While clinical depression is a common problem for older adults, it is not a normal part of aging. Common reasons why older adults show signs of depression include the loss of loved ones and ongoing medical conditions like diabetes, high blood pres sure, cancer, heart disease and changes in memory. More than half of cases represent a first onset in later life. It may be overlooked because for some older adults who have depression, sadness is not their main symptom. Depression is the most common mental health problem in older adults. The gds employs a simple yes or no response, and places less emphasis on the somatic symptoms of depression, which are often confounded in older adults by other physical conditions.
Depression in the elderly, the geriatric mental health training series, for the hartford center. Sep 28, 2011 depression is a major contributor to healthcare costs and is projected to be the leading cause of disease burden in middle and higher income countries by the year 2030. Depression in older persons fact sheet national council on. Older adults and depression pdf, 416 kb depression is not a normal part of aging. Feelings of sadness and occasional blue moods are normal. Depression is a significant health problem for people of all ages, but is particularly troublesome among older adults. Female gender and advanced age were significantly associated with perceived loneliness, depression and anxiety. Older people tend to underreport depressive symptoms and may not acknowledge being sad, down or depressed. Worse prognosis in older adults correlates with advancing age, physical comorbidities and functional impairment 70. It also identifies which ebps are available for older adults with depression and describes the available training resources. This prevalence seems to be lower or similar to previous surveys 1, 58 and clinically significant depressive symptoms of communitydwelling older adults 2, 9. In fact,white men age 85 and older have the highest suicide rate in the united states.
Depressed older adults are less likely to endorse affective symptoms and. Secondgeneration antidepressants ssris, snris or ndris are recommended for older adults due to the reduced risk of side effects and safety in the event of overdose. Depression can occur in the elderly, but it is not a normal part of aging. Depression and older adults national institute on aging. Depression in older adults british journal of medical. Treatment of depression in older adults evidencebased. Diagnostic difficulties are also encountered because depression in older adults can present with vague symptoms, which do not correspond to the classical triad of low mood, low energy levels. Depression in older adults university of pittsburgh. Access is most often gained through the door of a primary care physician. Depression in older people is associated with more functional and cognitive impairment than depression in younger adults1 and carries significant costs for the person, the family, and the nhs. Older adults do not typically access mental health services through mental health professionals. Depression and associated factors in older adults in south africa. Prevalence of loneliness and association with depressive. As a result of this attention to the mental health problems of older adults, the onceseparate public health and mental health systems are starting to work more closely together to address depression among older adults.
Although the difficult behaviors associated with depression may be less frustrating to staff than those associated with dementia, older adults with depression may present a number of challenges to staff providing patient. Major depression is reported in 516% of community dwelling older adults, up to 54% in the first year living in a nursing home, and 1012% of hospitalized older adults blazer, 2009. Two scales measure emotional problems and functional problems. Most people in this stage of life with depres sion have been experiencing episodes of the illness during much of their lives. Americans ages 65 and older suffer from depressive symptoms. Lateonset type depression in older adults has been associated with the term vascular depression 4547. Danielle steel media publishing objective the authors examine national patterns in psychotherapy for older adults with a diagnosis of depression and analyze correlates of. Geriatric depression is a mental and emotional disorder affecting older adults. Recent cdc behavioral risk factor surveillance data indicated that among adults age 50 or older, 7.
Types of depression there are several types of depression. Although suicide rates in the elderly are declining, they are still higher than in younger adults and are more closely associated with depression. The children s depression inventory is a modification of the beck depression inventory for adults. In part, its because it often shows up differently when youre older. Depression is common when youre over age 65, but it can be harder to spot. Older adult news spring 2020 older adult behavioral health initiative older adult behavioral health needs. Many older adults with depression need treatment to feel better. The state of mental health and aging in america depression as a public health issue depression is the most prevalent mental health problem among older adults 1.
The changes that often come in later liferetirement, the death of loved ones, increased isolation, medical problemscan lead to depression. Given that social isolation can lead to depression in older adults, one of the best ways to avoid or get rid of this type of depression is to prioritize social interaction. And although some studies examined the impact of low vision by comparing older adults with and without vision impairment 4, 79, 11, 14, 16, 17, only a very few compared older persons with low vision with older persons with other chronic conditions in order to study its relative impact on the aspects of daily. More facts depression affects more than 19 million americans every year, regardless of age, race, or gender. Latelife depression lld is defined as a depressive disorder occurring in a patient older than 60 years, although the onset and definition of cutoff may vary. The impact of low vision on activities of daily living. However, lasting depression is not a typical part of. Depression can also have potentially harmful effects on an older adults health in other ways. Do not dismiss depression as a normal part of having a chronic illness. Depression is a true and treatable medical condition, not a normal part of aging. In fact, studies show that most older adults feel satisfied with their lives, despite having more illnesses or physical problems. However older adults are at an increased risk for experiencing depression. Isolationinduced depression in seniors updated for 2020. For example, nearly a quarter of the 600,000 people who.
Depression is both underdiagnosed and undertreated in primary care settings. The principles for the assessment and management of depression in older adults are the same as for all adults. It is a medical condition that interferes with daily life and normal functioning. Depressive disorders are common across the life course and depressive symptoms are present in up to a third of older adults. Studies have found a significant higher rate and severity of white matter hyperintensities on mri imaging in older adults with depression compared to those without depression 46,48,50. Major depression occurs in 2% of adults aged 55 years or older, and its prevalence rises with increasing age. Depression among older adults american journal of geriatric. White men over age 65 have a suicide rate 5 times higher than the general population. Adverse effects of pharmacologic treatments of major depression in older adults. Unfortunately, all too many depressed older adults fail to recognize the symptoms of. Older adults with depression are at risk for suicide.
Depression in later life is an illness that can be treated. Older adults have a suicide risk almost twice that of the general population. Depression is the leading cause of disability for americans between the ages of 15 and 44 national institutes of mental health nimh. If you are concerned about a loved one, offer to go with him or her to see a health care provider to be diagnosed and treated. Depression is not a normal part of growing older healthy. The original scale consisted of 30 questions but was considered too time consuming by some patients and. Use the checklist on the next page to determine if you or someone you know may be at risk for depression. Treatment of depression in older adults evidencebased practices ebp kit substance abuse and mental health services administration.
While depression is not a normal part of the aging process, there is a strong likelihood of it occurring when other physical health conditions are present. Adult depression, published in june 2009, should be referred to for supplementary information and further details. Nov 28, 2018 depressive disorders are common across the life course and depressive symptoms are present in up to a third of older adults. In addition, the feelings of hopelessness and isolation that often spur thoughts of suicide are more prevalent among older adults, especially those with disabilities or confined to nursing homes. Preventive services task force recommends screening adults for depression when resources are in place to assure accurate diagnosis, treatment, and followup. Causes and diagnosis of depression in elderly people. Depression among older adults with diabetes mellitus. Depression in elderly people often goes untreated because many people think that depression. Cdc promotes public health approach to address depression. Depression is a common problem among older adults, but it is not a normal part of aging. If you are thinking about harming yourself or attempting suicide, tell someone who can help immediately. Loneliness, depression, anxiety, older adults and retirement background loneliness among the elderly is a risk factor for poor health outcomes such as poor quality of life, reduced cognitive. If considering medication for older adults with depression, the panel recommends combining it with interpersonal psychotherapy.
Depression depression is treatable even when other illness is present. However, important life changes that happen as we get older may cause feelings of uneasiness, stress, and sadness. Effective treatment for depression is available and can help even if you have another. Discuss interventions that promote mental health for residents. Further assessment the geriatric depression scale was developed as a screening and assessment tool for depression in older adults. Smith 1993, when you are more than down in the dumps.
The guideline recommends interventions for the treatment of depression in children and adolescents, adults, and older adults. Depression is the leading cause of disability worldwide, affecting about 121 million people world health organization who, 2008. This involves actively looking for ways to spend more oneonone time connecting with others. The study reports for the first time the prevalence of 4. Feb 01, 2020 adapted from sobieraj dm, baker wl, martinez bk, et al.
But after adjusting, many older adults feel well again. Depression is less prevalent among older adults than among younger adults, but it can have serious consequences. This brochure describes the signs, symptoms, and treatment options for depression in older adults. Dec 12, 2017 unipolar depression occurs in 7% of the general older population and it accounts for 5. While most people experience periods of sadness at times, depression is a treatable medical condition. Depression is a common problem among older adults, but it is. Purpose, objectives, content outline page 2 revised by m. Depression is the most common diagnosis in older adults who commit suicide, so it is critical that. They may have other, less obvious symptoms of depression or they may not be willing to talk about their feelings. Symptoms are often overlooked and untreated because they cooccur with other problems encountered by older adults. Older adults are less likely to talk about feeling depressed with their health care providers. The american geriatrics society also supports depression screening for older adults in primary care settings. Aetiology and associations of depression in older adults. Reducing anxiety, geriatric depression and worry in a.
Why does depression in the older population often go untreated. Psychotherapy for depression in older adults ebook pdf jan 24, 2020 free book by. Depression in older adults is associated with a slower rate of recovery 9, worse clinical outcomes compared to younger adults 3 and is associated with higher relapse rates 68. Accompanying selfcritical thinking may exacerbate and maintain a depressed state. Recognizing dementia, delirium and depression in older adults. Depression in older persons is closely associated with dependency and disability and causes great distress for the individual and the family. Offsetting the increasing prevalence of certain risk factors in late life are age.
Although common, it is not a normal consequence of aging. The number one cause of suicide in the united states is untreated depression. It negatively affects functioning, health outcomes, quality of life, and health care costs. Adverse events of pharmacologic treatments of major. Comorbid physical illness, poor social support, and bereavement are known to increase risk of developing depression. Medical conditions that can cause elderly depression its important to be aware that medical problems can cause depression in older adults and the elderly, either directly or as a psychological reaction to the illness. The impact of clinical depression in older adults can be significant, and choosing effective psychotherapeutic and pharmacological management options can be challenging. Depression in older adults is an increasing concern for health services given its current prevalence for this group, and its predicted trajectory to be the leading cause of disease burden in.
Clinical practice guideline for the treatment of depression. Depression in elderly people often goes untreated because many people think that depression is a normal part of aginga natural. Importance depression in older adults is a common psychiatric disorder affecting their healthrelated quality of life. It is not a normal part of aging, a sign of weakness, or a character flaw.
Stigma often prevents this generation of older adults from admitting to any mental health concern. Depression is among the leading causes of decreased disabilityadjusted life years in the world 1 and a serious public health problem. And the symptoms of elderly depression can affect every aspect of your life, impacting your energy, appetite, sleep, and interest in work, hobbies, and relationships. It assesses depression severity in children and adolescents 7 to 17 years old. Most people in this stage of life with depres sion have been experiencing episodes. Depression is one of the most common mental health problems in older adults. When diagnosing and assessing depression in older adults, it is important to consider variations in the typical presentation and also the possibility of confounding comorbidities.
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