Depression in the Elderly

Depression can occur in the elderly, but it is not a normal part of aging. While most people experience periods of sadness at times, depression is a treatable medical condition.Prevalence of depression among older adultsAccording to the Centers for Disease Control and Prevention (CDC), depression affects about 1%-5% of the general elderly population, 13.5% in elderly who require home healthcare, and 11.5% in older hospital patients.Older adults are at risk of misdiagnosis and lack of treatment because some of their symptoms can mimic normal age-related issues. Symptoms can also be mistakenly attributed to other illnesses, medications, or life changes.Symptoms of depression in older adultsThe essential feature of a major depressive episode is a period of at least two weeks when the person experiences either depressed mood (most of the day, nearly every day) or loss of interest or pleasure in nearly all activities.  According to the American Association for Geriatric Psychiatry, the most common symptoms of depression in the elderly include:

• Persistent sadness
• Feeling slowed down
• Excessive worries about finances and health problems
• Frequent tearfulness
• Feeling worthless or helpless
• Weight changes
• Pacing or fidgeting
• Difficulty sleeping
• Difficulty concentrating
• Somatic complaints (unexplained physical pain or gastrointestinal problems)
• Withdrawal from social activities

Depression and dementiaDepression and dementia share several symptoms, making it difficult to distinguish between the two. It helps to know how the common symptoms manifest in each disease. Depression

• Mental decline is rapid

• Patients can state the correct date and time
• Patients have difficulty concentrating
• Language and motor skills are slow but normal
• Patients notice and worry about memory problems and confusion

 Dementia

• Mental decline is slow

• Patients become confused and disoriented and may get lost, confuse dates, or wonder where they are
• Patients struggle with short-term memory
• Writing, speaking, and language skills are impaired
• Patients don’t notice or seem to care about memory problems ⁶

 Treatment of depression in older adultsEffective treatment of depression in older adults can require more than one approach.

• Psychotherapy: Ongoing, talk therapy can be a source of support for elderly patients. Short term, solution-focused therapy (Cognitive Behavioral Therapy) can also be effective in helping elderly patients eliminate thinking patterns and behaviors that contribute to depressive symptoms.
• Support groups: Groups designed to connect older adults experiencing similar issues (depression, medical conditions, bereavement, etc.) are beneficial in establishing social support and providing a safe space to talk.
• Medication: Antidepressants can be prescribed to relieve the symptoms of depression. Antidepressants can have significant side effects, and elderly patients are sensitive to medications. Medication should be closely monitored.
• Lifestyle changes: Daily exercise, healthy eating habits, and increasing social support are all important in helping elderly patients with depression. Friends and family members can help by doing the following:
  • Schedule group outings
  • Establish a weekly visit
  • Assist with transportation to medical appointments
  • Cook and freeze healthy meals for easy preparation
  • Help create a system to ease with taking medication regularly

 Suicide riskThere is always a risk of suicide with major depressive disorder. According to the latest data (2015), the second highest suicide rate in the United States (19.4) occurred in people 85 years or older. The highest rate (19.6) was among adults between 45 and 64 years of age.  Though a past history of suicide threats or attempts remains the biggest risk factor, most completed suicides are not preceded by unsuccessful attempts. If an elderly patient shows any signs of suicidal thoughts or behaviors, it is important to seek immediate assistance.Article by:  Katie Hurley, LCSW, https://www.psycom.net/depression.central.elderly.htmlImage courtesy of Stuart Miles at FreeDigitalPhotos.net