Wednesday, November 19, 2014

Geriatric Depression: Recognizing the Signs & Symptoms




Purpose:

The purpose of this blog is to provide credible information and review the internet for the best sites on geriatric depression



Intended Audience:

Anyone who is caring for an elderly individual or interested in geriatric depression




Preliminary Information on Geriatric Depression:

Geriatric or late-life depression is a debilitating illness that can occur in any individual over the age of 65. Current statistics state that 15 out of 100 elderly persons or 15% will experience depression in their lifetime (Alexopolous, 2005) Depression in the elderly is not a normal part of aging.  Depression can cause personal suffering and can promote disability in the elderly (Alexopoulos, 2005).  Elders with depression can have functional deficits and reduced quality of life (Alexopoulos, 2005).  Unfortunately, geriatric depression remains under-recognized in many settings, even family members can miss the signs and symptoms.  Persons caring for geriatric individuals with depression may mistake symptoms for loneliness or general physical decline.  However, the signs and symptoms of geriatric depression may have special clinical features that are different from typical adult depression and are listed below

Reference

Alexopoulos, G. S. (2005). Depression in the elderly. The Lancet, 365(9475), 1961-1970. doi:http://dx.doi.org.proxy.its.virginia.edu/10.1016/S0140-6736(05)66665-2









Typical signs and symptoms of clinical depression (Alexopoulous, 2005):



*Must have either depressed mood or diminished pleasure or interest for at least 2 weeks

AND

*At least five of the following symptoms must be present:

  1. Depressed mood
  2. Diminished interest in usual activities
  3. Weight loss or weight gain of more than 5% of body weight
  4. Insomnia or Increased sleeping during normally awake hours
  5. Agitated or slowed body movements
  6. Fatigue
  7. Feelings of worthlessness or inappropriate guilt
  8. Reduced ability to concentration
  9. Recurrent thoughts of death or suicide



Brief Video Explaining the Typical Symptoms of Depression:


Late-Life Depression Signs and Symptoms







Special clinical features of geriatric depression (Alexopoulous, 2005):



For elderly persons, there maybe other symptoms that are not classically associated with symptoms of depression.  These include the following:


  • Verbalizing lots of physical complaints or preoccupied with a certain bodily function (e.g. bowel movements)
  • Unexplained health concerns
  • Heightened pain complaints
  • Irritability, especially in the early mornings
  • Social withdrawal or discontinuation of normal social interactions
  • Loss in interest of activities that used to provide pleasure
  • Lack of emotional feelings
  • Ruminates on cognitive complaints (e.g. “I can’t think right anymore”)
  • Reduce ability to care for self
  • Seeing primary healthcare provider multiple times without resolution of problem




Links to Top Websites Providing Additional Information on Geriatric Depression

Websites are listed from most credible and reliable sources.  See below for ratings evaluation criteria.   

1.  National Institute of Mental Health ****




2.  Centers for Disease Control ****




3.  Helpguide ***




4.  Geriatric Mental Health Foundation ***




5.  National Alliance on Mental Illness ***




6.  Web MD  ***



7.  Harvard Health Blog ***




8.  Philips Lifeline **




9.  Health.com **




10.  Suicide Awareness Voices of Education **





Ratings Evaluation Criteria for Websites:

****   Information from a credible and well respected source of the highest quality

***     Information from  a credible source known for factual information

**       Information from a source that may or may not be credible 

*         Information from a non-credible source and only contains opinionated ideas















Attributes That Can Affect Late-Life Depression (Research Article)

This article is an academic research study presenting evidence that protective and risk factors can contribute to late-life depression in certain age groups.  The authors found that physical disabilities in individuals under 80 was a risk factor for depression, while those over the age of 80 it did not have as much importance.  The authors found that persons over 80 with lack of motivation or apathy was a risk factor for depression.  Finally, the authors found that a personal characteristic of resilience defined as well-adjustment into adverse life circumstances begins to lose is impact as a protective factors after the age of 80.  However, before the age of 80, the amount of resilience an individual has correlates to a protective factor for depression. 



Reference

Mehta, M., Whyte, E., Lenze, E., Hardy, S., Roumani, Y., Subashan, P., . . . Studenski, S. (2008). Depressive symptoms in late life: Associations with apathy, resilience and disability vary between young-old and old-old. International Journal of Geriatric Psychiatry, 23(3), 238-243. doi:10.1002/gps.1868 



Discussion Questions for This Blog Which Can Be Posted in Comments Section:

Have you been impacted by an elderly family member with depression?
Did they get proper treatment and did they improve with treatment?






Disclaimer:

This page was created by a University of Virginia student, an expert in this field, for a class on health care.  It should by no means be used to replace the advice and information offered to you by your personal health provider.




Date Last Modified:

November 19, 2014 by Brian J. Capel


















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