Late-Onset Depression & Chronic Medical Conditions

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Adults with no previous history of depression can develop it late in life due to changes and loss­es they experience. Late-onset depression often occurs simultaneously with a chronic medical condition, happening for the first time at age 65 or older.

Late-onset depression can develop due to physical limitations, decreased independence and the interruption of social networks that accompany a chronic medical condition or the onset of a new medical condition. For exam­ple, coronary artery disease is a risk fac­tor for depression; while having depres­sion can put you at risk for developing coronary artery disease.

Depression is not a normal part of aging, but it is often not viewed as an ac­tual medical issue. When seniors expe­rience depression and a chronic

When seniors experience depression and a chronic medical condition together, the depression can aggravate the condition and interfere with successful treatment.

When seniors experience depression and a chronic medical condition together, the depression can aggravate the condition and interfere with successful treatment.

medical condition together, the depression can aggravate the condition and interfere with successful treatment. The coexis­tence of major depression with chronic conditions is associated with more phy­sician visits, emergency department vis­its, days spent in bed because of illness and functional disability.

“Caregivers of seniors who have never previously experienced depression, and especially those who have been di­agnosed with a new chronic medical condition, should be alert to the warn­ing signs of depression,” says Mary El­len Knecht, RN, Director of Community Relations with The Medical Team. Med­ical conditions which cause depression can include coronary artery disease, chronic lung disease, cancer, chronic pain, diabetes, macular degeneration, sleep disorders, and stroke and neuro­degenerative disorders such as Alzheim­er’s and Parkinson’s diseases.

As many as one-third of individuals with a serious medi­cal condition may ex­perience symptoms of depression. For exam­ple, major depression occurs in more than half of patients within 6 months following a stroke; 20 percent of patients with Parkinson’s disease will experience a major depressive episode.

Older adults can be less inclined to acknowledge depression and may show less obvious symptoms. Many times they accept depression as part of aging when in fact it is not.

Signs and symptoms of depression can include:

• Persistent sad, anxious or empty feelings

• Feelings of hopelessness, guilt or help­lessness

• Irritability and restlessness

• Loss of interest in activities

• Fatigue

• Difficulty concentrating

• Insomnia or excessive sleeping

• Overeating or appetite loss

• Thoughts of suicide or suicide attempts

“Depression is often neglected when the focus is on treating a senior’s chron­ic medical condition but treating the depression could significantly improve quality of life,” added Knecht. According to the National Institute of Mental Health, only about 10 percent of seniors suffering from depression receive treat­ment. When untreated, depression leads to poor quality of life, decreased ability to live independently and an increased bur­den on caregivers.

Studies show that the majority of older adults with depres­sion respond well when they receive treatment, which can include an antidepressant, psychotherapy or both. A Pittsburgh Medical Center study found that 80 percent of seniors treated over a three-year period didn’t suffer re­current bouts, while only 10 percent of those without treatment avoided relapse.

There are treatment programs such as The Medical Team’s Journey Behavioral Health Program which can help patients and their caregivers in the comfort and familiarity of home. These programs provide a range of services and support tailored to the needs of individuals with a behavioral health diagnosis and can help them better manage their chronic medical conditions and cope with issues that may affect their ability to care for themselves.

“Depression shouldn’t be considered an inevitable outcome of chronic medical conditions and aging,” reminded Knecht. If you or a loved one might be suffering from depression, talk with your doctor about treatment options.

Sources: “Depression and Coronary Heart Disease,” http://circ.ahajournals. org/cgi/content/full/118/17/1768 and  “Chronic Illness & Depression,” http:// my.clevelandclinic.org/disorders/men­tal_illness/hic-chronic-illness-and-de­pression.aspx

Published: March 2014

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