Navigate Up

Cancer Center - A-Z Index

#
Q
Y

Print This Page

Depression - elderly

Depression is a medical illness in which a person has persistent feelings of sadness ,often with discouragement and a lack of self-worth.

Depression in the elderly is a widespread problem, but it is not a normal part of aging. It is often not recognized or treated.

Causes, incidence, and risk factors

In the elderly, a number of life changes can increase the risk for depression, or make existing depression worse. Some of these changes are:

  • A move from home, such as to a retirement facility
  • Chronic illness or pain
  • Children moving away
  • Spouse or close friends passing away
  • Loss of independence (for example, problems getting around or caring for oneself)

Depression can also be related to a physical illness, such as:

  • Thyroid disorders
  • Parkinson's disease
  • Heart disease
  • Cancer
  • Stroke
  • Dementia (such as Alzheimer's disease)

Overuse of alcohol or certain medications (such as sleep aids) can make depression worse.

Symptoms

Many of the usual symptoms of depression may be seen. However, depression in the elderly may be hard to detect. Common symptoms such as fatigue, appetite loss, and trouble sleeping can be part of the aging process or a physical illness. As a result, early depression may be ignored, or confused with other conditions that are common in the elderly.

Signs and tests

The doctor or nurse will examine you and ask questions about your medical history and symptoms.

Blood and urine tests may be done to look for a physical illness.

You may be referred to a mental health specialist to help with diagnosis and treatment.

Treatment

The first steps of treatment are to:

  • Treat any illness that may be causing the symptoms
  • Stop taking any medications that may be making symptoms worse
  • Avoid alcohol and sleep aids

If these steps do not help, medications to treat depression and talk therapy often help.

Doctors often prescribe lower doses of antidepressants to older people, and increase the dose more slowly than in younger adults.

To better manage depression at home, you should:

  • Exercise regularly, if your doctor says it is ok.
  • Surround yourself with caring, positive people and fun activities.
  • Learn good sleeping habits.
  • Learn to watch for the early signs of depression, and know how to react if these occur.
  • Drink less alcohol and do not use illegal drugs.
  • Talk about your feelings with someone you trust.
  • Take medications correctly and discuss any side effects with your doctor.

Expectations (prognosis)

Depression often responds to treatment. The outcome is usually better for people who have access to social services, family, and friends who can help them stay active and engaged.

The most worrisome complication of depression is suicide.

Men make up most suicides among the elderly. Divorced or widowed men are at the highest risk.

Families should pay close attention to elderly relatives who are depressed and live alone.

Calling your health care provider

Call your health care provider if you feel persistently sad, worthless, or hopeless, or if you cry often. Also call if you are having trouble coping with stresses in your life and want to be referred for talk therapy.

Go to the nearest emergency room or call your local emergency number (such as 911) if you are thinking about suicide (taking your own life).

If you are caring for an aging family member and think they may have depression, contact their health care provider.

References

Cassano P, Fava M. Mood disorders: major depressive disorder and dysthymic disorder. In: Stern TA, Rosenbaum JF, Fava M, Biederman J, Rauch SL, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 1st ed. Philadelphia, Pa: Mosby Elsevier;2008:chap 29.

Unutzer J. Clinical practice: late-life depression. N Engl J Med. 2007;357:2269-2276.

Updated: 9/17/2012

David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc. David B. Merrill, MD, Assistant Clinical Professor of Psychiatry, Department of Psychiatry, Columbia University Medical Center, New York, NY.


©  UPMC | Affiliated with the University of Pittsburgh Schools of the Health Sciences
Supplemental content provided by A.D.A.M. Health Solutions. All rights reserved.

For help in finding a doctor or health service that suits your needs, call the UPMC Referral Service at 412-647-UPMC (8762) or 1-800-533-UPMC (8762). Select option 1.

UPMC is an equal opportunity employer. UPMC policy prohibits discrimination or harassment on the basis of race, color, religion, ancestry, national origin, age, sex, genetics, sexual orientation, marital status, familial status, disability, veteran status, or any other legally protected group status. Further, UPMC will continue to support and promote equal employment opportunity, human dignity, and racial, ethnic, and cultural diversity. This policy applies to admissions, employment, and access to and treatment in UPMC programs and activities. This commitment is made by UPMC in accordance with federal, state, and/or local laws and regulations.

Medical information made available on UPMC.com is not intended to be used as a substitute for professional medical advice, diagnosis, or treatment. You should not rely entirely on this information for your health care needs. Ask your own doctor or health care provider any specific medical questions that you have. Further, UPMC.com is not a tool to be used in the case of an emergency. If an emergency arises, you should seek appropriate emergency medical services.

For UPMC Mercy Patients: As a Catholic hospital, UPMC Mercy abides by the Ethical and Religious Directives for Catholic Health Care Services, as determined by the United States Conference of Catholic Bishops. As such, UPMC Mercy neither endorses nor provides medical practices and/or procedures that contradict the moral teachings of the Roman Catholic Church.

© UPMC
Pittsburgh, PA, USA UPMC.com