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Risk Factors Triggering Depression among Seniors

by Dr. Patrick Arbore, Elder Abuse & Depression Expert
March 09, 2012

Question: What are the risk factors/triggers of my 80-year old father developing depression?

Answer: To begin with, approximately 6 million Americans aged 65 and older suffer from depression. Sadly, however, only 10% receive proper treatment. Thus, your question is so important because the capacity to recognize elderly depression may be in the observant eyes of daughters or other family members.  

There are several risk factors that have been identified through well-designed, longitudinal studies to trigger depression in some older adults. One general category is the impact of life stressors on older adults. How life events affect the mental health of older adults can be mitigated by evaluating whether a life event is perceived as undesirable. Can the older person adjust or adapt to this event? While the life event might be meaningful, e.g., a move from independent living to assisted living, are the emotional responses to this event negative and difficult to experience? Extreme life stressors, such as traumatic events, can also negatively affect the mental health of older adults.

Medical illness, especially diseases of the cardiovascular system, is a strong and consistently observed risk factor of major depression in the elderly. Because health related problems can precipitate a series of other events such as hospitalization, increased disability, changes in the nature of social relationships, residential relocation either temporary or permanent, and other changes, the outcome can result in depression.

Numerous studies have indicated death of a partner or significant family member as a strong risk factor for depression among the elderly. Not every older person, however, develops clinical depression due to the death of a loved one.  Careful observation is warranted when there is a significant death for an older person. Grief may be the most painful yet natural life experience that may not become pathological in nature.

Because disability and functional decline in late life can interfere with previous behavior, these problems can trigger depression. In a study that we conducted on our Friendship Line program in the late 1990s, we discovered that older clients who were recently disabled with a fractured or broken hip, for example, experienced higher levels of depression than those older people who had been disabled for many years.

Lack of social support in some older adults can also increase the risk of depression. Loneliness, or what I call toxic loneliness, can be an extreme example of a lack of emotional support for older adults.  

If you notice any changes in the areas that I have mentioned, I would speak directly with your grandfather about his perception of his mood. If he lacks the vocabulary for describing his emotional state, you may want to accompany him to his primary care physician and discuss your observations. By identifying these risk factors early, we can take the necessary steps to intervene and reduce his suffering.

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Dr. Patrick Arbore is the Founder and Director of the Center for Elderly Suicide Prevention and Grief Related Services (CESP), a program offered by the Institute on Aging in San Francisco. Dr. Arbore conducts workshops and lectures locally and nationally on aging-related subjects. He is the author of numerous articles and book chapters on suicide prevention, bereavement, suffering, etc., including a chapter he co-authored in the book, “When Professionals Weep".

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