SENIOR SPOTLIGHT: Depression in later life

Maureen Wendt

Depression in later life frequently coexists with other medical illnesses and disabilities. Factors that increase the risk of depression in these adults include: Being female, unmarried (especially if widowed), stressful life events (including the COVID-19 emergency) and lack of a supportive social network. Having physical conditions like stroke, cancer and dementia further increases that risk.

While depression may be an effect of certain health problems, it can also increase a person's risk of developing other illnesses — primarily those affecting the immune system, like infections.

Here are some facts about depression in older adults.

— Late life depression affects about 6 million Americans aged 65 and older, but only 10% receive treatment.

— Clinical depression can be triggered by long-term illnesses that are common in later life, such as diabetes, stroke, heart disease, cancer, chronic lung disease, Alzheimer's disease, Parkinson's disease and arthritis.

— Older adults with depression are more likely to commit suicide than are younger people with depression. Individuals aged 65 and older account for 19% of all deaths by suicide.

— Older patients with significant symptoms of depression have roughly 50% higher healthcare costs than non-depressed seniors. (The direct and indirect cost of depression in all ages is estimated to be nearly $44 billion a year.)

— Recent research shows that elderly women who have a vitamin B-12 deficiency are twice as likely to be severely depressed as those without this deficiency.

— People who are depressed often have poor eating habits, so it is difficult to determine whether the vitamin deficiency is a cause or result of depression.

Depression tends to last longer in elderly adults and increases the risk of death. Studies of nursing home patients with physical illnesses have shown that the presence of depression substantially increased the likelihood of death from those illnesses. Depression also has been associated with increased risk of death following a heart attack.

Making sure that an older person you are concerned about is evaluated and treated is important, even if the depression is mild. Because they're expected to slow down, doctors and family may miss the diagnosis of depression in elderly people, delaying effective treatment. As a result, many seniors find themselves having to cope with symptoms that could otherwise be easily treated.

Risk factors for depression that are often seen in the adults include: certain medicines or combination of medicines; other illnesses; living alone / social isolation; recent bereavement; presence of chronic or severe pain; damage to body image from amputation, cancer surgery, or heart attack; fear of death; previous history of depression; family history of major depressive disorder; past suicide attempt(s); and substance abuse.

There are several treatment options available for depression. In many cases, a combination of treatments is most successful. Most depressed people find that support from family and friends, involvement in self-help and support groups, and psychotherapy are very helpful.

Psychotherapy is a method of treatment that relies on a unique relationship between a therapist and his or her patient. The goal is to discuss issues and problems in order to eliminate or control troubling and painful symptoms, helping the patient return to normal functioning. It also can be used to help a person overcome a specific problem or to stimulate overall emotional growth and healing.

In regularly scheduled sessions, usually about 45 minutes in length, a patient works with a therapist to identify, learn to manage, and ultimately overcome emotional and behavioral problems. During the COVID-19 emergency, therapy sessions are available via TeleHealth, allowing you to get help while still at home.

The use of psychotherapy in older adults is especially beneficial because of the broad range of functional and social consequences of depression in this age group. Many doctors recommend the use of psychotherapy in combination with antidepressant medicines.

During the COVID- 19 crisis, people are being pushed to even more stressful levels. The Dale Association is a great resource for the community, including older adults and adults of all ages. If you think therapy could benefit you, please call 693-9961 to schedule an appointment.

Maureen A. Wendt is president and CEO of The Dale Association, a non-profit organization that provides senior, mental health, in-home care, caregiver support services and enrichment activities for adults. For more information, call 433-1937 or visit www.daleassociation.com .

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