Depression - elderly

Definition

Depression is a medical illness characterized by persistent sadness, discouragement, and loss of self-worth. These feelings are accompanied by reduced energy and concentration, sleep problems (insomnia), decreased appetite and weight loss. In the elderly, it also frequently presents with excessive concerns about bodily aches and pains.

Causes, incidence, and risk factors

Detecting depression in the elderly may be complicated by several factors. Often the symptoms of depression such as fatigue, loss of appetite, and sleeping difficulties are associated with the aging process or a medical condition rather than with major depressive disorder.

Contributing factors include the loss of a spouse or close friends, chronic pain and illness, difficulty with mobility, frustration with memory loss, difficulty adapting to changing circumstances such as moving from a home to a retirement facility, or changes within the family.

Depression can also be a sign of a medical problem. It may be complicated by brain disorders associated with the aging process such as Alzheimer's disease.

Depression in the elderly is a widespread problem that is often not diagnosed and frequently undertreated. Many older individuals will not admit to signs and symptoms of depression for fear of being seen as weak or crazy.

Symptoms

• depressed or irritable mood
  
• feelings of worthlessness or sadness
  
• loss of interest or pleasure in daily activities
  
• temper, agitation
  
• change in appetite, usually a loss of appetite
  
• change in weight
  o unintentional weight loss (most frequent)
  o weight gain
  
• difficulty sleeping
  o daytime sleepiness
  o difficulty falling asleep (initial insomnia)
  o multiple awakenings through the night (middle insomnia)
  o early morning awakening (terminal insomnia)
  
• fatigue (tiredness or weariness)
  
• difficulty concentrating
  
• memory loss
  
• abnormal thoughts, excessive or inappropriate guilt
  
• excessively irresponsible behavior pattern
  
• abnormal thoughts about death
  
• thoughts about suicide
  
• plans to commit suicide or actual suicide attempts
  

If these symptoms are present every day for more than 2 weeks, then depression is likely present.