Depression is not a normal part of aging, but unfortunately, it is very common in the elderly. The Mood Disorders Society of Canada advises that for seniors living in the community the incidence of depression is around 5-10%. For seniors in institutionalized settings the incidence rate of depression jumps to 30-40% . Depression tends to last longer in elderly adults, and depression in later life frequently coexists with other medical illnesses and disabilities. In addition, advancing age is often accompanied by loss of key social support systems due to the death of a spouse or siblings, retirement and/or relocation of residence. Because of their change in circumstances and the fact that they’re expected to slow down, doctors and family may miss the diagnosis of depression in elderly people, delaying effective treatment. As a result, many seniors find themselves having to cope with symptoms that could otherwise be easily treated.

There are certain risk factors that increase the risk of depression in the elderly. They include: Being female, unmarried (especially if widowed), stressful life events, and lack of a supportive social network. Having physical conditions like stroke, hypertension, atrial fibrillation, diabetes, cancer and dementia further increases that risk. While depression may be an effect of certain health problems, it can also increase a person’s risk of developing other illnesses—primarily those affecting the immune system, like infections. Other factors that can contribute to depression in the elderly are:

•    Taking certain medicines or combination of medicines
•    Other illnesses
•    Living alone/social isolation
•    Recent bereavement
•    Presence of chronic or severe pain
•    Damage to body image (from amputation, cancer surgery, or heart attack)
•    Fear of death
•    Previous history of depression
•    Family history of major depressive disorder
•    Past suicide attempt(s)
•    Substance abuse

When elders experience depression they also double their risk to develop cardiac diseases and increase their risk of death from illness, while reducing their ability to rehabilitate. For this reason, making sure that an elderly person you are concerned about is evaluated and treated is important, even if the depression is mild. Depression in the elderly is more likely to lead to suicide. The risk of suicide is a serious concern among elderly patients with depression. Elderly white men are at greatest risk, with suicide rates in people aged 80 to 84 more than twice that of the general population. The National Institute of Mental Health considers depression in people age 65 and older to be a major public health problem. Again, diagnosis and treatment is critical to the health and well-being of our elder citizens.