Recognizing and Treating Depression in the Elderly

Senior Depression May Go Undetected

WASHINGTON, D.C. — September 19, 2003 — Depression goes untreated in 80% of the senior population, and is not often recognized in nursing home residents, according to testimony before the U.S. Senate Special Committee on Aging (Donna Cohen, Ph.D., Professor, Department of Aging and Mental Health, University of South Florida). The lack of attention to the mental health problems of the elderly may be attributed to ageism, inadequate training of health care providers, the shortage of geriatric specialists, as well as to the need for more knowledge and research, Ms. Cohen said.

Another speaker pointed out that the effects of senior depression may be just as harmful as smoking, obesity, or hypertension (Jane L. Pearson, Ph.D., Associate Director for Preventive Interventions Chair, National Institute of Health Suicide Research Consortium). A depressed elderly patient recovering from a heart attack, for example, faces a greater risk of death than one who is not depressed, according to Ms. Pearson. She also described vascular depression, an illness that occurs late in life that is due to small strokes in parts of the brain that are responsible for mood regulation. Vascular depression responds to treatment with anti–depressant medications.

Some cases of senior depression lead to suicide. In the United States, suicide rates increase with age and are highest among those aged 65 years and older (National Center for Injury Prevention and Control, Centers for Disease Control). Elderly men, especially white males, are the group at highest risk for suicide, with a rate that is six times the national average. Their suicides are usually the result of depression. Sadly, about 70% of seniors who commit suicide have seen their primary care doctors within a month of their deaths, but their condition goes unrecognized, according to testimony at the Senate Committee hearing (Ira Katz, MD, Ph.D., Professor of Psychiatry, Director of Geriatric Psychiatry, University of Pennsylvania).

Treating Depression in the Elderly

The speakers stressed that primary care physicians and staff must be trained to recognize depression in the elderly. One ongoing study called “Prevention of Suicide in Primary Care Elderly,” followed a successful team approach to treating senior depression that involved nurses, social workers, and physicians in primary care practices (Jane L. Pearson, Ph.D., Associate Director for Preventive Interventions Chair, National Institute of Health Suicide Research Consortium). Various speakers also discussed using antidepressant medications and psychotherapy to treat senior depression.

Positive Aging Act Addresses Depression in the Elderly and Other Senior Mental Health Issues

“Seniors have the highest suicide rate in America, yet too often their mental health problems are ignored or treated as normal signs of aging,” said Sen. John Breaux, ranking member of the Senate Special Committee on Aging. “…It’s time we recognize that mental health problems like depression are a real problem for our nation’s seniors, and make diagnosis, treatment and prevention a high priority.” Sen. Breaux has introduced legislation to address some of these issues. Known as the Positive Aging Act of 2003, S.B. 1456 would:

• Make grants for demonstration projects that integrate mental health care services for seniors into primary care settings. Require screening services, referrals, and joint care for dementia, senior depression, anxiety, and other mental health problems.
• Provide funds to develop mental health outreach teams for community–based providers to the elderly.
• Authorize cooperative agreements with senior centers, adult day care programs, and assisted living facilities.
• Establish a Deputy Director for Geriatric Mental Health Services to develop research programs concerning senior mental health and depression in the elderly.
• Revise the membership of the Advisory Council for the Center for Mental Health Services to include representatives of older Americans, their families, and geriatric mental health specialists.
• Revise the criteria for state plans under Community Mental Health Services Block Grants to include initiatives for improving access to services for older adult patients.

For the full text of S.B. 1456, see the Thomas Legislative site. Scroll to “Bill, Amendment, or Public Law No.” and search on SB 1456. Please feel free to contact us if you have questions about the legal rights of an elderly loved one and their medical care. We are experienced in all areas of elder abuse and nursing home law, including neglect and inadequate pain management issues.

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Depression In the Elderly is a Serious Problem

• Depression is often not recognized in nursing home residents and goes untreated in 80% of the senior population.
• The effects of senior depression may be just as harmful as smoking, obesity, or hypertension.
• Senior depression can lead to suicide.
• Seniors have the highest suicide rates in America.

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