Depression in Older Adults

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The “golden years” come with concerns that can often lead to depression: financial worries in retirement, loss of independence, illness, fears of mortality. Depression in older adults sometimes has such obvious causes but, as at any age, it often comes out of nowhere.

Some signs and symptoms of depression in older adults are more subtle or mimic those of other medical conditions, according to a review published last May in the Journal of the American Medical Association. Drug side effects can also induce or mimic depression. And memory problems from depression can be difficult to distinguish from dementia.

Chronic illnesses or other health problems can contribute to depression-particularly if those conditions limit daily functioning. Roughly 80 percent of older adults have at least one chronic health problem, according to CDC data, and about two-thirds live with multiple chronic ailments. In a 2010 study published in Ageing Research Reviews, factors associated with increased risk of depression among older adults included stroke, loss of hearing, poor eyesight, heart disease, diabetes, and chronic lung disease. And health problems that limit physical abilities can decrease a person’s ability to participate in his or hercommunity, leading to the social isolation that itself is a risk factor for depression.

The loss of a spouse, other family members, or friends can have a lasting impact beyond the sadness of grieving. Such losses also disrupt a person’s social structure; with fewer companions, people can become increasingly isolated, which can trigger or exacerbate depression. Conversely, evidence has shown that older adults who have strong social ties and a sense of community are less likely to experience depression and tend to be physically healthier. Staying physically active and seeking out intellectual stimulation and challenges can also be protective.

Seeking treatment

Many older adults mistakenly believe their depression is just a normal result of getting older. Others tend to be embarrassed or reluctant to seek professional help for emotional problems. Or they may remember the days when treatments were less effective.

Depression can induce hopelessness and undermine the initiative to seek help or continue in treatment. Unfortunately,most cases of late-life depression are inadequately treated-or not treated at all. Many older adults are treated with doses of antidepressants that are too low, or treatment is stopped too early.

Untreated depression is likely to intensify and can worsen coexisting conditions like diabetes and high blood pressure, making them harder to control. It can indirectly harm well-being by leading people to not take care of themselves-skipping their medications, eating poorly, not exercising, and so on. Depression may increase certain inflammatory processes that underlie many medical conditions.

If you think you may be experiencing depressive symptoms, discuss your concerns with your doctor or another health professional. Getting the right treatment will help you manage symptoms and likely improve your quality of life. And once you find relief, you still need to be alert for returning symptoms.

If depression is diagnosed, treatment options include antidepressants, psychotherapy, or a combination of both. In addition to conventional treatments, exercise has been shown in numerous studies to help combat depression, in part by boosting thelevels of neurotransmitters that affect mood and by providing an activity (often a social one) outside the home. Other lifestyle changes, such as eating a healthier diet, avoiding processed and sugary foods, and adopting a more regular sleep schedule, can help. It’s a good idea to eliminate or limit consumption of alcohol. While many older adults use alcohol to mask or cope with depressive symptoms, alcohol can exacerbate depression, creating a vicious cycle.