Depression in the Elderly

Maureen Duffy’s memories of her grandmother are cloudy. Not because of time, but by a condition that cast a shadow over the woman Duffy had visited as a child.

“She was blue. Even as a child I could see it. She was very negative and just could never really find any joy in life…not even from her children or grandchildren,” Duffy recalls. “A physician diagnosed her with depression, but she was only given tranquilizers. She was not a happy person. By the time she went to a nursing home, no one wanted to visit her. It hurt my heart.”

Duffy’s story is not uncommon. According to the National Institutes of Health, of the 35 million Americans age 65 and over, about 2 million suffer from full-blown (major depressive disorder) depression and another 5 million suffer from less severe forms. In 2004, adults 65 and older accounted for 16 percent of suicides in the United States; non-Hispanic white men 85 and older have the highest suicide rate in the country.

“It is very much a serious condition that can be life-threatening. There are several risk factors that can make you more susceptible to it,” says Jair Soares, MD, chairman of the Department of Psychiatry and Behavioral Sciences at The University of Texas Medical School, part of The University of Texas Health Science Center at Houston (UTHealth) and co-director of the UT Center of Excellence on Mood Disorders. “Today, imaging also shows us that changes in the brain as we age can make a person predisposed for a type of depression called vascular depression.”

Vascular depression occurs when blood vessels leading to the brain become clogged, even to the point of stroke. The reduced blood flow impacts the cerebral nerve pathways that are involved in mood.

Risk factors for vascular depression include diabetes, high blood pressure, high cholesterol and high lipid levels. “It is just one of many physical and life changes that can increase an elderly person’s risk of depression,” Soares says.

Other risk factors include

* bereavement - mourning the loss of a spouse, family member or close friend or multiple losses of contemporaries
* loneliness and isolation that may be caused by living alone
* less social interaction or becoming a caregiver
fear of death and anxiety about aging
* job loss including retirement
* financial distress
* loss of purpose after retirement or reduced mobility
* a family history of depression
* necessary medications for other chronic conditions that can trigger depression
* Major illnesses including stroke and heart attack that can lead to depression. In fact, Soares says, 50 percent of stroke patients will develop depression

The encouraging news is that all forms of depression are highly treatable using medication and psychotherapy, Soares reassures.