Depression affects about 1 of every 6 older people. Some older people have had depression earlier in their life. Others develop it for the first time during old age.
Causes of Depression in Older People
Some causes of depression may be more common among older people. For example, older people may be more likely to experience emotionally distressing events that involve a loss, such as the death of a loved one or a loss of familiar surroundings, as when moving away from a familiar neighborhood. Other sources of stress, such as reduced income, a worsening chronic illness, a gradual loss of independence, or social isolation, may also contribute.
Depression Versus Dementia
In older people, depression can cause symptoms that resemble those of dementia: slower thinking, decreased concentration, confusion, and difficulty remembering. However, doctors can distinguish depression from dementia because when depression is treated, people with depression regain their mental function. People with dementia do not. Also, people with depression may complain bitterly about their memory loss and rarely forget important current events or personal matters. In contrast, people with dementia often deny memory loss.
Diagnosis of Depression in Older People
Depression is often difficult to diagnose among older people for several reasons:
Because depression may be difficult to identify, many doctors routinely ask older people questions about their mood. Family members should be alert for subtle changes in personality, especially lack of enthusiasm and spontaneity, loss of sense of humor, and new forgetfulness.
Treatment of Depression in Older People
Selective serotonin reuptake inhibitors (SSRIs) are the antidepressants used most often for older people who are depressed because SSRIs are less likely to have side effects. Citalopram and escitalopram are particularly useful.