Depression in Older Adults: What You Need to Know
Depression is not a normal part of aging, but it’s more common among older adults than many realize. Here we discuss risk factors, symptoms and treatment for depression in older adults.
GERIATRICSOLDER ADULTSMENTAL HEALTHDEPRESSION
Dushani L. Palliyaguru, Ph.D.
1/16/20252 min read
Depression is not a normal part of aging, but it’s more common among older adults than many realize. As people age, they may experience losses—whether it’s loved ones, health, or independence—which can increase their vulnerability to depression. Many adults aged 65 and older experience mental health disorders, including depression, but this number may be even higher due to underreporting.
Depression can be mistaken for other conditions common in later life, such as dementia or physical illnesses. Many older adults and even healthcare providers may dismiss symptoms as “just getting old” or confuse them with the natural emotional responses to life changes. In fact, depression is a major risk factor and co-morbidity for aging-related cognitive decline and dementia. Depression is a real medical condition that goes beyond feelings of sadness or grief. It’s a persistent, overwhelming feeling of hopelessness, worthlessness, or loss of interest in activities that once brought joy.
Conditions like heart disease, diabetes, chronic pain, hearing and vision loss are linked with depression. The brain and body are connected, so physical health issues can trigger mental health challenges. As friends and loved ones pass away or become geographically distant, many older adults experience loneliness, a key risk factor for depression. Physical limitations and frailty that can impact mobility and movement can also lead to depression via social isolation. Memory loss or early signs of dementia can worsen depression. The emotional toll of struggling with cognitive abilities can compound feelings of sadness or frustration. Certain medications taken for chronic conditions may cause depressive symptoms, including blood pressure drugs, steroids, and even pain relievers. Some of these medications can lead to hypotension, sedation, impaired attention, movement disorders and even cardiac toxicity. Untreated depression and use of antidepressants can also increase the risk of falls in older adults.
Symptoms of depression in older adults can manifest differently from those in younger people. Common signs include persistent sadness or anxiety, difficulty concentrating or making decisions, fatigue or lack of energy, changes in sleep patterns (too much or too little), appetite changes and unexplained weight loss or gain, complaints on aches or pains with no clear physical cause, loss of interest in activities or social interactions. Unfortunately, many of these symptoms are general and may be misinterpreted or mistaken for other conditions leading to underdiagnoses.
Depression is highly treatable at any age. Several therapeutic options exist for treating depression in older adults. Pharmacological treatments might be less effective in older adults with depression compared to younger patients but is still prescribed. Second-generation antidepressants such as Selective Serotonin Reuptake Inhibitors (SSRIs) are considered as the first-line treatment option. Antidepressants can help restore chemical balances in the brain. Older adults may require different doses due to slower metabolism and interactions with other medications.
Cognitive-behavioral therapy (CBT) is effective in helping people reframe negative thoughts and cope with stressors. Specific types of psychotherapy approaches used in geriatric depression including methods such as Problem Adaption Therapy (PATH) – a home-delivered psychosocial intervention helping with emotional regulation and Problem Solving Therapy (PST) – an 8-week, 7-step process to solve problems consisting of planning and implementation. Lifestyle interventions play an important role in preventing and managing depression in older adults. Regular physical activity boosts mood by increasing serotonin and endorphin levels, improving overall well-being. Encouraging older adults to maintain social networks, engage in hobbies, or join community groups can help reduce isolation.
Depression is not an inevitable part of aging. Recognizing the signs and seeking timely intervention can dramatically improve the quality of life for older adults. It’s important for families, caregivers, and healthcare providers to be vigilant and supportive in helping older adults maintain both their physical and mental health.
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