Causes and Risks: 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 depression. 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 or organic brain syndrome. Risk factors are related to contributing factors. Depression in the elderly is a widespread problem.

Prevention: Prevention is related to the contributing factors. Social supports the help deal with losses, mobility changes, and so on can be helpful. In many cases, there is no effective prevention.

Symptoms:

• depressed or irritable mood
• loss of interest or pleasure in daily activities
• temper, agitation
• change in appetite, usually a loss of appetite
• change in weight
  • weight loss (unintentional)
  • weight gain (unintentional)
• difficulty sleeping
  • daytime sleepiness
  • difficulty falling asleep or staying asleep (insomnia)
• fatigue (tiredness or weariness)
• difficulty concentrating
• feelings of worthlessness or sadness
• memory loss
• abnormal thoughts, excessive or inappropriate guilt
• abnormal thoughts about death
• excessively irresponsible behavior pattern
• thoughts about suicide
• plans to commit suicide or actual suicide attempts

Signs and Tests:

• physical examination to rule out medical causes of depression
• psychological evaluation
• a variety of tests may be indicated

Treatment: Sometimes depression can be alleviated by social interventions to help with isolation or loneliness such as group outings, volunteer work for the healthy elderly, or regular visits from concerned people.

Treatment of underlying medical conditions or the discontinuation of certain medications may alleviate symptoms.

Antidepressant drug therapy or electroconvulsive therapy may be indicated in the severely depressed if other measures are unsuccessful. Neuroleptic medications may help treat agitation but in some individuals they make symptoms worse. Antidepressants must be carefully monitored for side effects in the elderly.

Prognosis: If detected, depression may respond to medical treatment. Undetected it may lead to complications. The outcome is usually worse for those who have limited access to social services or family or friends who can help promote an interest in activities.

Complications: Depression may cause or be complicated by Alzheimer’s disease, organic brain syndrome, dementia, or other medical conditions in the elderly.

Call your health care provider if you are feeling worthless or hopeless or you are crying frequently. Also call if you feel that you are having difficulty coping with stresses in your life and want a referral for counseling.

Go to the emergency room or call your local emergency number (such as 911) if you feel like you might end your life.