Why is the diagnosis of depression in the elderly often overlooked?

Elderly white men have twice the suicide rate of the general population.
Elderly white men have twice the suicide rate of the general population.


­The resounding mantra of geriatric psychology is that depression isn't a natural part of aging. Granted, growing old brings with it a host of difficult scenarios, including physical disabilities, loss of family and friends, greater dependence on others and so on. A common byproduct of those complications is depression, and 15 out of 100 adults more than 65 years old in the United States suffer from it [source: Geriatric Mental Health Foundation]. But depression isn't something that must go hand in hand with aging. Moreover, when depression in the elderly is recognized and treated, patients have an 80 percent recovery rate [source: Geriatric Mental Health Foundation].

For anyone battling depression, the daily struggle it presents can be debilitating. Associated behaviors include loss of appetite, withdrawal and insomnia. Among the elderly in particular, depression can lead to and aggravate physical illnesses. It's also the leading cause of suicide. The link between geriatric depression and suicide figures most prominently in white men over the age of 80; this cohort has twice the suicide rate of the general population. Severe depression left untreated isn't happening for lack of medical care. Seventy percent of the elderly who commit suicide have visited a primary care physician within the past month [source: Breitung]. Perhaps, as the statistic implies, doctors are failing to recognize and address depressive symptoms.

­Identifying depression in the elderly (people 65 years of age and older) is easier said than done. Clinical depression is one of the most common medical illnesses in the world, but it can prove far more elusive in older people. For one thing, the physical and cognitive ailments that may affect an older person can mask depressive symptoms. In addition, older patients may be more hesitant to seek treatment for depression because of a negative social stigma or simply having no one to talk to about it. Consequently, caregivers and healthcare providers often overlook it.

In 2011, the oldest of the 78 million baby boomers will turn 65. The healthcare industry is bracing for that milestone when the elderly population in the United States will swell. If one in five faces geriatric depression, as with today's elderly, it will have a devastating effect not only on the older community but also on the caregivers and the healthcare system as a whole. But in order to reduce that high incidence rate, we must first understand depression's unique manifestations in older patients.