What is the most common mental health problem in older adults?
Depression is the most common mental health problem among our older population. Nearly a quarter of the 600,000 people who experience stroke in a given year will experience clinical depression. This is an important statistic because it goes back to the fact that mental health issues, mainly depression, are a huge barrier to helping our patients meet their goals. We need to utilize tools for developing our plan of care that help us identify all of the barriers. For example, the International Classification of Functioning Disability and Health is a tool used to develop care plans that take into account not only barriers but positive factors that we consider for the plan of care.
Depression affects patient motivation, the ability to focus and attend, and the ability to concentrate and meet goals. People aged 85 and older have the highest suicide rate of any age group, which is startling. Additionally, two-thirds of seniors with mental health problems do not get the treatment that they need, which makes our jobs even more important in helping to identify these issues.
There are three different depression types: major depression, persistent depressive disorder, and minor depression. The most significant difference between these has to do with time. Major depression is identified by the symptoms that most of us are familiar with: trouble sleeping, eating, enjoying life, et cetera. But the time factor is what is taken into account with diagnosing major depression. These are severe episodes that happen frequently. The individual will have several episodes and then they have about a two-month timeframe in between where there is no depression. So major depression happens in episodes with a period of two months or more in between those episodes.
Persistent depressive disorder (dysthymia) is when a person demonstrates the same symptoms as in major depression, however, the timeframe is a lot longer with episodes lasting two years or more. So, this is a chronic condition that lasts for a long period of time. That's the difference between major depression and persistent depressive disorder.
Minor depression has symptoms that are not as serious as those in major depression or PDD. They are minor symptoms but it's not as simple as “being blue.” Everybody gets "the blues" once in a while. Minor depression includes the same symptoms, they just aren’t as severe and they don’t last quite as long.
Depression is more common in people who have other illnesses (such as heart disease or cancer) or whose functioning becomes limited. That definitely pertains to a lot of our patients that we see who are suffering from a major trauma, a chronic illness, stroke, Parkinson's disease, etc. Those individuals are more likely to suffer from depression.
Older adults are often misdiagnosed and undertreated for their depression. There is actually a lot of research about older adults being afraid to bring the topic up to their physicians or healthcare providers. They're concerned with the stigma that's attached to being depressed. I think our older population has more of that stigma idea than the younger populations do, but they're often not treated the way they should be as far as their depression is concerned. Additionally, studies by the CDC estimate that 7 million American adults over the age of 65 experience depression each year.
Refer to the SpeechPathology.com course, Mental Health and Aging: An Introduction for Healthcare Professionals, for more information on the most common mental health diagnoses found in the elderly population, including risk factors and symptoms.