
• sleep disturbances, including daytime sleepiness and insomnia
• confusion
• loss of appetite and weight loss
• increase in eating and weight gain
• fatigue
• thoughts of or plans for suicide
• irritability
• delusions
• hallucinations
• withdrawal from or demonstrated lack of interest in usual social pursuits
• abnormal thoughts, including about guilt and death
• lessened ability to perform habitual activities
• complaints about physical discomfort

Because many of these symptoms can be due to other factors - such as side effects of medication, results of another medical condition, or the outcomes of normal aging - they can be difficult to identify with depression.

Treatment of Elderly Depression

Treating elderly depression encompasses the same sorts of options as in other patients: psychotherapy, antidepressants, and electroconvulsive therapy (ECT) and combined approaches. However, side effects and drug interactions are an important consideration with elderly patients.  In particular, the elderly population may be more sensitive to antidepressants on the one hand, and they may take longer to begin working, on the other hand. In addition, forgetfulness is an issue with medications, because it’s important for them to be taken consistently.

A newer treatment, transcranial magnetic stimulation (TMS) has been FDA approved and may also be offered. Other parts of a treatment plan may include support groups and the support of family and friends. Medication cost may also be a consideration.

Sources

neuropsychiatryreviews.com
webmd.com
nimh.nih.gov
nami.org
nlm.nih.gov