SENIOR SPOTLIGHT: Study links depression and physical decline

Maureen Wendt

Depression is not a normal part of aging.

Growing older certainly involves a variety of life stressors that can lead to depression. Some people have trouble making the transition from full time productive careers to retirement. Others have been forced to retire because of chronic health problems or disability. For some, the loss of a loved one, or serious illness in a lifelong friend, or in your spouse, can add tremendous care giving responsibilities and also create much sadness. Lack of mobility, due either to physical illness or loss of driving privileges, can result in social isolation and loneliness. All these factors can lead to depression.

Successful treatment of depression not only improves older adults' emotional health, it also helps them perform daily activities such as remembering to take medications, according to a study published in the Journal of the American Geriatrics Society. This is the first report indicating that successful treatment of depression in older adults also improves their ability to perform tasks critical to independent living — like keeping track of medications or managing money. Prior clinical tests of successful treatment of depression in this age group reported improvement in emotional functioning, but had not demonstrated that improved emotional health also translated into improved physical health. Older adults with depression report persistent greater functional impairment than those without depression.

This study is important for two reasons. First, even older adults with failing physical health can be successfully treated for depression. Second, it shows that treating depression also slows physical decline.

Study participants were placed randomly in two groups. One group received standard care for depression from their primary care physician. A depression clinical specialist as well as the patient's primary care physician co-managed depression treatment for those in the second group. In both groups, patients whose depression improved were more likely to experience improvement in physical functioning than patients whose depression was not successfully treated. Depression was more likely to improve in those who received treatment by collaborative care management than those who had usual care.

The study followed 1,801 patients age 60 and older with major depressive symptoms for 12 months. This is the largest clinical trial of late life-depression reported to date. The study authors concluded that patients with late-life depression often experience a downward spiral of worsening depression and functioning. Effective treatment of late-life depression may interrupt this downward spiral.

Many people think that depression will go away by itself, or that they're too old to get help or that getting help is a sign of weakness or moral failing. Such views are simply wrong. Depression is a treatable disorder. Even the most seriously depressed people can be treated successfully and return to a happy and more fulfilling life. The Dale Association can assist.

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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