Depression - Ages 65+

Depression - Ages 65+ in Mississippi

Mississippi

Depression is a common mood disorder that can negatively impact health. Risk factors for depression among older adults include loneliness, isolation, loss of loved ones, financial hardship, fear of death or dying, chronic health problems and a reduced sense of purpose brought on by major life changes, such as retirement. Depression in older adults may also be a side effect of certain medications. If left untreated, depression may lead to:

• Decreased physical, cognitive and executive functioning.
• Diminished health-related quality of life.
• Higher use of primary health care services.
• Suicide. 

Depression is associated with significant direct and indirect societal costs stemming from increased use of health care services, social services and medications, as well as unpaid caregiver costs, lost workplace and household productivity and possibly suicide-related costs. One study estimated that total inpatient and outpatient medical costs were 47% to 51% higher among older adults with major depression than among those without depression — even after adjustment for chronic illness, as late-life depression frequently occurs in the context of chronic disease. 

Estimating the true prevalence of depression among older adults is challenging. For example, older adults may assume depression and depressive symptoms are an inevitable part of aging, while others are isolated with few people around to recognize depressive symptoms.

The prevalence of depression is higher among:

• Older women than older men.
• Older adults who are multiracial compared with those who are Asian. American Indian/Alaska Native, Hispanic and white older adults also had a high prevalence.
• Older adults with less than a high school education compared with college graduates. Those with some post-high school education also had a high prevalence.
• Older adults with an annual household income less than $25,000 compared with those with incomes of $75,000 or more.

Hospital patients and residents of long-term care facilities also have higher rates of depression.

Depressive disorders are treatable. Many older adults experience improvements in their depressive symptoms when treated with psychotherapy or antidepressant drugs. If an older adult thinks they have depression, the first step is to discuss it with their medical provider. The Centers for Disease Control and Prevention published a brief highlighting several evidence-based programs and web resources that communities can use to address depression among older adults. The National Institute of Mental Health also recommends several treatment options for older individuals with depression.

Centers for Disease Control and Prevention, and National Association of Chronic Disease Directors. 2009. “Issue Brief 2: Addressing Depression in Older Adults: Selected Evidence-Based Programs.” The State of Mental Health and Aging in America. Atlanta, GA: National Association of Chronic Disease Directors. https://www.cdc.gov/aging/pdf/mental_health_brief_2.pdf.

Donovan, Nancy J., Qiong Wu, Dorene M. Rentz, Reisa A. Sperling, Gad A. Marshall, and M. Maria Glymour. 2017. “Loneliness, Depression and Cognitive Function in Older U.S. Adults: Loneliness, Depression and Cognition.” International Journal of Geriatric Psychiatry 32 (5): 564–73. https://doi.org/10.1002/gps.4495.

Greenberg, Paul E., Andree-Anne Fournier, Tammy Sisitsky, Mark Simes, Richard Berman, Sarah H. Koenigsberg, and Ronald C. Kessler. 2021. “The Economic Burden of Adults with Major Depressive Disorder in the United States (2010 and 2018).” PharmacoEconomics 39 (6): 653–65. https://doi.org/10.1007/s40273-021-01019-4.

Huang, Chang-Quan, Bi-Rong Dong, Zhen-Chan Lu, Ji-Rong Yue, and Qing-Xiu Liu. 2010. “Chronic Diseases and Risk for Depression in Old Age: A Meta-Analysis of Published Literature.” Ageing Research Reviews 9 (2): 131–41. https://doi.org/10.1016/j.arr.2009.05.005.

Katon, Wayne J., Elizabeth Lin, Joan Russo, and Jürgen Unützer. 2003. “Increased Medical Costs of a Population-Based Sample of Depressed Elderly Patients.” Archives of General Psychiatry 60 (9): 897–903. https://doi.org/10.1001/archpsyc.60.9.897.

Lockwood, Kathryn A., George S. Alexopoulos, and Wilfred G. van Gorp. 2002. “Executive Dysfunction in Geriatric Depression.” American Journal of Psychiatry 159 (7): 1119–26. https://doi.org/10.1176/appi.ajp.159.7.1119.

Menchetti, Marco, Nadia Cevenini, Diana De Ronchi, Roberto Quartesan, and Domenico Berardi. 2006. “Depression and Frequent Attendance in Elderly Primary Care Patients.” General Hospital Psychiatry 28 (2): 119–24. https://doi.org/10.1016/j.genhosppsych.2005.10.007.

Penninx, Brenda W. J. H., Jack M. Guralnik, Luigi Ferrucci, Eleanor M. Simonsick, Dorly J. H. Deeg, and Robert B. Wallace. 1998. “Depressive Symptoms and Physical Decline in Community-Dwelling Older Persons.” JAMA 279 (21): 1720–26. https://doi.org/10.1001/jama.279.21.1720.

Snow, Caitlin E., and Robert C. Abrams. 2016. “The Indirect Costs of Late-Life Depression in the United States: A Literature Review and Perspective.” Geriatrics 1 (4): 30. https://doi.org/10.3390/geriatrics1040030.

Thakur, Mugdha, and Dan G. Blazer. 2008. “Depression in Long-Term Care.” Journal of the American Medical Directors Association 9 (2): 82–87. https://doi.org/10.1016/j.jamda.2007.09.007.

Unützer, Jürgen, Donald L. Patrick, Paula Diehr, Greg Simon, David Grembowski, and Wayne Katon. 2000. “Quality Adjusted Life Years in Older Adults With Depressive Symptoms and Chronic Medical Disorders.” International Psychogeriatrics 12 (1): 15–33. https://doi.org/10.1017/S1041610200006177.

Wilkinson, Philip, Catherine Ruane, and Katie Tempest. 2018. “Depression in Older Adults.” BMJ 363 (November): k4922. https://doi.org/10.1136/bmj.k4922.