Depression Among the Elderly

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Introduction

One common stereotype of growing older is that there is a high chance of becoming depressed. This stereotype has fostered the exploration of depression as a natural aspect of aging and how depression and age are related. During the past decade, there have been significant research findings concerning depression in the aging and the aged. Psychologist are aiming to find answers to numerous of questions concerning depression in the aging which is such a major public health concern. New research findings have suggested that depression in late life occurs in the context of numerous social, physical, and related disability problems.

Influence of Aging on Depression

One study on the influence of aging on depression was done by Baqar Husaini (1997), who studied the predictors of depression among the elderly with a focus on racial differences over time. The study administered compared 600 white and 600 black elderly people over a period of 18 months. Findings from this study suggest that there are no racial differences in levels of depression that exist amount the older adults. However, there were similar factors associated with depression between the two different races of aging adults. There was no evidence found that depression comes as a natural part of aging. There are certain factors that foster the onset of depression which so happen to occur during many stages of life, and commonly occur during the later stages of life. However these predictors could happen during middle adult life too. The depressive symptoms that were found relate to lower levels of social support, accumulation of chronic medical disorders, general stress, and the number of stressful life events experienced by the elderly (Husaini, 1997).

New research findings related to the topic of influence of aging on depression, suggests that growing old does not in fact increase the risk for depression. Other researchers have found valid information that further the investigation of what factors of aging are related to being depressed. Roberts et al (1997) examined whether growing old increases the risk for depression. To investigate the effect of aging on rates of depression accurately, the authors collected two forms of data from community residents 50 years old and older. The panel study contained 12 variables that ranged in categories of biological and social factors (i.e., age, gender, education, marital status, financial strain, chronic medical conditions, functional impairment, cognitive problems, life events, neighborhood problems, social isolation, and social support). These factors measured the depression of the subjects by using the DSM-IV diagnostic criteria for major depressive episodes (Roberts et al., 1997). There was no significant age related effects on depression found. The results show that "gender, chronic health conditions, problems with activities of daily living, cognitive problems, neighborhood problems, and social isolation were predictors of depression" (Roberts et al., 1997). Thus, Roberts et al. concluded that what seem to be age-related effects on depression are only attributable to physical health problems, social factors, and related disability problems.

Yet, another research finding on the influence of aging on depression was studied by Hughes et al (1993). The authors' hypothesis was whether age makes a difference in the effects of physical health and social support on the outcome of a major depressive episode (Hughes et al., 1993). Two groups of subjects were studied: 67 patients who were less than 60 years old and 46 patients who were 60 years old or older. They administered a face-to-face interview and then a follow-up interview over the telephone after 6 months. The interviews were studied by Hughes et al. (1993) with finding data on their patients physical health and social support influences. The results of this research showed a similarity of the two age groups. The authors found as that the mean illness index score of the older patients was slightly higher and their mean impaired subjective social support score was slightly lower than the younger patients (Hughes et al., 1993). Thus, their findings show that the illness index (physical health) and impaired subjective support (social support) measures were significant predictors of depressive symptoms in the elderly.

Also, contributing to new studies done on a related topic of the influence of aging on depression were Alexpoulos et al. (1997). The authors goal was to examine the clinical presentation of a group of depressed elderly patients with clinically defined risk factors for vascular depression compared with a group of elderly depressed patients without such risk factors (Alexpoulos et al., 1997). A previous study by these authors proposed that late-onset depression encompasses a high percentage of patients with neurological brain disorders. The authors sought out to find a correlation between vascular depression and depression in the elderly due to the research found. Which shows damage that occurs in vascular depression to the basal ganglia has been associated with depression (Alexpoulos et al., 1997). Cognitive deficits, disability, and depressive symptoms were examined in 33 elderly patients with vascular depression and 32 patients with nonvascular depression, all of whom were depressed in old age. The results of their study show no correlation between the two groups of patients. The study does not establish a causative relationship between vascular disease and late-onset depression (Alexpoulos et al., 1997). However, the authors found that a way to receive a causitive relationship (which may prove relevant for treatment decisions for elderly who are depressed) would be by the demonstration of distinct lesions on the striato-pallido-thalamo-cortical pathways and meaningful differences between patients with vascular and nonvascular depression treatment responses (Alexpoulous et al. 1997).

Conclusion

Studies on the elderly and depression have brought forth new and substantial information. This research has found a number of factors that influence depression throughout the aging process. These factors are no longer found to be age-related as in past research. The research presented demonstrates that depression in late life occurs in the context of numerous social support issues, stressful life events, and physical problems. There is still continuous research going on to answer the many questions and hypothesis psychologists have of depression in elderly people since it is such a major public health concern.

References

Alexopoulos, M.D., George S., Meyers, M.D., Barnett S., Young, M.D., Robert C., Kakuma, Ph.D., Tatsu, Silbersweig, M.D., David, & Charlson, M.D., Mary. (1997). Clinically Defined vascular Depression. American Journal Of Psychiatry, 154(3), 562-565.

Hughes, R.N., Ph.D., Dana C., DeMaillie, M.D., Diane, & Blazer, M.D., Ph.D., Dan G. (1993). Does Age Make a Difference in the Effects of Physical Health and Social Support on the Outcome of a Major Depressive Episode? American Journal of Psychiatry, 150(5), 728-733.

Husaini, Ph.D., Baqar A. (1997). Predictors of Depression Amoung the Elderly: Racial Differences Over Time. American Orthopsychiatric Association. 67(1), 48-58.

Roberts, Ph.D., Robert E., Kaplan, Ph.D., George A., Shema, M.S., Sarah J., & Strawbridge, Ph.D., William J. (1997). American Journal of Psychiatry, 154(10), 1384-1390.

Web Resources

Diagnosis and Treatment of Depression in Late Life (from National Institutes of Health)

Depression in Elderly Emergency Department Patients

New Treatment for Depression in Elders Good News


Contributed by Sarah Snyder, December 2, 1997.

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