Depression In Elderly

Depression in elderly is very common but that does not mean that it is normal. It affects about 6 million Americans who are above the age of 65 years. Older patients are more at risk of suffering from depression due to a number of factors like retirement, isolation, death of loved ones and medical problems.

Depression- Definition: Anyone can feel sad or down but when these feelings of sadness are persistent causing trouble in daily routine activities then it becomes a disease. Depression is defined as a medical illness in which there is persistent feeling of sadness, often associated with discouragement and lack of self worth.

Clinical Features:Identifying an elderly suffering from depression is necessary as it is frequently confused with the symptoms of other medical conditions the patient is already having and with the affect of multiple treatments the patient is receiving. It is important to remember that depression is a disease that affects both the body and the mind. The main signs and symptoms are as follows:

• Sadness
• Fatigue
• Lost of interest in hobbies and things that used to give pleasure in the past
• Decreased appetite
• Sleep disturbances ( both either difficulty sleeping or excessive sleep )
• Weight loss
• Subtle signs of distress like irritable, agitated or difficulty sitting still.
• Inability to concentrate.
• Generalized body aches, headaches, digestive disturbance
• Thoughts of suicide or a suicidal attempt.

Depression In elderly Is Different from Depression In Younger Patients:

• Depression affects older people differently than in younger patients. Depression in the elderly often increases the risk of cardiac disease by two fold and thus increases the risk of death.
• Depression reduces the elderly person’s ability to rehabilitate.
• The chances of suicide are more in elderly suffering from depression.
• Its easy to miss the symptoms of depression in an older person due to isolation, lack of expression of feelings and avoiding to go for a regular medical checkup.
• Many elderly patients do not recognize that their symptoms are due to depression and not a part of normal aging.

Cause of depression:
Causes and risk factors that contribute to depression in older patients and the elderly include:

• Health problems like chronic pain, disability, damage to body image due to disease or surgery etc
• Living alone and isolated
• Death of close friends or loved ones.
• Feeling of purposelessness following a retirement and lack of daily routine activity .
• Fear of death
• Anxiety and financial problems.
• Con current medical illness like heart disease, stroke, Parkinson’s disease , diabetes etc.
• Side effect of certain medications.
• Lack of social supportive network

Management:
It is important to manage older patient suffering from depression as untreated depression leads to many serious problems like increased risk of death from heart attack, increased chances of suicide and worsening of previous medical problems. Here are a few ways how can depression be managed in elderly:

1. Increase in physical activity and exercise helps relieve depression and is as effective as an antidepressant.

2. Connect with others and engage in social activities to avoid isolation.

3. Get enough timely sleep and maintain a regular schedule helps prevent insomnia or excessive sleepiness.

4. Eating a healthy balanced diet avoiding junk food.

5. Try to participate and volunteer in activities that give pleasure as well as help keep busy.

6. Get a supportive counselling.

7. Medications called anti depressants may be prescribed depending on the severity of condition and balancing the benefits versus side effects from the medications.

8. Electroconvulsive therapy is sometimes used for very severe depression that is not responding to therapy or medicines.

9 It is also important to identify and treat associated medical conditions that are contributing to depression.