Chalmers Butterfield

Depression in the Elderly

Articledepressionelderly
Behavioral & Mental Health
Men's Health
+3
Contributed byKrish Tangella MD, MBAAug 24, 2018

What are the other Names for this Condition? (Also known as/Synonyms)

  • Clinical Depression in the Elderly
  • Depression in Older Adults
  • Dysthymic Disorder in the Elderly

What is Depression in the Elderly? (Definition/Background Information)

  • Depression is a condition in which an individual is overall sad and discouraged with oneself to the point that daily life becomes a struggle. Depression, specifically in the elderly, is something that is seemingly overlooked as a significant issue.
  • Self-worth is commonly questioned as individuals grow older; however, when the stress of aging becomes overwhelming, feelings of hopelessness and depression set in. Depression in the Elderly is more likely to occur in older women.
  • Causes of Depression in the Elderly include decline in overall health, memory loss, multiple illnesses, personal bereavement, chronic pain, and due to side effects of medications.
  • Depression in Older Adults may be manifested as insomnia, neglect of hygiene habits, weight loss, and lack of motivation, becoming more confused or forgetful than usual, alcohol abuse, appetite loss, and suicidal tendencies. These may lead to complications such as complete isolation and even suicide.
  • Treatment of Depression in the Elderly requires lifestyle modification that include regular exercises, abstinence or minimal alcohol use, support group therapy, and antidepressant medications.
  • The prognosis is generally good with appropriate support and management of the condition.

Who gets Depression in the Elderly? (Age and Sex Distribution)

  • The condition may affect any elderly adult (typically over 60-65 years) due to a variety of reasons
  • Depression in the Elderly is more likely to occur in women

What are the Risk Factors for Depression in the Elderly? (Predisposing Factors)

Risk factors of Depression in the Elderly include:

  • Being female
  • Substance abuse
  • Loss of loved ones
  • Previous suicide attempts
  • Fear of death
  • Not having a significant other, staying alone
  • Cancer
  • Absence of social support
  • Medications

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Depression in the Elderly? (Etiology)

The elderly experiences a multitude of life changes that may negatively affect their outlook on the world and where they see themselves in it. Depression in Older Adults can be a sign of a physical illness, a psychological reaction to the illness, and/or directly caused by the physical illness.

Causes of Depression in the Elderly include:

  • Struggles with memory loss, dementia
  • Chronic pain
  • Onset of physical illness such as cancer or Alzheimer’s disease
  • Multiple illnesses
  • Decline in overall health
  • Medication side effects
  • Death of loved ones
  • Feeling of loneliness
  • Reduced sense of purpose
  • Change of residence (say moving to a retirement home)

What are the Signs and Symptoms of Depression in the Elderly?

The signs and symptoms of Depression in the Elderly may include, but is not limited to the following:

  • Fatigue
  • Insomnia
  • Sadness
  • Neglect of hygiene habits such as showering, shaving, clipping nails, etc.
  • Weight loss, loss of appetite
  • Lack of motivation, loss of interest in hobbies
  • Considerably becoming more confused or forgetful
  • Abuse of alcohol or medication
  • Self-loathing
  • Suicidal thoughts or attempting suicide

How is Depression in the Elderly Diagnosed?

A diagnosis of Depression in the Elderly is difficult because the majority of symptoms and signs are similar to those of the normal aging (and grieving) process.

  • A correct diagnosis requires open communication between the affected individual and healthcare professionals
  • A physician may do the following to determine ‘why or if’ depression is present:
    • Conduct blood and urine tests to determine if any underlying illness is the source of depression
    • Recommend speaking to a psychiatrist who may prescribe necessary mediations, as well as differentiate between grieving and depression

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Depression in the Elderly?

Complications associated with Depression in the Elderly include:

  • Complete isolation
  • Sickness due to improper medication usage, starvation
  • Suicide

How is Depression in the Elderly Treated?

Treatment for Depression in Older Adults is equally effective, as it is for younger people. However, medications generally take longer to have the desired result.

A treatment of Depression in the Elderly may include some or all of the following strategies:

  • Regular exercise
  • Low dose of antidepressant drugs
  • Abstinence or minimal alcohol use
  • Open talk with a trusted friend or relative about uncomfortable or insecurity feelings
  • Omega-3 fatty acids (may boost the effectiveness of antidepressants)
  • Folic acid
  • Support therapy groups, regular counseling sessions
  • Actively exploring new social experiences
  • Learning a musical instrument or a new language

How can Depression in the Elderly be Prevented?

Depression in the Elderly may be prevented by:

  • Exercising
  • Taking medications as instructed
  • Participating in regular social activities
  • Talking with someone about worries before they manifest into burdens
  • Through support of family and friends

What is the Prognosis of Depression in the Elderly? (Outcomes/Resolutions)

  • The prognosis of  Depression in the Elderly is generally good with proper and continued support and treatment
  • Treatment is typically effective and success rates increase for individuals who have access to family, friends, and social gatherings

Additional and Relevant Useful Information for Depression in the Elderly:

  • The suicide rate in people aged 80-84 years is more than twice that of the general population
  • Depression in the Elderly affects around 6 million Americans over the age of 65 years
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Krish Tangella MD, MBA

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