Depression Affects Millions of People in the United States
Depression is a medical condition that affects millions of people in the United States, including up to 5 percent of Americans age 65 or older. The prevalence of depression is significantly higher – between 11.5% and 13.5% – in older hospitalized patients and in who require home health care.
Unfortunately, older Americans also face a greater risk that their depression will not be properly diagnosed or treated, in part because they may be less likely to share feelings of sadness or vulnerability and in part because symptoms may be dismissed as a normal part of aging.
The experience of depression is more than just feeling sad or blue but rather a serious mood disorder that requires treatment. It is important to recognize that, although depression may be more common in older adults, it is not a normal part of aging.
Care managers can help older patients and clients understand the risks associated with depression, identify troubling symptoms that could be signs of depression, and access services for assessment, diagnosis, and treatment.
Symptoms of Depression in Older People
There are three common types of depression: minor depression, in which symptoms are less severe and do not last long; persistent depressive disorder (dysthymia), which can last up to two years; and major depression, in which symptoms can interfere with the ability to work, sleep, concentrate, and enjoy life.
Many older adults who experience depression do not recognize the symptoms, which can include:
- Persistent sadness and/or tearfulness
- Thoughts of suicide, suicide attempts
- Feelings of guilt, worthlessness, and/or helplessness
- Difficulty concentrating, remembering details, making decisions or confusion
- Insomnia, early-morning wakefulness, or excessive sleeping
- Overeating or loss of appetite and weight changes
- Delusions (fixed false beliefs) or hallucinations
- Increased use of alcohol or drugs
- Vague complaints of physical aches and pains
- Slowed movement or speech
- Neglecting personal care
- Pacing, fidgeting, or restlessness
- Excessive worries about finances and health
- Withdrawal from social activities, apathy
- Help-seeking or demanding behavior
- Loss of interest in activities or hobbies once pleasurable
Risk Factors for Depression in Older People
Care managers can look for risk factors in clients or patients who may be experiencing depression. These factors may include common life experiences such as health problems, loss of mobility, or the recent death of a spouse or another loved one.
Life changes such as retirement or moving away from a longtime home or community can also lead to feelings of loneliness and isolation and a reduced sense of purpose, which can lead to depression.
Other risk factors for depression in older people include being female, having a chronic medical illness or disability, or having an underlying sleep disorder. Specific medications can increase the risk as well as a personal or family history of depression.
Those suffering from depression do not just “snap out of it.” Depression is a medical condition that affects quality of life and the ability of the individual to follow medical recommendations.
Treatment options can include psychotherapy, antidepressant medication, and lifestyle changes such as daily exercise, healthy eating habits, quality sleep, and increasing social support.
SOURCES
(January 31, 2017) Depression is Not a Normal Part of Growing Older. Centers for Disease Control and Prevention.
(May 1, 2017) Depression and Older Adults. National Institute on Aging.
Duckworth, K. (October 2009) Depression in Older People. National Alliance on Mental Illness
Gensichen, J., Beyer, M., Muth, C., Gerlach, F. (February 2006) Case management to improve major depression in primary health care. Psychological Medicine, 36(1):7
National Institute of Mental Health. Older Adults and Depression.
Pequignot, R., Dufouil, C., Peres, K., Artero, S. (January 17, 2019) Depression Increase the Risk of Death Independently From Vascular Events in Elderly Individuals. Journal of the American Geriatrics Society, 67(3):546