Preventing Depression in Older Adults

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UPMC copyBy Dr. Charles Reynolds

Brain Health 

When people think about staying fit, they generally think from the neck down. But the health of your brain plays a critical role in almost everything you do: thinking, feeling, remembering, working, playing — and even sleeping. Recent research has shown that in the healthy aging brain, new synapses continue to form and nerve cells can regenerate. Aging is not a time of irreversible mental decline, and dementia is not universal and inevitable. Depression is not a normal part of the aging process. (Reference:  www.alz.org)

A healthy brain is important to remain independent and vital. 

  • Older adults are at increased risk for depression.
  • Depression is more common in people who also have other illnesses (such as heart disease or cancer) or whose function becomes limited.
  • Older adults are often misdiagnosed and undertreated.
  • Healthcare providers may mistake an older adult’s symptoms of depression as just a natural reaction to illness or the life changes that may occur as we age, and therefore not see the depression as something to be treated.
  • Older adults themselves often share this belief and do not seek help because they don’t understand that they could feel better with appropriate treatment.

(Reference:  CDC, 2012)

Older adults are at increased risk of developing a depression and research has shown that people with depression have an increased risk of developing a dementia.  

Risks of depression in older adults

We know that depression is not a normal part of aging, and we know that while depression is treatable, it can be hard to overcome.  Research has shown that about 15% of adults age 65 and older are depressed.  Ideally, a person at risk of developing depression will never become depressed in the first place, but prevention of depression is something we know little about.

Older adults face unique challenges that may increase their risk of becoming depressed.  Chronic pain and disease, death of family and friends, declining physical abilities, and financial strain are just some of the stressors faced by older adults.

Seniors who receive in-home services, such as a visiting nurse, home delivered meals, and personal care are considered to be at high risk for becoming depressed.  This may be because they have mobility problems, decreased ability to care for themselves, are often lonely, and may be poor.  About 10% of older adults with in-home services become depressed every year

Individuals with knee arthritis and the associated pain often find themselves reducing activities that they previously enjoyed. This change in activity may at times increase stress and could increase their risk of depression in the later years.

People with Mild Cognitive Impairment — the state between no memory problems and dementia – are also at higher risk for becoming depressed. Some researchers think that it is the stress of losing one’s memory and independence that increases the risk for depression.  Another possible explanation is that changes in the brain contributing to memory loss may also increase the risk for depression.  This is another reason why MAINTAINING BRAIN HEALTH is important to managing stress and preserving independence.

Can Depression in the Later Years of Life Be Prevented?  That is the central question that the iManage (Independence, Managing Activities, No Matter What Age) research studies at the University of Pittsburgh is trying to answer.  

The iManage Studies, funded by the National Institute of Mental Health, are designed to learn if new ways to solve problems and manage stress will help to improve sleep and quality of life, lower stress and pain, and help maintain independence.

Someone may be eligible for one of the studies if they are age 60 and older and experiencing one of the following:

• Stress or pain from knee arthritis

• Stress from mild memory changes

• Receive weekly home care services such as visiting nurses or assistance with personal care or daily activities

To learn more about the studies, please visit the iManage website (http://imanagestress.org) or call 412-246-6006 or email imanage@upmc.edu