In the elderly, depression often occurs with other medical illnesses and disabilities and lasts longer. Depression in the elderly is associated with an increased risk of cardiac diseases and an increased risk of death from illness. At the same time, depression reduces an elderly person’s ability to rehabilitate.
Older adults also may have more medical conditions, such as heart disease, stroke, or cancer , which may cause depressive symptoms. Or they may be taking medications with side effects that contribute to depression.
Causes and Risk Factors for Late – Life Depression Delayed , complicated grief. Social isolation. Disability. Financial concerns and struggles. Using a number of medications to treat physical problems.
When it comes to antidepressants for seniors, most experts recommend SSRIs or selective norepinephrine reuptake inhibitors (SNRIs), which help increase the brain chemicals serotonin and norepinephrine. These drugs tend to have fewer serious side effects and drug interactions than older antidepressants on the market.
What Are the Main Causes of Depression ? Abuse. Past physical, sexual, or emotional abuse can increase the vulnerability to clinical depression later in life. Certain medications. Conflict. Death or a loss. Genetics. Major events. Other personal problems. Serious illnesses.
When talking with an older adult who has an anxiety problem: Be calm and reassuring. Acknowledge their fears but do not play along with them. Be supportive without supporting their anxiety . Encourage them to engage in social activities. Offer assistance in getting them help from a physician or mental health professional.
Late-life depression refers to a major depressive episode occurring for the first time in an older person (usually over 50 or 60 years of age ).
Depression impacts older people differently than younger people . In the elderly , depression often occurs with other medical illnesses and disabilities and lasts longer. Depression in the elderly is associated with an increased risk of cardiac diseases and an increased risk of death from illness.
Tricyclic antidepressants , especially amitriptyline and dothiepin ,16 are known to pose a high risk of death in overdosage. These drugs should therefore be avoided in older people whose medication is not supervised and who are at risk of taking an overdose.
SSRIs considered to have the best safety profile in the elderly are citalopram, escitalopram, and sertraline.  These have the lowest potential for drug-drug interactions based on their cytochrome P-450 interactions.
Diphenhydramine and amitriptiline are the most common inappropriately prescribed medications with high risk adverse events while propoxyphene and doxazoxin are the most commonly prescribed medications with low risk adverse events.
An enlarged and hyperactive amygdala, along with abnormal activity in other parts of the brain , can result in disturbances in sleep and activity patterns. It can also cause the body to release irregular amounts of hormones and other chemicals in the body, leading to further complications.
Research suggests that continuing difficulties – long-term unemployment, living in an abusive or uncaring relationship, long-term isolation or loneliness, prolonged work stress – are more likely to cause depression than recent life stresses.
Basic and clinical studies demonstrate that depression is associated with reduced size of brain regions that regulate mood and cognition, including the prefrontal cortex and the hippocampus, and decreased neuronal synapses in these areas.