Age depression is often not recognized – and therefore not treated. Dejection, social withdrawal and loss of interest are all too quickly seen as the natural side effects of aging – and not as symptoms of depression. Therapy can significantly improve the quality of life in depression even in old age. Read all important information about age depression here.
Age depression: description
In depressive patients over the age of 65, physicians speak of age depression or depression in old age. In addition to dementia, age depression is the most common psychiatric disorder in the elderly. About 15 percent of people over the age of 65 suffer from depression. Some suffer from depression at a young age, others have the disease for the first time in old age. Even in old age women are more at risk of developing depression than men. The growing number of older people in our society will also make depression in old age more common in years to come.
Distinction between dementia and age depression
Concentration, memory difficulties and language problems can occur both in the context of depression and dementia. The differentiation is therefore very difficult. For a successful treatment, however, the distinction between dementia and age depression is of great importance. Some key features help in the classification of the symptoms.
In contrast to an age depression, which can occur suddenly, the symptoms of dementia begin gradually and become stronger with time. Another distinguishing feature is that people with age depression complain about their condition, while dementia patients tend to deny the memory problems. In addition, people with depression do not lose their orientation, as is typical for dementia patients. When patients take antidepressants, the symptoms usually improve significantly.
Age depression: symptoms
The diagnosis is made – as in younger people – for symptoms such as depression, lack of drive and loss of interest. However, the central symptoms in older people are often overlaid with other ailments. This is why depression in old age is often not easy to recognize.
For example, in the case of old-age depression, physical complaints are often in the foreground. The patients complain for example about pain, gastrointestinal problems or dizziness, which may also have psychosomatic causes. Also, the difficulties of concentration, which can occur in the context of a depression, are often assigned in older people more likely to a beginning senile dementia.
Experts believe that about 40 percent of depression in old age is not recognized. Because in older people, it makes sense to first look for the physical causes of the symptoms.
Age depression: causes and risk factors
The causes of age depression as well as depression at a younger age are attributed to genetic, biological and psychosocial factors. Even if there is a genetic predisposition to depression, it can not erupt until old age.
Age is associated with many challenges that cause stress and increase the risk of depression. Being old means being confronted with losses again and again. Body and mind are not as powerful as before, Zipperlein and diseases plague the elderly increasingly. By losing the partner or friends, some people are becoming lonely.
The transition from working age to retirement is also a big cut for many people. The daily routine is gone. Many do not feel needed anymore.
Especially in old age there is a risk that drugs trigger depression. For example, cardiovascular and Parkinson’s medicaments may have corresponding side effects. Also, disease-related changes in the brain can cause depression in old age. Diseases that are commonly associated with depression include Alzheimer’s, Parkinson’s and strokes. Dementia is also often associated with depression.
Examinations and diagnosis
The age depression is not immediately recognizable even for experts. Especially as patients often go to the doctor due to physical discomfort. Depression is thus quickly overlooked, as symptoms such as sleep disturbances and tiredness are frequent and normal signs of aging.
Age depression is also easily confused with dementia or a natural grief reaction. An incorrect diagnosis will result in wrong treatment. The suffering of the person concerned remains. A detailed diagnosis by a doctor is therefore particularly important.
At a higher age, physical illnesses are very common. The doctor will therefore first examine the physical condition. These include, for example, blood tests to check the thyroid gland, as well as examinations of the brain by means of EEG (electroencephalogram) or MRI (magnetic resonance tomography). The doctor will also inquire about medications the patient is taking.
Because even some medications can have a negative effect on the mood.
To differentiate the age depression from other diseases, there are special questionnaires, such as the geriatric depression scale. The following questions could ask the doctor for the diagnosis of age depression:
- Have you given up many of your activities and interests?
- Do you find that your situation is hopeless?
- Do you think you have more memory problems than most?
In addition to specific questions, the doctor will also inquire about the general situation of the patient. The loss of friends or partner can also cause depressive symptoms.
Age depression: treatment
Dejection and loss of interest do not have to be accepted by older people as a normal symptom of aging. Even old people can regain much more joie de vivre when their depression is treated. The prerequisite is, of course, that the age depression is recognized at all.
If physical pain, depressed mood, sleep and concentration disorders over a longer period of time, you should also think of seniors to depression. The first contact person can be the family doctor. This can rule out the physical causes of the condition or treat existing complaints that arise from the natural physical degradation with increasing age.
If there is a suspicion of age depression, the family doctor will refer you to a psychiatrist or psychotherapist. Specialists can check the diagnosis and choose an appropriate treatment with the patient.
As with younger depressives, the type of treatment depends on the severity of the depression. For severe depression, experts recommend the combination of medication and psychotherapy. In mild depression, sole psychotherapy is the treatment of choice.
As with younger depressives, a combination of medication and psychotherapy is a good option. The choice of the right antidepressant is sometimes more difficult in older people, as they usually take more medication and therefore must be considered possible interactions. Serotonin reuptake inhibitors (SSRIs) are often prescribed because of fewer side effects. Especially for severe depression, medications can significantly improve the condition. It is important to take the medication regularly and in the long term even after the symptoms have resolved, as the probability of recurrence in old age is particularly high.
Nevertheless, care must be taken even with the elderly that the drugs are well tolerated. It is important that the patient reports changes and symptoms to the doctor after taking the medication.
Psychotherapy is just as important part of the treatment. Older people should definitely take this opportunity and not shy away from it. Meanwhile, there are studies that show that psychotherapies also achieve good results in the elderly. In old age, Cognitive Behavioral Therapy and Problem Solving Therapy have proven to be most effective.
Age depression: disease course and prognosis
If depression is not treated in old age, the mental disorder is usually chronic. For example, suicide attempts are much more common in older people than in younger people. Therefore, it is important to recognize and treat depression in old age.
However, a death wish in the elderly is not automatically an indication of age depression. If no other depressive symptoms occur, it can occur independently of a mental disorder. Some old people feel they have lived their lives and want to finish with it.
A few years ago, it was assumed that the prognosis for depression is rather bad. Meanwhile, research has shown that timely treatment has a good chance of success. 25 percent of those affected get well again. However, the relapse rate is higher at 50 percent than at younger age. Because the course of a depression also depends on the physical condition of the person. And he is with people Age depression usually worse than younger depressives.