Depression does not become more common as you get older, but it may become more complex.  Recent findings on age and depression confirm the so-called ‘U-curve’ of well being and happiness over the human life cycle.  Put simply, we’re at our most dissatisfied in our mid-forties – a finding that’s so in 47 of 55 countries surveyed. Depression seems to have much less of an impact in terms of daily disability in the older age groups.

But depression in the elderly is complicated by other diseases and it’s often hard to sort out cause and effect. Do you get depressed because you’ve had a heart attack? Does depression make it more likely that you’ll get diabetes? We really don’t know! Elderly depression is not so much about the numbers of people who are depressed, but more a matter of knowing how best to treat it.  Higher costs in terms of time, money and health care resources are involved in treating elderly depression and, too often, such resources simply aren’t adequate.  Moreover, the growing number of people over 60 (and, proportionately, even more so those over 80), means that elderly depression is set to rise dramatically. As yet, society seems unprepared for this.   Recent findings from the Zürich Study of younger persons (stretching over 20 years and with an age range of 20-41) have pointed to high levels of chronic depression existing alongside heart and lung problems, insomnia, pain (other than backache and headache) and sexual problems. Interestingly, the authors ascribe the heart and lung problems   in this age group as probably ‘associated with increased anxiety’.

In the elderly, by contrast, depression tends to exist alongside age-related conditions like stroke, high blood pressure, atrial fibrillation, diabetes, cancer and dementia.

The Zürich Study also found that other mental health problems co-exist with depression in the   20-41 age group. The six leading risk factors were found to be tobacco dependence, substance abuse, generalized anxiety disorder, obsessive-compulsive syndrome, panic attacks and alcohol use disorder. Again, with the exception of anxiety, these are probably more prominent risk factors for depression in younger persons than for the elderly. The psychosocial impact of bereavement, loneliness and growing physical and cognitive problems in coping with the normal activities of daily life are more characteristic associations with depression in old age.

The next article in this series looks at current   practice in the diagnosis and treatment of elderly depression.

Sources:

J. Angst, A. Gamma et al, “Long-term depression versus episodic major depression: results from the prospective Zürich study of a community sample”, J. Affective Disorders 115, 112-121, 2009
N. G. Choi & J. S. Kim, “Age group differences in depressive symptoms among older adults with functional impairments”, Health & Social Work 32[3], 177-188, August 2007

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Elderly Depression : New approaches to the management of elderly depression 5/6
Elderly Depression : where do we go from here? 6/6