Introduction
Depression is not a normal part of aging but, unfortunately, it is very common in the elderly.
Depression in later life frequently coexists with other medical illnesses and disabilities. In addition, advancing age is often accompanied by loss of key social support systems due to the death of a spouse or siblings, retirement and/or relocation of residence.
Lastly, depression is a serious concern in the elderly because it is more likely to lead to suicide.
Overview and Facts
According to the studies done by IDRAAC, 8.6 % of the Lebanese older adults will have depression and among Lebanese aged 60 and above, females were found to be twice more likely to have depression.
Furthermore, in a study that assessed depression among hospitalized older adults based on the Geriatric Depression Scale (GDS), it was found that 3 out of 10 hospitalized older adults are depressed.
Symptoms
Depression is suspected when a person experiences a change from their previous usual state. The signs to watch for are:
- Persistent sadness or irritability
- Lost of interest or pleasure in activities that were previously enjoyed
- Feelings of fatigue and loss of energy
- Sleeping too much or too little
- Eating too much or too little
- Difficulty concentrating
- Loss of self-confidence and negative thoughts about one’s self and one’s life
Causes and Risk Factors
Factors that increase the risk of depression in the elderly include:
- Being female
- Being unmarried (especially if widowed)
- Stressful life events
- Lack of a supportive social network
Having physical conditions like stroke, hypertension, atrial fibrillation, diabetes, cancer and dementia further increases that risk. While depression may be an effect of certain health problems, it can also increase a person’s risk of developing other illnesses -- primarily those affecting the immune system, like infections.
Tests and Diagnosis
To diagnose depression in the elderly, a person should consult a mental health professional who will rely on scientific criteria to check whether he/she has depression. The Geriatric Depression Scale (GDS) can be used to assess depression in the elderly. The doctor will also perform a full examination including a mental health assessment.
Also, lab tests can be ordered to rule out other conditions that can cause similar symptoms.
Treatment
There are several treatment options available for elderly depression including medicine, psychotherapy (counseling), electroconvulsive therapy or in more difficult to treat cases, a combination of these treatments.
- Antidepressant Medicines: Most of the available antidepressants are believed to be equally effective in elderly adults, but the risk of side effects or potential reactions with other medicines must be carefully considered.
- Psychotherapy and counseling: Most depressed people find that support from family and friends, involvement in self-help and support groups, and psychotherapy are very helpful.
- A combination of psychotherapy and antidepressant medicines.
- Electroconvulsive Therapy (ECT): ECT plays an important role in the treatment of depression in older adults. Because many older patients are unable to take traditional antidepressant medicines due to side effects or interactions with other medications they may be taking, ECT is an extremely effective alternative.
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