Facts about Depression in Older Adults

Depression is NOT a normal part of aging.

An estimated 20% of older adults in the community and as many as 50% in nursing homes suffer from depression.

Older Americans have the highest suicide rate of any age group, and depression is its foremost risk factor. Although older adults comprise only 13% of the population, they account for 20% of the suicide deaths in our country.

Depression in older adults not only causes distress and suffering but also leads to impairments in physical, mental, and social functioning.

Because depression tends to be a recurrent disorder, many older adults will have experienced previous bouts of depression and will be at increased risk.

Risk factors for late-onset depression include: widowhood, physical problems, educational attainment less than high school, impaired functional status, and heavy alcohol consumption.

Depressed older adults tend to utilize health services at high rates, engage in poorer health behaviors, and evidence what is known as "excess disability."

There are a variety of well-established treatments for geriatric depression, including psychotherapy, psychosocial interventions, and/or pharmacological interventions.

Research suggests that 83% of older adults want to be treated for their depression.

A variety of barriers reduces the accessibility of older adults to appropriate treatment of depression, including the lack of parity for mental health services in private insurance and Medicare, poor diagnosis and referral services in primary care, and an insufficient geriatric mental health workforce.

Psychological Treatment of Depression in Older Adults

Research suggests that older adults who are given thorough descriptions of interventions state a preference for receiving psychologically based treatments.

A variety of well established psychological interventions for depression exist, including:

Interpersonal Therapy focuses on role disputes, role transitions and interpersonal deficits. It can be especially meaningful for older adults given the multiple losses, role changes, social isolation, and helplessness associated with late-life depression.

Problem Solving Therapy postulates that deficiencies in social problem solving skills increase the risk for depression and other disorders. By improving these skills, individuals are given the tools to be able to cope with stressors, thereby reducing symptoms of depression.

Brief Psychodynamic Therapy focuses on the resolution of interpersonal conflicts, adaptation to loss and stress, and reconciliation of personal accomplishments and disappointments.

Reminiscence Psychotherapy is an intervention developed specifically for older adults based on the premise that reflection upon significant positive and negative life experiences enables the individual to overcome feelings of depression and despair.

American Psychological Association, September 2003