Geriatric Depression Self-Test & Preventative Measures

Depression is a mental health condition that can affect anyone, regardless of age. But older adults may be at an increased risk. The World Health Organization estimates that 10% to 20% of older adults struggle with depression worldwide5.

Depression in older adults is common, disabling, and accompanied by high levels of chronic illness and disability. Yet, older adults, or geriatric adults, are one of the most commonly misdiagnosed and undertreated groups. Geriatric depression is often mistaken for normal aging symptoms, but depression, within any age group, isn’t normal.

Take Geriatric Depression Scale (Self-Test)

If your responses indicate that you have moderate to severe depression, speak to a mental health professional as soon as possible. If you received a score in the not likely to mild depression range, your risk for depression is low. However, you should seek professional help to receive an accurate medical diagnosis.

If you experience symptoms of geriatric depression, seek out professional help, regardless of your risk score.

Please note this tool is for self-evaluation purposes only. This test is not intended to replace a medical diagnosis. If you believe you have generalized anxiety disorder or another psychological condition, seek professional treatment.

What is Geriatric Depression?

Geriatric depression is a disorder that causes feelings of sadness, apathy, and irritability. It can also manifest in physical symptoms, like aches and pains, fatigue, and sleep issues. The geriatric population is defined as people over the age of 65.

It’s estimated that major depressive disorder (MDD) affects 5.7% of U.S adults over 65 years old15. MDD is what most people commonly refer to as “depression” and consists of depressive symptoms that last more than two weeks.

A little-known fact is that depression in older people is more likely to be subsyndromal depression. Subsyndromal depression occurs when a person has symptoms of depression, but it is not severe enough to be diagnosable as MDD.

Subsyndromal depression affects approximately 15% of geriatric individuals and only increases with age15. Older adults may not be able to access much-needed treatments without a diagnosis of depression. The rates of misdiagnosis and undertreatment of depression are high in this age group.

    The Link Between Dementia and MDD

    As a large part of the world’s population ages, global dementia rates drastically increase. As of 2020, there are over 55 million people worldwide living with dementia1.

    There’s a worrying connection between dementia and MDD. Older adults with dementia are twice as likely to suffer from depression than individuals without dementia3. At the same time, depression raises the risk of dementia and cognitive decline.

    While research is ongoing, experts think that dementia and depression share similar risk factors4. Another explanation is that the two illnesses have a common link to vascular disease and inflammation. If you or someone you know suffers from dementia, it’s vital to test for depression as well.

    Causes and Risk Factors

    Depression is a complex mental health disorder with multiple causes and risk factors that can be medical, social, genetic, or circumstantial. The causes of depression are often linked to other elements of your health.

      Some of the most common risks and causes for depression include:6

      • Family history of depression
      • Physical, emotional, or sexual abuse
      • Stressful or traumatic life events
      • Medications or medical treatments
      • Chronic illnesses
      • Substance abuse
      • Other mental health disorders

      Older adults have an additional and unique list of causes and risk factors that also applies. Because of their age and stage in life, they may experience issues that younger people don’t.

        Some age-specific causes include:8

        • Death of a loved one, such as a partner or friend
        • Mobility reduction
        • Vision or hearing changes
        • Retirement
        • Financial strain
        • Illnesses like cancer, dementia, and stroke
        • Age-related medication
        • Disabilities
        • Facing mortality
        • Poor or reduced sleep
        • Loneliness and social isolation
        • Leaving the family home/moving to a healthcare setting
        • Loss of independence

        Depression and substance abuse have a strong connection, and the two are often co-morbid diagnoses12. Research shows that substance use among older adults with depression is particularly dangerous. Older adults are more sensitive to alcohol, illegal drugs, and prescription medication.

          Symptoms of Depression

          Most late-life depression symptoms are similar to standard MDD symptom2. In order to be diagnosed with MDD, symptoms need to be felt most of the day, almost every day, for 2 weeks or more.

          Symptoms of MDD can include feelings of:

          • Sadness
          • Worthlessness
          • Hopelessness
          • Irritability
          • Restlessness
          • Helplessness
          • Emptiness

          Emotions are not the only symptoms that occur with depression. Depression can also appear with symptoms of behavioral changes.

            Behavioral symptoms of depression can include:

            • Pacing, fidgeting, or other nervous behaviors
            • Unexplained crying spells
            • Lack of focus and motivation
            • Doomed thinking or thoughts of suicide
            • Loss of interest in hobbies
            • Withdrawal from social life and family

            While MDD symptoms in geriatric individuals are similar to the younger generation, geriatric adults with depression commonly feel confused or forgetful, have difficulty sleeping, and lose their appetite14. Physical symptoms like fatigue are also common in depression. Fatigue can lead to an even greater withdrawal from social activities and hobbies. Aches, pains, and gastrointestinal issues may also occur.

              The Dangers of Undiagnosed and Untreated Depression

              Untreated depression can turn life into a burden. Constant negative thoughts and unexplained physical symptoms can severely affect daily life. Undiagnosed individuals may not even consider depression as the root of their issues.

              Undiagnosed depression can lead to feelings of:

              • Hopelessness
              • Guilt
              • Confusion
              • Anxiety and panic

              As time goes on, the depression symptoms may become deeper and more severe. That’s when untreated depression is likely to increase the risk of:

              • Disabilities
              • Chronic illness
              • Premature death
              • Suicidal ideation
              • Substance abuse
              • Worsening of other illnesses
              • Cognitive decline

              Since this population tends to be the most underdiagnosed, these risks are even more worrying. Suicide is especially concerning the danger of untreated depression. Older adults make up 12% of the population but are estimated to account for 18% of the suicides in the United States10.

              For every attempted suicide in the U.S, 25% of older adults succeed compared to 0.5% of youth10. Seniors also have a more difficult time recovering from an attempted suicide than younger populations.

              How to Treat Depression

              Depression is a treatable disorder following a proper diagnosis. Treatment options should be individualized because each person can react differently to types of treatment methods.

              An interesting finding centers around the concept of resilience and treatment7. Resilience is defined as the ability to adapt and flourish when encountering hardship. Studies show that older adults had greater success, quality of life, and fewer mental health symptoms when they showed higher resilience.

              Psychotherapy

              Because medication use can be limited or determined to be an unsafe option for geriatric individuals, psychotherapy is often part of the treatment plan. Research consistently agrees that psychotherapy can be an effective treatment for depression11.

              Older adults typically benefit from these three types of therapy:

              • Problem Solving Therapy (PST) – teaches problem-solving tools and strategies for real-life situations to help manage daily stress
              • Cognitive Behavior Therapy (CBT) – evidence-based psychotherapy founded on the idea that changing your thoughts and emotions can influence your behaviors and reactions
              • Interpersonal Psychotherapy (IPT) – goal-oriented therapy that focuses on the present and social relationships

              Medications

              While medication is a common element of the treatment plan for depression for younger adults, older adults have additional risks when taking medication for depression. Antidepressants can be prescribed for individuals struggling with MDD. Antidepressants are a group of medications that attempt to increase neurotransmitter activity in the brain.

              Older individuals with depression pose a greater risk of drug interactions because geriatric individuals often take five medications or more regularly13. As your body grows older, medications can be absorbed and used differently which puts older individuals at a greater risk of negative symptoms from antidepressants and other drugs. Concerns associated with antidepressants in the older population and not the younger population is the risk of falls, osteoporosis, and intracranial hypotension.

              Transcranial Magnetic Stimulation – TMS

              Transcranial Magnetic Stimulation (TMS) is a non-invasive and medication-free treatment that focuses on stimulating the brain’s prefrontal cortex where people with depression have lower activity. Depression commonly affects the neurotransmitters (brain chemicals) that are linked to moods such as norepinephrine, serotonin, and dopamine. TMS uses magnetic stimulators to discharge currents for a small duration on the top of the head to help the brain generate these neurotransmitters.

              TMS is free of common side effects seen in antidepressant medications and often has few to no side effects. This treatment method is also FDA-approved for people suffering from treatment-resistant depression and requires no recovery time.

              Self-Help Methods

              Having depression and being isolated can only make depression worse. Finding the courage to become social and find support can be difficult when feeling depressed, but support and self-help methods can help symptoms of depression.

              Some activities that can help lessen depression symptoms include:

              • Volunteering your time
              • Joining a depression support group
              • Learning a new skill or joining a club
              • Getting outside and enjoying nature
              • Well-balanced diet
              • Meeting friends and family
              • Taking care of a pet
              • Getting involved in your neighborhood or community
              • Traveling

              Additionally, letting go of negative behaviors can help reduce the symptoms of depression. Smoking, drinking alcohol, and using illicit substances can negatively impact depression symptoms.

              Finding motivation may seem impossible when suffering from depression. Small steps towards self-help can be a good way to start with finding recovery from your depression symptoms. Setting attainable, small goals can be less daunting than a large task that can become overwhelming.

              Preventative Measures

              Preventative measures and protective factors can help an older person reduce their risk of developing geriatric depression. Protective factors are characteristics that can help reduce the effects of risk factors or negative outcomes. Preventative measures and protective factors can help maintain psychological health and improve coping strategies for older people.

              Preventative measures that can help geriatric individuals reduce their risk of depression include:4

              • Physical health
              • Financial capabilities
              • Family ties
              • Social networks
              • Social participation
              • Social support

              An older individual who has all of these qualities is at a lower risk for developing depression. These preventative measures and protective factors can increase the resilience of geriatric individuals, especially when they are faced with a crisis or need to cope with a problem.

               

              Getting Help For Geriatric Depression

              If you or a loved one is struggling with geriatric depression, you are not alone. Geriatric depression is a common condition that has several treatment options to help with a range of symptoms and can increase the quality of life. A medical professional can provide a diagnosis of depression and possible treatment options that can work best.

              Transcranial Magnetic Stimulation can be an alternative treatment for depression that is non-invasive and medication-free. For older adults, antidepressant medications may not be the safest and best option due to the additional risk of side effects. Therapy can be a helpful component of a treatment plan but may not be completely effective.

              To schedule an initial assessment or learn more about our program, contact Brain Therapy TMS. We offer TMS, coupled with psychotherapy to maximize treatment success. Our expert, empathetic staff can walk you through the entire process and answer any questions you may have.

              Sources

              1. ADI. (2020). Adi – dementia statistics. Alzheimer’s Disease International (ADI). Retrieved February 11, 2022, from https://www.alzint.org/about/dementia-facts-figures/dementia-statistics/
              2. Alberts, N. (2021, August 19). Major depressive disorder symptoms and treatment. EverydayHealth.com. Retrieved February 11, 2022, from https://www.everydayhealth.com/depression/major-depressive-disorder/
              3. Andreasen, P., Lonnroos, E., & Euler-Chelpin, M. C. (2014, February 24). Prevalence of depression among older adults with dementia living in low- and middle-income countries: A cross-sectional study. European journal of public health. Retrieved February 11, 2022, from https://pubmed.ncbi.nlm.nih.gov/23417621/
              4. Barnes, D. E. (2012, May 1). Midlife vs late-life depressive symptoms and risk of dementia: Differential effects for alzheimer disease and vascular dementia. Archives of General Psychiatry. Retrieved February 11, 2022, from https://jamanetwork.com/journals/jamapsychiatry/fullarticle/1151485
              5. Barua, A., Ghosh, M. K., Kar, N., & Basilio, M. A. (2011). Prevalence of depressive disorders in the elderly. Annals of Saudi medicine. Retrieved February 11, 2022, from https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC3221135/
              6. Higuera, V. (2021, November 1). Everything you want to know about depression. Healthline. Retrieved February 11, 2022, from https://www.healthline.com/health/depression
              7. Laird, K., Lavretsky, H., Paholpak, P., Vlasova, R., Roman, M., Cyr, N., & Siddarth, P. (2019, February). Clinical correlates of resilience factors in geriatric depression. International psychogeriatrics. Retrieved February 11, 2022, from https://pubmed.ncbi.nlm.nih.gov/29335041/
              8. Li, Y.-T., & Tung, T.-H. (2020, January). Effects of protective factors on the depressive status of… : Medicine. LWW. Retrieved February 11, 2022, from https://journals.lww.com/md-journal/fulltext/2020/01030/effects_of_protective_factors_on_the_depressive.14.aspx
              9. Maier, A., Riedel-Heller, S. G., Pabst, A., & Luppa, M. (2021, May 13). Risk factors and protective factors of depression in older people 65+. A systematic review. PLOS ONE. Retrieved February 11, 2022, from https://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0251326
              10. NCOA. (2021, September 7). Suicide and Older Adults: What You Should Know. The National Council on Aging. Retrieved February 11, 2022, from https://www.ncoa.org/article/suicide-and-older-adults-what-you-should-know
              11. Raue, P. J., McGovern, A. R., Kiosses, D. N., & Sirey, J. A. (2017, September). Advances in psychotherapy for depressed older adults. Current psychiatry reports. Retrieved February 11, 2022, from https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC6149527/
              12. Satre, D. D., Sterling, S. A., Mackin, R. S., & Weisner, C. (2011, August). Patterns of alcohol and drug use among depressed older adults seeking outpatient psychiatric services. The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry. Retrieved February 11, 2022, from https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC3242695/
              13. Taylor, W. D. (2015, July 21). Should antidepressant medication be used in the elderly? Expert review of neurotherapeutics. Retrieved February 11, 2022, from https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC4552589/
              14. UMHS. (2020, September 23). Depression in older adults. Depression in Older Adults | Michigan Medicine. Retrieved February 11, 2022, from https://www.uofmhealth.org/health-library/ug5127
              15. VanItallie, T. B. (2005). Subsyndromal depression in the elderly: Underdiagnosed and undertreated. Metabolism: clinical and experimental. Retrieved February 11, 2022, from https://pubmed.ncbi.nlm.nih.gov/15877312/

               

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