Geriatric Depression: Causes, Symptoms, Treatment, Diagnosis

Geriatric depression is a mental health condition affecting the elderly that leads to loss of interest and feelings of sadness. According to the World Health Organization, most older adults have good mental health, but, still many are at risk of developing mental health conditions such as depression.⁽¹⁾

According to the Centers for Disease Control and Prevention, 7 million elderly aged 65 years or above experience depression.⁽²⁾

Geriatric depression can be due to numerous reasons and has different therapies to treat it.

The exact cause of depression is not known but it is believed to be caused due to some factors. A combination of these factors can lead to depression in older adults. According to the National Health Service, these factors include:⁽³⁾

• Genetics: Having a family history of depression makes a person two to three times more likely to have geriatric depression.⁽⁴⁾ Research suggests that depression is 30-50% times due to genetics.⁽⁵⁾
• Brain Structure And Chemistry: Imbalance in the neurotransmitter is responsible for causing depression. Neurotransmitters are the chemical messengers that regulate biological processes in the body. A study showed that people with depression showed abnormality in the frontal lobe of the brain.⁽⁶⁾
• Medical Condition: People, suffering from diabetes, arthritis, cancer, heart disease and chronic pain are more at risk of suffering from depression.
• Stress: Any type of stressful event can increase the risk of depression.
• Female Sex Hormone: People with female sex hormones are more likely to have depression.⁽⁷⁾
• Substance Use: People with a history of alcohol use disorder are at a higher risk of depression. Research has also linked certain medications such as anticonvulsants, statins, and stimulants with depression.⁽⁸⁾

The symptoms of depression vary in people. The common signs and symptoms of geriatric depression include:

• Low or sad mood
• Lack of interest in activities
• Excess sleep or very little sleep
• Feeling of guilty
• Difficulty in thinking, concentrating, and making decisions
• Change of appetite
• Irritability
• Restlessness
• Aches and pain
• Withdrawal from family and friends
• Digestive issues
• Suicidal thoughts and attempts

A healthcare professional can help in ruling out the causes and finding effective treatments.

If the signs and symptoms of depression last for 2 weeks, the doctor may diagnose geriatric depression.⁽⁹⁾

Before making a diagnosis, a doctor will take a medical history and use a geriatric depression scale while asking about symptoms. He would also enquire about the duration of the symptoms.

Physical examination is done and tests are ordered to rule out any underlying cause before providing treatment.

The option for treating geriatric depression include medication, psychotherapy, and alternative therapies.

The doctor may prescribe anti-depressants such as selective serotonin reuptake inhibitors, serotonin, and norepinephrine reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, and atypical antidepressants.

A person should have to take a complete course of medication to bring about improvement in symptoms.

Psychotherapy can be helpful in improving symptoms of geriatric depression.⁽¹⁰⁾ It is also known as talk therapy and may include interpersonal and cognitive behavior therapy.

Cognitive behavior therapy may help a person to think and behave in new ways and change habits that may be causing depression.

Interpersonal therapy can also be effective in treating depression as it helps in identifying and changing emotional challenges that affect mood.

If a person does not respond to medication and psychotherapy the doctor may suggest electroconvulsive therapy. It is a form of brain stimulation using electric current that activates the brain and treats depression.

A review found electroconvulsive therapy to be a safe and effective treatment for older adults with depression.

Treatment can offer long-term benefits and can be helpful in alleviating the worsening of symptoms. Without treatment, the episodes can last for several weeks and even longer. This can decrease the quality of life and increase the risk of suicide.