Running head: Geriatric Depression 1

Depression in Geriatric Patients

Annabel E. Cantrell

James Madison University

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Abstract

Depression is a mental health condition experienced across all ages. In the elderly, depression

can significantly impact quality of life. Simple lifestyle interventions can help prevent depression

from onset. After onset, early detection and treatment is important to restore quality of life.

Nurses have the opportunity to intercept patients and help meet their needs by preventing,

lessening or providing treatment for depression.

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Depression in Geriatric Patients

As individuals age, their health status (physical and mental) change also. A common

misconception about aging and the elderly population is that as individuals age, quality of life

decreases. However, most elderly individuals enjoy a fulfilling life. One major mental health

disorder that can effect their quality of life is depression. Although, the CDC (2017) reports that

a surprisingly small amount (less than 1% to 5%) of the elderly population in the community

suffer from depression, it is important to note is that when they do, quality of life is greatly

impacted. Nurses encounter elderly patients in many setttings, such as hospitals, clinics,

extended care facilities, home health and in the community. These encounters give nurses the

opportunity to identify, assess, and assist elderly individuals suffering from depression.

Depression is defined as a mental health condition characterized by persistent feelings of

sadness and loss of interest (Mayo Clinic, 2018). It can be displayed in a variety of ways for

elderly patients, to include: vegetative symptoms, insomnia, depressed appetite, hopelessness,

helplessness and decreased interest in sex, among others (Eliopoulos, 2018). Quality of life is

defined, seeked and fulfilled differently by each individual. As elderly become less independent

and less in control of their life, quality of life can be greatly impacted. An article by Voros

(2020), explores qualtity of life (QOL) in the elderly and the effect depression has on it. Other

factors that were found to have an impact on the QOL include physical activity, self-reliance,

awareness of usefulness, interpersonal relationships, practicing religion, safe and comfortable

living conditions, health status, medications, cognitive functions, and psychological symptoms.

Although all these factors can have an impact on QOL, none of them have as strong of an impact

resembling depression alone. No matter what the health status of an elderly individual is, results
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from the study show that an increase with the severity of depression correlates with the

individual’s quality of life. (Voros, 2020)

An article by Takeda (2020), shares that, “it is estimated that 5% and 15% of elderly

individuals aged ≥65 years meet the diagnostic criteria for major and minor depression,

respectively” (Takeda, 2020, p.480). Although these percentages are hopeful in quality of life

and happiness experienced for most in elderly life, depression when suffered by elderly have a

major negative impact on quality of life. Lifestyle habits such as healthy diet, exercise, leisure

activities, intellectual activities, and rest were studied on their ability to reduce cognitive decline

in the elderly (Takeda, 2020, p. 485). Alzheimer’s disease is another type of cognitive decline

experienced by the elderly. It has been suggested that having a history of depression is a risk for

developing Alzheimer’s Disease. In including the suggested healthy lifestyle changes in the

elderly before cognitive decline, we may help prevent depression, while also lessening the risk

for developing Alzheimer’s disease. Among the participants of Takeda’s study already with

depression, the lifestyle changes had no effect. However, the lifestyle changes on those without

depression showed a maintenance of wellbeing. (Takeda, 2020)

The U.S. elderly population is projected to grow as baby boomers begin to age. Home

health care needs and use will no doubt increase along with the aging population. With as many

as 4.7 Americans receiving home health care today (HHC), it is wise to study the effects HHC

has on mental health disorders in the elderly (Wang, 2016, p.107). “Depression and anxiety, the

two most common mental health disorders, are reported in 24% and 15.2% of older HHC

patients in the United States”, (Wang, 2016, p.108). This is two to five times more than elderly

individuals not receiving HHC. Surprisingly, the study by Wang found that although many

elderly patients in HHC suffering from depression were being treated with interventions, a small
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amount had actually received qualified psychiatric nursing services. A positive finding in the

study revealed that mental health disorders in general decreased from admission to discharge

from HHC services. This demonstrates HHC services can enhance a patient’s overall mental

status. (Wang, 2016)

Treatment for depression can include antidepressant medication, acupressure,

acupuncture, guided imagery, light therapy, and psychotherapy (Eliopoulos, 2018). Music

therapy is also an effective alternative therapy to ease and prevent depression in elderly

individuals. Based on statistics from the Centers for Disease Control, “from 2007 to 2008, 76%

of older adults used two or more prescription drugs and 37% had used five or more in the past

month” (Quach, 2017, p.58). Taking many medications can have risks for adverse reactions and

negative side effects. Music therapy can provide a safe, easily accessible, and cost-effective

treatment for depression alone or along with medications or other therapies used to treat

depression. Music therapies that can be utilized include listening to music, playing a musical

instrument, singing, or a combination of any of these. Health care professionals, especially those

working with elderly individuals should be educated in the usefulness of music therapy. (Quach,

2017)

The results of these various studies shed light on the importance of early detection and

treatment of depression in the elderly to maintain or improve quality of life (Voros, 2020). Thus,

it can be concluded that elderly individuals at risk for depression should be proactively started on

lifestyle interventions to help prevent depression and simotaneously lower chances of developing

Alzheimer’s disease (Takeda, 2020). Simple lifestyle interventions (healthy diet, exercise, leisure

activities, intellectual activities, and rest) could easily be implemented by nurses at locations

where elderly individuals reside or are treated including clinics, hospitals, assisted living
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facilities, long-term care facilities and during home health care visits (Takeda, 2020p. 485).

Nurses have the opportunity to assist elderly patients in living their best life, free from

depression.
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References

Centers for Disease Control (CDC). (2017, January 31). Depression is not a normal part of

growing older. Retrieved November 14, 2020, from

https://www.cdc.gov/aging/mentalhealth/depression.htm

Eliopoulos, C. (2018). Mental health disorders. Gerontological nursing (pp. 412-417).

Philadelphia, PA: Wolters Kluwer.

Mayo Clinic. (2018, February 03). Depression (major depressive disorder). Retrieved November

14, 2020, from https://www.mayoclinic.org/diseases-conditions/depression/symptoms-

causes/syc-20356007

Quach, J., & Lee, J.-A. (2017). Do music therapies reduce depressive symptoms and improve

QOL in older adults with chronic disease? Nursing, 47(6), 58–63.

https://doi.org/10.1097/01.NURSE.0000513604.41152.0c

Takeda, S., Fukushima, H., Okamoto, C., Kitawaki, Y., & Nakayama, S. (2020). Effects of a

lifestyle development program designed to reduce the risk factors for cognitive decline on

the mental health of elderly individuals. Psychogeriatrics, 20(4), 480–486.

https://doi.org/10.1111/psyg.12538

Voros, V., Martin Gutierrez, D., Alvarez, F., Boda-Jorg, A., Kovacs, A., Tenyi, T., Fekete, S., &

Osvath, P. (2020). The impact of depressive mood and cognitive impairment on quality

of life of the elderly. Psychogeriatrics, 20(3), 271–277.

https://doi.org/10.1111/psyg.12495
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Wang, J., Kearney, J. A., Jia, H., & Shang, J. (2016). Mental health disorders in elderly people

receiving home care. Nursing Research, 65(2), 107-116.

doi:10.1097/nnr.0000000000000147