Researcher Finds Keys to Detecting Depression in Older People

Better Understanding Should Help Improve Care to Overlooked Population

April 05, 2004

"Family can either help or hinder the process of detecting depression and getting treatment for those experiencing symptoms."

The ravages of depression have proven especially devastating among the elderly because the disease has been so misunderstood in that population. Now, a researcher at the University of Rochester Medical Center has identified risk factors associated with depression and suicide in the elderly, and observed some surprising differences in the way depression manifests itself in older adults compared to children and younger adults.

The findings are important because friends, family members, and even care providers might not realize that the signs of depression in the elderly can be different. That lack of understanding is just one of several reasons older adults may not seek and receive the treatment they need, with sometimes tragic results in the case of the growing problem of geriatric suicide.

“Kids with depression will express feelings of sadness more readily, but older adults may not show or express sadness as much,” explains Paul Duberstein, PhD., associate professor of psychiatry and oncology and co-director of the Center for the Study and Prevention of Suicide.

More common signs of depression among the elderly include a lack of appetite, fatigue, and problems concentrating – the kinds of things often attributed to the aging process rather than depression. Older people with depression tend to stop doing things, says Duberstein. They might clean less or go to church less frequently. Again, friends and family might not realize the true cause of such changes in behavior.

In fact, Duberstein has launched a study to determine just how aware people are of the health and behavior changes in older adults that they know.  It’s crucial information because older adults are less likely to seek treatment for depression on their own. The stigma of seeking mental health treatment is a bigger factor in an older population, raised at a time when having a mental health problem was often synonymous with being “crazy.” Transportation problems are another issue for some, as is the lack of mental health services that are near primary care services.

“Family can either help or hinder the process of detecting depression and getting treatment for those experiencing symptoms,” says Duberstein, noting that some people have the misconception that depression simply comes with age.

Last month, Duberstein published findings in the journal Psychological Medicine based on a study conducted in the Rochester area. While researchers had linked certain mental disorders, particularly depression, to increases in suicide risk, few definitive studies had pinpointed the stressful factors that contribute to suicide risk. Duberstein found that poor health, family conflict, or money worries were the problems most likely to increase suicide risk in adults 50 years of age or older.

The findings are important for people concerned about how to keep their family members safe and also for clinicians trying to determine interventions to reduce the risk of suicide in the elderly population.

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