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Geriatric Depression

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Depression can be a normal part of aging with the decline of health, loss of independence and loved ones, and isolation. However, if an individual experiences prolonged periods without enjoyment of previously enjoyed pastimes, with diminished self-worth, with sadness, fatigue, sleep loss, and/or an increase in substance use, social withdrawal or isolation, and/or a fixation on death, these are could be signs of major depression.

Depression in the elderly population is often hypothesized as being caused by recent bereavement, isolation, health problems, medications (especially for those on numerous medications), reduced sense of purpose, and/or fears.

Suicide among the geriatric persons is quite high; in fact, people over the age of 75 have the highest suicide rate of any sector. Therefore, diagnosis of and careful attention to depression in older individuals is extremely important.

Sometimes the elderly population will not exhibit signs of depression like their younger counterparts. Often times instead of feeling sadness, depression in the elderly can have lack of energy, low motivation and physical complaints. Unfortunately, depression in the older population often goes undetected or undiagnosed,1 but given the suicide rate among the geriatric population, diagnosis and subsequent treatment is critical. The Geriatric Depression Scale is a self-reported assessment of depression specifically designed for elders. The original 30 question assessment now has a shorter 15 question version in which one point is assigned to each answer that indicates the presence of depression. Ten or more points on the 30 question assessment could, along with a comprehensive exam given by a practitioner, lead to a diagnosis of major depression in an older individual. (There is some debate around how reliable this test is for those suffering with dementia.)

References 1. Steffens, DC. A multiplicity of approaches to characterize geriatric depression and its outcomes. Current Opinion in Psychiatry 2009 Nov; 22(6): 522-6.

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