Depression in the elderly is very common, although it is not a normal part of aging. Late-life depression affects about 6 million Americans age 65 and older, but only 10% receive treatment for depression. This is likely because the symptoms of depression in the elderly are often confused with the effects of multiple illnesses and the medicines used to treat them.
Depression in later life frequently coexists with other medical illnesses and disabilities. In addition, advancing age is often accompanied by loss of key social support systems due to the death of a spouse or siblings, retirement and/or relocation of residence. Because of their change in circumstances and the fact that they're expected to slow down, doctors and family may miss the diagnosis of depression in elderly people, delaying effective treatment. As a result, many seniors find themselves having to cope with symptoms that could otherwise be easily treated.
Depression tends to last longer in elderly adults. It also doubles their risk to develop cardiac diseases and increases their risk of death from illness, while reducing their ability to rehabilitate. Studies of nursing home patients with physical illnesses have shown that the presence of depression substantially increased the likelihood of death from those illnesses. Depression also has been associated with increased risk of death following a heart attack. For that reason, making sure that an elderly person you are concerned about is evaluated and treated is important, even if the depression is mild.
Depression in the elderly is more likely to lead to suicide. The risk of suicide is a serious concern among elderly patients with depression. Elderly white men are at greatest risk, with suicide rates in people ages 80 to 84 more than twice that of the general population. The National Institute of Mental Health considers depression in people age 65 and older to be a major public health problem.
Factors that increase the risk of depression in the elderly include: Being female, unmarried (especially if widowed), stressful life events, and lack of a supportive social network. Having physical conditions like stroke, hypertension, atrial fibrillation, diabetes, cancer and dementia further increases that risk. While depression may be an effect of certain health problems, it can also increase a person's risk of developing other illnesses—primarily those affecting the immune system, like infections.
The following risk factors for depression are often seen in the elderly:
Persons who develop their first depression in old age are very likely to have very small abnormal areas seen on head imagery that indicate tiny spots in the brain that may not be receiving adequate blood flow. Consequent chemical changes in these cells may enhance the likelihood of depression, apart from any life stress.
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