By Mardy Chizek
Depression is more common in the elderly than in any other age group, affecting 20% of those living in the community and 40% of those who are living in care homes, according to the Mental Health Foundation statistics on mental health. Clinical practice suggests that the number may even be greater than this.
Depression is not a normal part of aging. Depression is grossly under diagnosed and treated in the elderly. Untreated depression is a significant quality of life issue for seniors. The presentation of depression in the elderly is different than in younger individuals. Seniors often present with weight loss and difficulty sleeping rather than feelings of hopelessness and worthlessness. The rate of recurrence of depression in the elderly is as high as 33 percent within a year. This is serious condition that requires diagnosis, treatment and ongoing monitoring for recurrence. The missed diagnosis is often because we do not look for it.
Medical evidence in clinical practice has long been thought to be a precursor for dementia. New research suggests that older women suffering from depression were nearly twice as likely to develop dementia and cognitive impairment. In a study involving 302 women who were at least 85 years old, 70 percent of whom had been depressed five years previously, demonstrated at least mild cognitive impairment, compared with just 37 percent of the women who were not depressed.
This has ramifications for women, as supported by findings published in 2012 in the Archives of General Psychology that found that more women were depressed than men at each interval of the study, and women were more likely than men to suffer from depression at different time points. However, older women were less likely than men to die while depressed.
Caregivers need to recognize the potential for depression in their family members. Depression treatment options depend on whether the depression is secondary to an acute loss or is more profound problem lasting weeks or months. Unfortunately our society does not recognize that mental health issues are as painful and debilitating as physical health issues. With depression, the quality of life and long term outcome of the senior’s life is dependent on recognition and treatment by all involved.
The diagnosis of depression in elderly people is different than that in the younger population. It does not mean that depression is any less significant a problem for seniors. It is simply different. It is of special concern because of the well documented risks of suicide and dementia seen in depressed seniors. Depression is not a sign of weakness and inability to handle life; it is a real physiologic condition that requires aggressive treatment.
Mardy Chizek, RN, FNP, BSN, MBA, AAS is the president of Westmont’s Charism Elder Care Services. For more information on depression and dementia visit Charism Eldercare Services at www.charism.net.