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Depression - elderly - Overview

Definition of Depression - elderly:

Depression is a medical illness in which a person has persistent feelings of sadness,often with discouragement and a lack of self-worth.

Depression in the elderly is a widespread problem, but is often not recognized or treated.

Causes, incidence, and risk factors:

See: Depression - major for more information about the causes of depression.

In the elderly, a number of life changes can increase the risk for depression, or make existing depression worse. Some of these changes are:

  • Adapting to a move from home to an apartment or retirement facility
  • Chronic pain
  • Feelings of isolation or loneliness as children move away and their spouse and close friends die
  • Loss of independence (problems getting around, caring for themselves, or driving)
  • Multiple illnesses
  • Struggles with memory loss and problems thinking clearly

Elderly people often use alcohol to self-treat depression, but this may make symptoms worse.

Depression can be a sign of a physical illness. It can be a psychological reaction to the illness, or directly caused by the physical illness.

  • Physical illnesses that increase the risk for depression include: thyroid disorders, Parkinson's disease, heart disease, cancer, and stroke.
  • Symptoms of depression may occur as part of dementia ( Alzheimer's disease).
  • Symptoms of depression are also a side effect of many drugs commonly prescribed for the elderly.

Many older people will not admit to feeling depressed, for fear that they will be seen as "weak" or "crazy." Some older people will not report their depression because they believe that feeling sad is "normal," or that nothing can be done about it.

  • Reviewed last on: 8/15/2010
  • David B. Merrill, MD, Assistant Clinical Professor of Psychiatry, Department of Psychiatry, Columbia Unviersity Medical Center, New York, NY. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Cassano P, Fava M. Mood disorders: major depressive disorder and dysthymic disorder. In: Stern TA, Rosenbaum JF, Fava M, Biederman J, Rauch SL, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 1st ed. Philadelphia, Pa: Mosby Elsevier;2008:chap 29.

Unutzer J. Clinical practice: late-life depression. N Engl J Med. 2007;357:2269-2276.

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