Running head: GERIATRIC DEPRESSION 1

Depression in the Geriatric Population

RACHEL I RAGLAND, RN

James Madison University

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Abstract

Geriatric depression throughout history has unfortunately been an expected part of aging in many

cultures. With thorough assessment and thoughtful management seniors do not have to accept a

decrease in their quality of life as they age due to depression and other mental health disorders.

Nursing implications should include knowledge of signs and symptoms of geriatric depression,

proper assessment and treatment, as well as prevention strategies for seniors. Promoting healthy

mental health habits and treating dysfunctions promptly is best practices for the geriatric

depression.
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Depression in the Geriatric Population

Depression is a common mental health disorder that can affect individuals in all stages of

life. The geriatric population is at an increased risk with “Twenty percent of all suicides

committed are by persons aged 65 years and older (American Psychological Association, 2015).”

(Eliopoulos, 2018). Proper assessment, diagnosis and treatment are critical to ensure high quality

of life in an elderly patient. There are many ways in which these three areas differ in the geriatric

population. Late life burdens are heavy and the U.S. population is living longer than ever.

Depression must be considered and addressed in the geriatric population.

Often depression in the elderly is evaluated at the primary care office on routine health

visits. The Geriatric Depression Scale has been a widely used assessment tool. “The Geriatric

Depression Scale (GDS) is the first and the most popular scale used to screen for late‐life

depression. It is endorsed by the Royal College of Physicians and the British Geriatric Society

(1992)” (Gana et al.,2017). The scale consists of basic question to assess the persons feelings

about how their mental health is doing. It’s a simple tool that is quick to use that can give insight

to how the patient is coping with life at that time.

Common adult symptoms of depression apply to the geriatric population but they may also

present with atypical symptoms that should not be missed. Sadness, trouble concentrating,

feelings of guilt, worthlessness, and helplessness are all typical depression symptoms. Also,

somatic symptoms including insomnia or sleeping too much, loss of interest, overeating or

appetite loss, aches, pains, headaches and digestive upsets can be present with depression in all

adults. “The present study suggests that somatic symptoms are present in elderly patients with

depression. However, the prevalence of certain somatic symptoms is less than that seen among

adult patients” (Mehra et al., 2017).

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Some signs and symptoms that are specific to the geriatric include “vegetative symptoms

which include insomnia, fatigue, anorexia, weight loss, constipation, and decreased interest in

sex”. (Eliopoulos, 2018). Cognitive changes may also be seen careful assessment to differentiate

dementia and depression is imperative. “Depression is a recurring disorder. Older persons

present atypically in that depressive symptoms may not be demonstrated as tearfulness, but

rather be exhibited as angry outbursts, decreased appetite, change in sleep patterns, and/or low

energy” (Harris et al.,2017).

The geriatric population is at increased risk of depression due to the burdens of late life

that are naturally occurring. Elders are faced with declines in their own health as well as their

spouses and other loved ones. Loss of loved ones, isolation, increased vulnerability and

dependency are all hardships the elderly is up against. Financial burdens on retirement budgets

with ever increasing medical cost are leaving some seniors in tough situation. Cost of

prescriptions and healthy eating are not always guaranteed in the elderly population. Some of

life’s most difficult challenges come during this time in one’s life. Medications can also have

side effects of a decreased mood. Regardless of the cause depression should be acknowledged.

The expression of feelings should always be promoted, maintaining hobbies, asking for

emotional support when needed are all healthy choices to promote one’s mood. Support groups

are helpful for seniors to share their experience with others. Adequate coping skills and support

are not always present. Standard treatment for geriatric depression includes psychotherapy,

antidepressants, and electroconvulsive therapy. Medications should be started with the lowest

dose in this population. Its important to promote a healthy lifestyle including eating well, rest

and regular exercise to reduce risk or severity of geriatric depression. Alternative or natural
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therapies are also available to treat geriatric depression like acupuncture, guided imagery, and

natural supplements such as St. Johns wort.

Alcohol and substance abuse may be present and contributing to the senior’s depression.

Misuse of medications including overdoses or not taking necessary prescribed medications

should all be evaluated in the depressed elder. Engaging in dangerous behavior or refusing to eat

can also be self-harm actions that should be taken seriously with the increased risk of suicide in

older adults.

While geriatric depression is reality for many it can be properly managed a variety of

ways. Depression should not be left untreated regardless of persons age or condition. An

individual’s quality of life can be greatly decreased by untreated depression. Depression is not

the only mental health disorder affected by aging. Mental health disorders such as anxiety,

substance abuse and paranoia are all increased with age as well. Geriatric depression should not

be considered a normal part of aging, it should be evaluated by a professional.

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References

Eliopoulos, C. (2018). Gerontological nursing. Philadelphia, PA: Wolters Kluwer.

Gana, K., Bailly, N., Broc, G., Cazauvieilh, C., & Boudouda, N. (2017). The Geriatric

Depression Scale: does it measure depressive mood, depressive affect, or both?:

Geriatric Depression Scale. International Journal of Geriatric Psychiatry, 32(10), 1150–

1157. https://doi.org/10.1002/gps.4582

Grotmol, K., Lie, H., Hjermstad, M., Aass, N., Currow, D., Kaasa, S., Moum, T., Pigni, A., &

Loge, J. (2017). Depression—A Major Contributor to Poor Quality of Life in Patients

With Advanced Cancer. Journal of Pain and Symptom Management, 54(6), 889–897.

https://doi.org/10.1016/j.jpainsymman.2017.04.010

Harris, M., Walmer, M., Nwogu, C., Peraza-Smith, G., & Cacchione, P. (2017). Basic

considerations for the treatment of geriatric depression in primary care. Geriatric

Nursing (New York), 38(3), 258–261. https://doi.org/10.1016/j.gerinurse.2017.05.011

Mehra, A., Grover, S., Chakrabarti, S., & Avasthi, A. (2017). Symptom profile of depression in

elderly: Is assessment with geriatric depression rating scale enough? Journal of Geriatric

Mental Health, 4(1), 18–25. https://doi.org/10.4103/2348-9995.208605