DEPRESSION IN OLDER PEOPLE
Depression that occurs among individuals 65 years or older with no previous history of depression is known as late-life depression. A 2021 study highlights that Despite its prevalence, depression in seniors is often underrecognized and undertreated. Understanding its causes and risk factors is crucial for enhancing their quality of life. Meta-analyses show that depression is 17.1% among those aged 75 and older and 19.5% among those aged 50 and older.
Given that presence and persistence of depressive symptoms, leads to lower life quality, higher suicidal mortality, higher non-suicidal mortality (e.g. by enhancing the risk of heart disease).
CAUSES OF DEPRESSION IN OLDER PEOPLE:
A complex interplay of biological, psychological, and social factors can trigger depression in older adults.
1: Biological Factors: As people age, changes in brain chemistry and structure can make them more susceptible to depression. Conditions such as cardiovascular disease, chronic illness, and neurodegenerative disorders like Alzheimer's and dementia can contribute to depressive symptoms.
2. Psychological Factors: Aging often brings significant life changes, including retirement, losing loved ones, and decreased independence. These transitions can lead to feelings of sadness, anxiety or even post-traumatic stress.
3. Social Factors: Social isolation is a significant risk factor for depression in older people. Many seniors experience a decrease in social interactions due to physical limitations, relocation to assisted living facilities, or the loss of friends and family members.
SYMPTOMS OF LATE-LIFE DEPRESSION:
2023 research on late-life depression highlights that depression affects every 1 in 5 individuals in a lifetime. When it occurs in old age, it becomes challenging to distinguish it from dementia, as both these diagnoses have overlapping symptoms. It's possible to recognize depression in older people through the following symptoms, which should be consistently present for at least two weeks:
1. Persistent Sadness: A prolonged sense of sadness or emptiness is a core symptom of depression. Older adults may seem unusually down or lose interest in activities they once enjoyed. Older adults with depression may experience feelings of worthlessness, excessive guilt, or shame. The perceived burden of aging can intensify these emotions.
2. Changes in Appetite and Weight: Significant changes in appetite, leading to weight loss or gain, can indicate depression. Some seniors may overeat, while others may lose their appetite entirely.
3. Sleep Disturbances: Depression can cause various sleep issues, such as insomnia, early morning awakening, or excessive sleeping. These disturbances can worsen overall health and well-being.
4. Fatigue and Low Energy: A common symptom of depression is persistent fatigue or a lack of energy. Older adults may feel unusually tired and need more motivation to engage in daily activities.
5. Cognitive Difficulties: Depression can affect cognitive function, leading to problems with concentration, memory, and decision-making. This may sometimes be confused with cognitive decline or dementia.
6. Physical Complaints: Depression in older people can manifest as unexplained physical symptoms, such as aches and pains, digestive issues, or headaches. These symptoms may not have a clear medical cause and can be a sign of underlying depression.
HOW TO DEAL WITH OLD AGE DEPRESSION?
Effective treatment for depression in older adults involves a comprehensive approach that includes medical, psychological, and social interventions. It is essential for healthcare providers to carefully monitor medication use in older adults due to potential side effects and interactions with other medications. Cognitive-behavioral therapy (CBT) and other forms of psychotherapy can be effective in dealing with depression. Therapy helps individuals address negative thought patterns, develop emotional intelligence, and improve resilience. Encouraging regular physical activity, a balanced diet, and social engagement can significantly improve mood and reduce feelings of loneliness.
A WORD FROM MENTAL NURTURING:
Depression in older adults is a common, multifaceted issue with various causes, symptoms, and treatment options. Identifying the risk and protective factors associated with this mental disorder in older people is a crucial area of research. Firstly, modifiable factors, such as physical activity, cognitive engagement and social networks can serve as targets for preventive interventions. Secondly, non-modifiable factors, including genetic predispositions and physical impairments, can help identify subgroups that may require additional preventive measures.
The prognosis for late-life depression tends to be worse than that for younger age groups, highlighting the importance of preventive strategies. By recognizing the signs and getting a diagnosis, caregivers and healthcare professionals can provide better support and effective treatment. A holistic approach that encompasses medication, therapy, lifestyle changes, and social support is essential for improving the quality of life for older adults dealing with depression. By fostering greater awareness and empathy, we can break the stigm surrounding depression in elderly individuals. This will help ensure they receive the support they need to face their challenges, allowing them to let go of the past and live more fully in the present.
RESOURCES:
1. Cuijpers P, Karyotaki E, Eckshtain D, Ng MY, Corteselli KA, Noma H, Quero S, Weisz JR. Psychotherapy for Depression Across Different Age Groups: A Systematic Review and Meta-analysis. JAMA Psychiatry. 2020 Jul 1;77(7):694-702. doi: 10.1001/jamapsychiatry.2020.0164. PMID: 32186668; PMCID: PMC7081149.
2. Alexopoulos GS. Depression in the elderly. Lancet. 2005 Jun 4-10;365(9475):1961-70. doi: 10.1016/S0140-6736(05)66665-2. PMID: 15936426.
3. Vaughan L, Corbin AL, Goveas JS. Depression and frailty in later life: a systematic review. Clin Interv Aging. 2015 Dec 15;10:1947-58. doi: 10.2147/CIA.S69632. PMID: 26719681; PMCID: PMC4687619.
4. Fang H, Tu S, Sheng J, Shao A. Depression in sleep disturbance: A review on a bidirectional relationship, mechanisms and treatment. J Cell Mol Med. 2019 Apr;23(4):2324-2332. doi: 10.1111/jcmm.14170. Epub 2019 Feb 7. PMID: 30734486; PMCID: PMC6433686.
Written by:
Hana Noor
Medical reviewed by :
Dr. Saba
On October 05, 2024
