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

Treating Geriatric Depression

­As the list of age-related physical ailments grows, so does the functional morbidity that elderly patients must live with. Functional morbidity refers to the inability to participate in the daily activities that give someone a sense of purpose and meaning, whether it's driving to the grocery store or cooking dinner [source: Fresh Air]. From there, the likelihood for becoming depressed also increases.

But elderly people may not understand that they're experiencing depression or may be hesitant to discuss it. Depression's negative social stigma may persist in their minds as a sign of weakness or instability. In that case, it's up to someone else in a patient's sphere of care -- including friends, family and healthcare providers -- to comprehend what's going on. However, as functional morbidity intensifies, that network may shrink. The loss of a spouse can be especially devastating, causing severe depression in 10 to 20 percent of widows and widowers as a significant figure is eliminated from their social networks [source: Harvard Medical Letter].

The relationship between caregivers and elderly patients can also play an important role in identifying and alleviating depression. Research estimates that up to half of all nursing home residents suffer from depression [source: Harvard Medical Letter­]. In long-term care scenarios, depression can take on a contagious quality between patients and caregivers, mutually affecting both people [source: Fresh Air]. In that case, a depressed caregiver might not be as quick to recognize depression in a patient.

­Even in professional nursing homes and long-term care facilities, the staff may not include specialists trained to spot signs of geriatric depression. Routine exams with a primary care physician can also miss the mark due to limited time and insufficient attention to mental health. Geriatric specialists, on the other hand, may take a more holistic approach when a patient comes in for a checkup. By inquiring more about an elderly patient's daily routine, outings and interactions, a geriatric specialist can assess his or her overall well-being more accurately [source: Neighmond].

With solid support networks and healthy living environments, many elderly people live out their final years happily. Although the pervasiveness of geriatric depression may be uncomfortable to confront, understanding its epidemiology and pathology in later life benefits everyone. The more steps we take to enrich elder care, the more we can reinforce the mantra that depression isn't a natural part of growing old.

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