Depression is a disorder that many older adults deal with at some point in their lives. More than 15% of older adults suffer from either major depression or some depressive symptoms, and depression has been associated with increased morbidity and increased risk of death (Huang et. al, 2000). Older adults also have a high risk of suicide, making up 20% of the United States' suicides in 1992, a number which increased steadily from 1980-1990 (O'Donnell, 2005). Since one of the symptoms of depression is thoughts of suicide, many of these elderly people who committed suicide probably suffered from depression. Various reasons have been found as to why there is such a high instance of depression in the elderly.
Many studies have been completed to connect depression to vision loss in the elderly. O'Donnell (2005) examined various researches that have looked into this topic. About one-fourth of older adults suffer from some kind of vision impairment, which results in these adults becoming more dependent on others for everyday tasks. The main reasons that older adults suffer from depression is because of a loss of meaningful roles, decrease in functioning, and experiencing a decline in social contacts. All of these occur when a person loses their vision, making it more likely for the adult to become depressed. With vision loss comes a fear of dependence, and results in more difficulty in completing activities of daily living. Another problem that occurs is no longer being able to read and drive. Both of these things connect a person to their social community. This lack of time spent with friends may cause a person to experience depression. People with vision loss are not as likely to attend church, movies, or go out to a restaurant compared to those who have not lost vision. Therefore, because of a fear of dependence, loss of functional ability, and social isolation, an elderly person is more likely to suffer from depression when vision declines or is lost.
Older adults have an increased risk of hospitalization compared to the younger population. Huang et al (2000) conducted a study to determine if depression in older adults is associated with increased risk for hospitalization. This study was carried out with a sample of 3,486 adults aged 65 and older. Participants completed a baseline interview and the researcher studied how much a person was hospitalized during the 6 months following this interview. The participants' depression symptoms were then measured and compared to their hospitalization records. The study found that depressive symptoms were highly associated with increased hospitalization. This means that in the sample, the people with depression suffered from poorer health and more physical disability. It was also found that the group with the most significant correlation was men aged 75 or older. This is emphasized by the fact that the age group containing the oldest men has the highest rate of suicide, which is many times a consequence of depression. Therefore, the researchers determined that depression is correlated with an increase in hospitalization. However, because of how the study was done they were not able to determine if depression caused the hospitalization or if the hospitalization caused depression.
Older adults also tend to deal with many physical disability problems. Pennix et al. (1999) conducted a study to determine if depression affects the extent of physical disability a person suffers. A sample of 6,247 participants aged 65 years and older was studied. This sample excluded people who had shown disability at baseline in order to illustrate the relationship between depression and physical disability more clearly. The participants were followed up to six years, and their disabilities were noted, then the disability of depressed participants was compared to those of nondepressed participants. This research determined that depression significantly increases the risk for disability in previously nondisabled people. Depression increased the risk of activities of daily living disability by 67% and increased the risk of mobility disability by 73%. These finding can be explained in several ways, but one of the prominent reasons is that people suffering from depression are less likely to have social contacts. Social support is a way for older adults to do activities that help them to achieve better physical ability. Since depressed older adults do not have the social support, they do not participate in these activities, which results in an increase in disability. Depression can also be linked to poorer health habits, which causes a decrease in physical ability. Therefore, this study determined that depression increases the risk of physical disability in older adults.
A problem that many people face as they age is ageism, which is discrimination for or against an age group. As people get older, they tend to experience more and more negative ageism and this is especially true for women. Saucier (2004) focused on this issue and says that a huge aspect of society today concentrates on women needing to retain their youthful looks, and when this is not accomplished it can result in depression. There is so much of a concern over physical appearance that most women in their adult years are on a diet, and a majority of fourth grade girls are also dieting. Women constantly try to make their bodies conform to society's standards, which becomes more and more difficult to accomplish as the person ages. It has been found that as women age and society no longer sees them as desirable, they have to regain their identity, and this struggle often leads to depression. These points show how ageism can lead to depression in old age, especially for women.
According to the research that has been done, depression is prevalent in the older population and can result in many negative consequences. Depression can be the result of physical disability that becomes more prevalent in old age, such as loss of vision which leads to fewer social contacts and more dependence. However, depression can also be the cause of these disabilities. The greatest influence on depression and physical ability seems to be social support, because without it, an older adult is more likely to experience both depression and physical disability. One problem in late life is dealing with Ageism, and the result of this, especially for women, can lead to depression. Women face ageism when it comes to society telling them that they are supposed to always look young, and when this begins to disappear, women may become depressed. Through these studies, it was found that depression in old age can be caused by or the cause of many different things.
Huang, B.Y., Cornoni-Huntley, J., Hays, J.C., Huntley, R.R., Galanos, A.N., & Blazer, D.G. (2000). Impact of Depressive Symptoms on Hospitalization Risk in Community-Dwelling Older Persons. Journal of American Geriatrics Society, 48(10), 1279-84.
O'Donnell, C. (2005). The Greatest Generation Meets Its Greatest Challenge: Vision Loss and Depression in Older Adults. Journal of Visual Impairment & Blindness, 99(4), 197-208.
Pennix, B.W.J.H., Leveille, S., Ferrucci, L., VanEijk, J.Th.M, & Guralnik, J.M. (1999). Exploring the Effect of Depression on Physical Disability: Longitudinal Evidence From the Established Populations for Epidemiologic Studies of the Elderly. American Journal of Public Health, 89(9), 1346-52.
Saucier, M.G. Midlife and Beyond: Issues for Aging Women. Journal of Counseling and Development, 82(4), 420-425.
National Institute of Mental Health (http://www.nimh.nih.gov/publicat/elderlydepsuicide.cfm)
Depression Community: Depression in the Elderly (http://www.healthyplace.com/communities/depression/elderly.asp)
Information and Treatment for depression (http://www.depression.com/)
Contributed by Lauren Blews, February 19, 2006.