Depression in the Elderly Introduction Depression is a common mental disorder that is estimated to be prevalent in 7-12% in adult of over 65 years (Ning, 2009). Like other disease such as diabetes and cancer, depression is chronic disease. It increases the risk of death and is associated with high rates of suicide among the elderly and therefore requires a lot of attention. However, depression in the elderly many times, goes undiagnosed or is under-treated because people associate its symptoms with that of aging. This situation is alarming especially when considering that the population of most western countries is aging. In order to effectively address this problem, causes of this condition and its symptoms must be well understood. This paper will focus on identifying some of the risk factors for elderly depression, its symptoms and how this condition can be addressed. Summary of Relevant Studies There are various studies that have attempted to link depression in the elderly to some risk factors. The study titled Depression in the elderly living in a rural area and other related factors by Fernandez et al (2006) is one such study. Fernandez s aimed at linking the rates of depression in the elderly to the living environment they are exposed to. According to Fernandez 10%- 30% of the elderly in the developed countries are suffering from depressive disorders. Several causative factors were considered. One of them is the actual aging process. According to Fernandez et al (2006) many people find it difficult to deal with the aging process. Some cannot appreciate the fact they can longer perform some of the activity they used to while young while others do not like how their bodies have turned out. Another factor considered is the overlapping of psychological disorders and physical ailment. Fernandez found that depression was more prevalent in the elderly suffering from chronic aliments such as cancer, diabetes and heart diseases. It is estimated that 20-40 % of the older generation suffering from chronic ailments exhibit symptoms of depression. Psychological stress in such patients has been associated with physical pain and fatigue caused by the chronic ailment. Social support is another risk factor that was associated with depression in the elderly. 1 / 5
Fernandez et al (2006) discovered that more elderly people, who were living on their own, exhibited symptoms of depression. Gender was also identified as a factor that contributes to depression. Fernandez recorded that more elder women than men exhibited symptoms of depression. Depression in the elderly may present itself in very many signs and symptoms. Porzych et al (2005) also conducted a study that explores this issue of depression in the elderly. Porzych study was especially useful in establishing how elders suffering from depression may be identified. According to this article, depression is usually difficult to diagnose since it usually exhibit unclear and non-uniform clinical signs. There are many conditions that also mimic the symptoms of depression. These include; substance use and dementia. According to Porzych, the most common symptom for depression among the elderly is anxiety. This exhibits itself at three different spheres of life. First, anxiety may exhibit itself in the emotional sphere. This may be manifested as sense of threatening, sense of constant tension, difficulties in making decisions and inability to relax. In this case the patient remains in a state of fear always finding something to worry about; for some, it is usually their state of health while others it is usually religious issues, death and the afterlife. Second, anxiety may also manifest itself in the cognitive sphere. Inability to concentrate and having feelings that dominate rational evaluation are signs of anxiety at the cognitive level. The third sphere where anxiety may strike is the physical sphere. This will involve symptoms such as constant headaches, palpitation, dyspnoea, hypertonus, sweatiness, pressure in urinary bladder, chronic constipation and dry mouth. According to a report released by Ning Program (2009) antidepressants are usually effective in 70% of elderly depression cases. However, this will only work with proper diagnosis and management. Therefore, according to Ning Program (2009) treatment of depression in the elderly begins with accurate diagnosis. Patients experiencing depression condition that are unrelated to medical conditions should be placed under antidepressants. These are such as risperidone or olanzapine for psychotic patients. However most of these drugs may have side effects such as absorption inhibitions. SSRI s have been endorsed as first line drugs in the treatment of elderly depression. These have very few side effects for patients over 65 years and those suffering for other medical conditions such as cardiovascular. Therapy is also a possible treatment for elders suffering from depression. These are such as support therapy, therapy treatment, group therapy and dignity conserving therapy. Hospitalization should be considered for patients much affected by depression as this condition is one of the 10 ten cause of suicide among the elderly. It is important to treat elderly depression at an early stage as failure to treat may result in to high cost and higher risk of death. 2 / 5
Discussion The above articles have demonstrated that depression is very prevalent in the older generation. This is condition is usually serious as it causes much pain and suffering, are leading causes of suicide and may also lead to death of patients. Despite, the seriousness of this problem many people overlook them for various reasons. Some of these reasons include; the conditions sometimes manifest symptoms of other diseases and its symptoms may also be confused to signs of aging (Fernandez, 2006). It is time that this condition should taken seriously as it has been noted that failure of treatment may make the condition more severe leading to severe mental impairments, deteriorating physical conditions or even death. Failure to address this condition also have cost implication as the elder will keep on checking into hospital for unexplained or more chronic ailments (Ning, 2009). This is especially considering that the population structure in the US and most developing countries is aging. Failure to address it will mean that a large proportion of the population will be ill reducing productivity and spending millions in treatment. This condition is more prevalent among certain groups that exposed to the risk factors. One of these vulnerable groups are the chronically ill patients (Porzych, 2005). It was noted that patients suffering from diseases such as cancer, cardiovascular and diabetes are at more risk of going into depression at old age. This is mainly due to pain and fatigue associated with fighting these diseases and at times because of the medication. Another group that was found to very vulnerable are the adults with minimal social support. This means support from friends, family or close relatively. This usually leads to depression associated with the feeling of loneliness. It is not easy to identify people suffering from depression. Common symptoms may include; inability to rest at one position, bending of hands and necessity in walking. Others include; sleep disturbance, loss of appetite, lack of energy and loss of mood, severe joint pains, weight loss and abdominal pains (Ning, 2009). Depression is a condition that should be treated. Depression in the elderly is medical condition which can be treated. However, there is no single treatment as treatment must respond to the specific needs of the patients and accommodate all the patient s conditions including physical health and financial condition. Antidepressants and psychotherapeutic treatment have proved to be effective treatments for this condition. 3 / 5
Implication for Older People The elderly and their family members should understand that depression is serious aliment that requires attention. Aging does not bring about loss of appetite, loss mood, loss of weight and palpitation; all this are signs of depression and should not be associated with normal aging process. In order to effectively reduce elderly depression, people should be aware of it causes, symptoms and available treatment. It is high time to conduct an extensive awareness program that will address this condition that affects many in silence. Conclusion Depression is one of the most common aliment among the older people. Though this condition is treatable, many elders continue to suffer in silence. This is partly because they are not aware of there condition or because they are not willing to address them. As much as many have tried to overlook it, this condition is among the leading causes of suicide among the elderly, accelerate death and leads to development of other forms of ailment. Therefore this problem need to address and in order to address it people must become aware of it causes, symptoms and method of treatment. References Porzych K. et al (2005). Depression and Anxiety in Elderly Patients as a Challenge for Geriatric Therapeutic Team. Annales Acadmiae Medicae Bialostocensis: 50 4 / 5
Fernandez C. (2006). Depression in the Elderly Living in Rural Area and other Related Factors. Actas Esp Psiquitr : 34 (6), 355-361 Ning Program (2009). Pharmacological Treatment of Depression in the Elderly. Dementia Educational & Training Program 5 / 5