The Canadian Psychological Association’s fact sheet on Depression lists the symptoms of depression, many of which are also experienced by depressed older adults. Those symptoms of depression most common in older adults are loss of energy, decreased interest and pleasure in activity, pain and bodily complaints, and complaints of memory problems.

 

 

Although depression is not necessarily associated with aging and older age, a significant number of seniors do experience depression. About 15-20% of older persons, living independently in the community, experience clinical levels of depression.

 

There is a higher rate of depression among patients with serious medical problems (25%). Approximately 25% of older persons with Alzheimer’s disease will struggle with depression in the early phase of the disease.

 

Further, among older adults living in nursing homes and residential settings, the rate of depression is even higher (30% to 50%). In addition, between 25% and 50% of older adults who care for a family member with dementia will experience depression.

 

 

Depression worsens an older person’s experience of medical problems and makes it harder for them to recover from problems such as hip fracture and stroke. People are less active and independent when depressed which, for the older adult, can lead to declines in physical condition and more disability.

 

Depression increases the risk of death in older adults by 2 to 3 times and is the most important factor associated with suicide in old age.

 

 

Depression can be hard to detect in older adults because older adults are often reluctant to admit to psychological symptoms or difficulties and are more likely to report physical symptoms.

 

Also, the myth that it is normal for older adults to feel some amount of depression may result in true cases of clinical depression being overlooked.

 

 

Some depressed older adults will have experienced depression before and others will face depression for the first time in their later years. The factors that put people at risk for depression in later life are the same as those for adults in general.

 

The factors that seem to particularly trigger depression in older adults are loss of control and independence as the result of illness and/or disability, social isolation, and lack of social support.

 

 

Psychological treatments used with younger adults have been found effective with older adults as well. In particular, cognitive behaviour therapy, interpersonal therapy, problem-solving therapy and reminiscence therapy are effective treatments.

 

Cognitive-behaviour therapy helps clients understand the interactions among thoughts, feelings and behaviour and how negative ways of thinking affect behaviour and mood – thereby causing or maintaining depression.

 

Interpersonal therapy helps clients work through depression by focusing on current stresses and challenges in interpersonal relationships – these can include conflicts with other people, grief following a loss, changes in roles and activity, and a lack of social support.

 

Problem-solving therapy helps the depressed person cope with current difficulties, such as managing a health condition or adjusting to living in a nursing home, by developing effective problem-solving skills.

 

Reminiscence therapy helps clients work through depression by revisiting past and pleasant times, rediscovering coping skills, and finding meaning by re-evaluating good and bad aspects of their lives.

 

These psychological treatments are safe and effective alternatives to drug therapy for mild to moderate depression. Combined drug and psychological treatment is usually recommended for severe depression.

 

However, research does not conclusively show that the combination of treatments works better than either drug treatment or psychological treatment alone.

 

Psychological treatments are of particular importance for people who are unable to, or uninterested in, taking medications.

 

 

More information on depression in older adults, including more detailed descriptions of psychological treatments and other supports, can be found at http://www.therapyadvisor.com.

You can consult with a registered psychologist to find out if psychological interventions might be of help to you. Provincial, territorial and some municipal associations of psychology often maintain referral services. For the names and coordinates of provincial and territorial associations of psychology, visit http://www.cpa.ca/public/provincialandterritorialassociations. The Canadian Register of Health Service Providers in Psychology also has a listing service and can be reached through http://www.crhspp.ca.

This fact sheet has been prepared for the Canadian Psychological Association in cooperation with the Canadian Coalition for Seniors Mental Health by Dr. Philippe Cappeliez, Professor, School of Psychology, University of Ottawa.

Revised: January 2009