Why Depression in Later Life is Often Overlooked

By Jane Farrell

Depression can occur at any age, but it’s often overlooked in adults 65 and older—a population that is expected to soar to 72 million by the year 2030.

In her new book Depression in Later Life: An Essential Guide, Dr. Deborah Serani says depression affects an estimated 15 percent of Americans aged 65 and older, but the mood disorder is often mistaken for normal signs of aging, and many seniors can experience symptoms of depression but not meet the clinical diagnosis.

“Given their advanced age, many mistake this mood disorder for other conditions associated with getting older, like memory loss, muscle or joint weakness, or side effects from medication,” Serani says. “As a result, upwards of 90 percent of seniors living with depression don’t receive adequate care, and 78 percent don’t receive any treatment at all.”

Another startling factor is that seniors have the highest death by suicide rate—according to a 2010 Centers for Disease Control and Prevention report, the rate of late-life suicide is 14.3 per 100,000. Put another way, a senior dies by suicide every 97 minutes. And one out of every two suicide attempts by seniors succeeds, compared to one out of 200 for those under age 25.

Recognizing suicide risk in seniors can be difficult, but getting treatment is essential in living a fuller life in later years. Serani points out five main domains that raise the risk of suicide in later life: major psychiatric illness, personality traits and coping styles, physical illness and pain, social disconnectedness, and functional impairment (not being able to physically take care of oneself).

“Depression and confusion is not a normal part of aging. Caregivers need to know the warning signs, because by the time an older adult or loved one is in the throes of depression, they may not have the means to get the help that they need,” says Serani. “The more we know, the more we can prevent it.”

Some warning signs to look out for include agitation, loss of happiness in things that were once pleasurable, apathy, decreased ability to care for oneself, the feeling of being a burden or being hopeless, loss of self-confidence, and increased anxiety, among others.

Depression can also have physical symptoms like excessive aches and pains, increase or decrease in appetite or weight, increase or decrease in sleeping, slowness in movements or gait, and vascular changes in the brain or body. Cognitive symptoms include distractibility, foggy thinking, indecisiveness, memory loss, negative thinking, and thoughts of death or suicide.

“Depression in seniors is differently experienced than in younger ages,” says Serani. “Most older adults aren’t aware they are depressed, and often report more physical and cognitive difficulties than sadness, per se.”

But living with depression in later life doesn’t mean that you can’t still live a full life, says Serani.

“If you think having depression in later life means the last chapter of your life will be limited, think again,” she says. “Although there will be many seniors whose level of depression will impair their quality of life, there will be many more who can recover. What science says about living well in spite of having a chronic illness like depression is this one simple word: perspective.”