Question

Why do many people believe that older adults are more likely to be depressed than younger adults? What does the evidence on prevalence rates show?

Answer 1

Ans)Depression is less prevalent among older adults than younger adults, but merits special attention because it can have serious negative consequences, including increased burden of physical illness, impaired functioning, and risk of suicide. More than half of depressed older adults had the first episode after age 60.

- The presentation of depression differs in older adults compared to younger adults. Older adults are less likely to endorse affective symptoms and more likely to display cognitive changes, somatic symptoms, and loss of interest than are younger adults.

- Factors leading to the development of late life depression likely comprise complex interactions of genetic vulnerabilities, cognitive diathesis, and age-associated neurobiological changes with the particular types of stressful events that occur more often in late life.

- A common pathway to depression in older adults, regardless of whether predisposing risks are biological, psychological, or social, may be curtailment of daily activities. Accompanying self-critical thinking may exacerbate and maintain a depressed state.

- Age-related increases in psychological strengths, and reductions in psychological vulnerabilities, offset the increasing prevalence of certain risk factors in late life. Other protective factors include higher education and socioeconomic status, good health and cognitive function, engagement in valued activities, and religious involvement.

- Depression in late life is treatable, even among older adults with dementia. Empirical evidence indicates that behavioral therapy, cognitive behavioral therapy, cognitive bibliotherapy, problem-solving therapy, brief psychodynamic therapy, and life review/reminiscence therapy are effective but too infrequently used with older adults. Specialized, evidence-based approaches have been developed for individuals with dementia and for caregivers.

- Emerging evidence supports the use of psychological and somatic interventions to prevent the onset of depression in late life, including cognitive and behavioral interventions for bereaved older adults, individuals with chronic illnesses and caregivers, and prophylactic antidepressant treatment in individuals who have had a stroke. The adequate treatment of residual symptoms following an acute depressive episode, including insomnia symptoms, may prevent relapse.