Facts about Geriatric Depression
depression is widespread with at least 16% of patients receiving
care in a primary care setting and a higher percentage in
hospitals and nursing homes exhibiting depression. (Reynolds
and Kupfer, 1999). At least 15-20% of the elderly in the general
population may experience depression (Kaplan and Sadock, 1998).
Steffens and colleagues (2000) found that the point
for depression in older adults was 4.4% in women and 2.7%
in men, higher than previous estimates in the United States.
Yet depression in the elderly is a complex
problem, particularly difficult to diagnose
due to medical illness, dementia syndromes,
and heterogeneity of patient populations
(Small, 1998). Arriving at an accurate diagnosis
requires that clinician to differentiate
between such problems as
, stroke, and other types of brain injuries
and illnesses.
Depression in the older adult can be disabling,
contributing to problems with activities
of daily living and thus increasing their
dependence on others and the health care
system (Oslin, Streim, Katz, Edell, and
TenHave, 2000). Reynolds and Kupfer (1999)
argue that depression in later life has
serious consequences, including increased
health costs, patient and caregiver distress,
amplified disabilities, and increased mortality
related to medical illness and suicide.
In fact, there is evidence that depression
in the elderly is strongly associated with
poor cognitive function and decline (Yaffe,
Blackwell, Gore, Sands, Reus, and Browner,
1999).
The older adult is more at risk for depression
and suicide due to the losses they experience,
including death of a spouse, death of friends,
retirement, and medical illness and disability.
With an increasingly older population, this
group requires closer examination and understanding
of the mechanisms by which depression is
manifested and treated.
Sources:
Kaplan, H.I. and Sadock, B.J.
(1998). Synopsis of Psychiatry. Philadelphia:
Lippincott, Williams, Wilkens.
Oslin, D.W., Strein, J., Katz,
I.R., Edell, W.S., TenHave, T. (2000).
Change in disability follows impatient
treatment for late life depression. Journal
of the American Geriatrics Society, 48(4):357-62.
Reynolds, C.F., and Kupfer,
D.J. (1999). Depression and aging: A look
to the future. Psychiatric Services, 50
(9): 1167-72.
Small, G.W. (1998). Treatment
of geriatric depression. Depression and
Anxiety Suppl. 1:32-42
Steffans, D.C., Skoog, I.,
Norton, M.C., Hart, A.D., Tschanz, J.T.,
Plassman, B.L., Wyse, B.W., Welsh-Bohmer,
K.A., and Breitner, J.C. (2000). Prevalence
of depression and its treatment in an
elderly population: the Cache County study.
Archives of General Psychiatry, 57(6)601-7.
Yafffe, K., Blackwell, T.,
Gore, R., Sands, L., Reus, V., Browner,
W.S. (1999). Depressive symptoms and cognitive
decline is nondemented elderly women:
a prospective study. Archives of General
Psychiatry, 56(5): 425-30.
