Although estimates vary, studies have shown that combined depression and cognitive dysfunction is present in roughly 25% of older adults. This strikingly number has encouraged us to focus on depression in the elderly, as it is often overlooked and untreated. Older adults in remission of their first episode should be treated for a minimum of one year and up to 2 years from time of improvement. If depression prevention interventions become a standard part of mental health services, unnecessary suffering due to depression will be greatly reduced. Latelife depression affects about 6 million americans ages 65 and older. Depression is a common problem among older adults, but it is. Depression in older adults northwestern university. Depression in older adults british journal of medical. For example, nearly a quarter of the 600,000 people who experience a. Sleep disturbance, fatigue, psychomotor retardation, loss of interest in living, and. They may have other, less obvious symptoms of depression or they may not be willing to talk about their feelings. Causes and diagnosis of depression in elderly people.
Treatments that combine empirically supported psychological elements with a. Depression in older adults depression affects more than 19 million americans every year, regardless of age, race, or gender. Depression in older adults may present somewhat differently than in younger adults. Combining reminiscence and pbm is justified by the fact that each method. Depression is common when youre over age 65, but it can be harder to spot. Oct 08, 2018 older adults grapple with clinical depression more than any other age group. 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. In fact, studies show that most older adults feel satisfied with their lives, despite having more illnesses or physical problems. Psychological and social risk factors for depression in older adults are similar to those that increase vulnerability to depression in younger adults.
However, when there is a history of depression in earlier life, it is likely that genetic factors may contribute to the course of. N1801, 60 yrs and older 18 primary care clinics 5 states intervention. The good news is that, in most cases, depression is treatable in older adults. An older person may be depressed if, for more than two weeks, he or she has felt sad, down or miserable most of the time or has lost interest or pleasure in most of his or her usual activities, and similar to anxiety, has experienced several of the signs and symptoms across at least three of the categories below.
Depression can also lead to suicide, particularly if left untreated, and you are more likely to develop a physical illness if you have depression. Adult depression, published in june 2009, should be referred to for supplementary information and further details. Experts agree that depression in older adults often goes unrecognized and untreated. Depression, elderly people, prevalence of depression. Depression in older people is often underdetected and untreated and should never be regarded as a.
Depression in older adults contrary to popular belief, depression is not a normal part of the aging process. Depression and older adults national institute on aging. Unfortunately, the symptoms of depression in older adults are often missed and thus go untreated. For example, your doctor will want to determine if your lack of appetite or sleep is due to depression or some other health issue. However, lasting depression is not a typical part of. This brochure describes the signs, symptoms, and treatment options for depression in older adults.
The elderly represent percent of the population but 16 to 20 percent of the nations suicide rate, with the highest rates in males 80 years and older. Older adults and depression pdf, 416 kb depression is not a normal part of aging. This fact sheet from the national alliance on mental illness provides information on depression in older adults including statistics on prevalence, symptoms, risk, diagnosis, and treatment. Illness and disability, chronic or severe pain, cognitive decline, damage to your body image due to surgery or sickness can all be contributors to depression. Depression is one of the leading causes of worldwide disability. Depression is common in older adults, although not as prevalent as in younger adults.
Depression is the most common mental health problem in older adults. In part, its because it often shows up differently when youre older. Depression in older people is associated with more functional and. Powerpoint, the slides have also been converted into a pdf file which allows you to. As we grow older, we often face significant life changes that can increase the risk for depression. Moreover, studies that examine the models used to deliver mental health services have been limited. Depression in older persons fact sheet this fact sheet from the national alliance on mental illness provides information on depression in older adults including statistics on prevalence, symptoms, risk, diagnosis, and treatment. However older adults are at an increased risk for experiencing depression. The research to date suggests that the prevention of major depression is a feasible goal for the 21st century. 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. As in younger adults, depression in older adults is treated with medicine, counselling, therapy, or a combination. Depression in older adults key issues depression and older adults.
The centers for disease control and prevention estimates that 7 million of the 39 million americans over age 65 experience depressionthats nearly 20. Their management may be complicated by contraindications for antidepressants. Depression care older adults clinicbased the community guide. It is not a normal part of aging, a sign of weakness, or a character flaw. It may be overlooked because for some older adults who have depression, sadness is not their main symptom. Medication alone is not as effective as combining talking medication therapy. Older adults with depression are at increased risk of suicide and are more likely than younger adults to complete suicide.
They may have other, less obvious symptoms of depression or. Depression in older adults draft des moines university. Ect can be safe and highly effective for severe, treatmentresistant depression, as well as a variety of other serious mental disorders. Types of depression in older people the most common type of depression in older age is nonmelancholic depression which is linked to psychological factors, personality characteristics and stressful life events. A 2012 study2found that the frequency of major depression in the community was 3. Depression in older adults uf health, university of. Although common, it is not a normal consequence of aging. A neglected chronic disease as important as dementia around the world we are witnessing a continued upward trend in life expectancy with the proportion of people aged over 80 years growing fastest.
Depression is common and underrecognised in older adults. For example, neurotic and ruminative personality traits, stressful life events, grief and loss, change in social status and reduced participation in. Yet despite these dismal statistics, depression in older adults is frequently ignored. Anxiety and depression signs and symptoms in older people. Older adults may benefit from early, continuing, and longterm treatment. Depression, especially in middleaged or older adults, can cooccur with other serious medical illnesses such as diabetes, cancer, heart disease, and parkinsons disease. Depression can affect older adults living in any setting. In general, the length of treatment for depression in the elderly is longer than it is in younger patients. In terms of age groups, prevalence peaks in older adulthood above 7. Overview depression affects an estimated 15% to 19% of americans ages 65 and older living in a variety of settings, yet the illness often goes unrecognized and untreated. Older adults and depression contra costa health services. Depression in older adults is a widespread problem, but it is not a normal part of aging.
There are brief screening tools that have proven effective in this population, and once recognized, depression is highly treatable. Older adults grapple with clinical depression more than any other age group. Many older adults with depression need treatment to feel better. Depression is a common problem among older adults, but it is not a normal part of aging. Mild to moderate depression in older patients may better be treatedwithpsychotherapy,whichmayevenbeeffectiveinmore severedepression.
Depression is a true and treatable medical condition, not a normal part of aging. However, important life changes that happen as we get older may cause feelings of uneasiness, stress, and sadness. Try joining a senior center, a book club, or another group of people with similar. These images are a random sampling from a bing search on the term depression in older adults. Such functional impairment is linked to loss of independent function and increased rates of disability 26. Somatisation in older adults is associated with structural brain changes and cognitive deficits 24. Depression in older adults uf health, university of florida. The community preventive services task force cpstf recommends depression care management in primary care clinics for older adults with major depression or chronic low levels of depression dysthymia on the basis of sufficient evidence of effectiveness in improving shortterm depression outcomes. The changes that often come in later liferetirement, the death of loved ones, increased isolation, medical problemscan lead to depression. Health care providers should monitor the older adult for reoccurrence of depression for the first 2 years after treatment.
The number of community residents with both depressive symptoms and impaired cognition doubles every five years after the age of 70. Effective treatments can reduce the severity of depression in up to 80 percent of older adults. Older adults with recurrent episodes should receive indefinite maintenance therapy in ltc homes, response to therapy should be evaluated monthly after initial improvement and then every three months, as well as annual assessment after remission of symptoms. It is a mood disorder in which feelings of sadness, loss, anger, or frustration interfere with daily life for weeks or longer. The principles for the assessment and management of depression in older adults are the same as for all adults. Depression in later life is an illness that can be treated. Mar 01, 2014 some older adults with latelife depression may exhibit a reversible dementia syndrome previously termed pseudo dementia, i. Depression in older adults is associated with an increased risk of death and disability. Although evidencebased depression interventions exist, relatively few older adults seek care from mental health specialists. Antidepressants may take longer to start working in older people than they do in younger people. How to help elderly family members, friends and neighbors who may be depressed nili raquel larish, mph 2011. This module is freely available to all new zealand general practices. Depression in older people often goes undetected but has severe consequences on. Depression is an important cause of suffering among older adults as well as a significant contributor to the morbidity and mortality caused by other illnesses.
Depression in older persons is closely associated with dependency and disability and causes great distress for the individual and the family. 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. Most clinicians will encounter older patients with. Improving the lives of 40 million older adults by 2030. Older adults are less likely to talk about feeling depressed with their health care providers. Depression is a common but undertreated condition in the elderly.
Known risk factors for older adults include having chronic medical conditions, physical or cognitive functional decline, polypharmacy, experiencing multiple losses, and social isolation. Despite ects efficacy and safety record in older adults, many misconceptions still persist among both patients and health care professionals. Why does depression in the older population often go untreated. Pdf effectiveness of treatment for depression in older people. Ect may cause side effects, such as confusion and memory loss. Yet there is abundant evidence that depression in older adults is treatable, perhaps in as high as 65% to 75% of cases. Use the checklist on the next page to determine if you or someone you know may be at risk for depression. Depression is a significant health problem for people of all ages, but is particularly troublesome among older adults. It negatively affects functioning, health outcomes, quality of life, and health care costs. Depressive symptoms have been associated with increased. Depression is not just having the blues or the emotions we feel when grieving the loss of a. 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. Depression in young adults article pdf available in advances in psychiatric treatment 101.
Please contact bestpractice decision support for further information. Chronically ill medicare beneficiaries with accompanying depression have significantly higher. This article describes the signs and symptoms common in older adults, outlines several types of depressive disorders, discusses screening tools, describes treatment modalities, and addresses nursing. Cognitive and functional impairment and anxiety are more common in older than in younger adults with depression. Depression in older adults is associated with functional impairment cognitively, physically and socially 7,12,25. Depression is a situation where a person feels enormously sad. Depression in older adults typically defined as an individual aged. Key issues is an overview of important information that you should know about depression in older adults. Cdc promotes public health approach to address depression. D w supervising psychiatrist education care management support of antidepressants from pcp problem solving treatment usual care control unutzer j et al. Fellow in geriatric psychiatry northwestern university medical school. Untreated depression can lead to unnecessary suffering, poor health outcomes, high health care costs, and suicide. However, the literature on pain and depression in older people is complex and nuanced. Depressed older adults are less likely to endorse affective symptoms and more.
Depression is one of the most common mental health problems in older adults. Click on the image or right click to open the source website in a new browser window. It is a medical condition that interferes with daily life and normal functioning. Started in 1995, this collection now contains 6769 interlinked topic pages divided into a tree of 31 specialty books and 732 chapters. Depression in the elderly, the geriatric mental health training. Depression can make these conditions worse and vice versa. Geriatric depression is a mental and emotional disorder affecting older adults. 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. For example, older adults are less likely to endorse cognitiveaffective symptoms of depression, including dysphoria and worthlessnessguilt, than are younger adults gallo et al. Since elderly people are more sensitive to medicines, doctors may prescribe lower doses at first. Depression in elderly people often goes untreated because many people think that depression is a normal part of aginga natural. Depression is not a normal part of growing older healthy. Feelings of sadness and occasional blue moods are normal. The community preventive services task force cpstf recommends depression care management in primary care clinics for older adults with major depression or chronic low levels of depression dysthymia on the basis of sufficient evidence of effectiveness in improving shortterm depression outcomes the cpstf has related findings for the following interventions to reduce depression.
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