Among community-dwelling older persons the prevalence of major depressive illness is fairly low, at 1%-2%. However, 6% to 10% of older persons seen in ambulatory primary care settings have major depression. Among older patients requiring inpatient care estimates of the prevalence of major depression range from 11% to 45%. Minor, or chronic low level depression is even more prevalent, affecting 8% to 40% of medical outpatients. Approximately half of patients with late-life depression are suffering their first episode.
Depression lowers patients’ quality of life and contributes to poor adherence. Major and minor depression are treatable conditions in elderly patients, with response rates comparable to those in younger populations. Persons aged 65 and over represent less than 13% of the populations but account for 25% of suicides. More than 75% of older adults who commit suicide were suffering from a major depression; a physician had seen the vast majority within 1 month of suicide. Risk factors for late-life suicide include depression, concurrent physical illness, living alone, male gender, and alcoholism. Answering the two following questions can give you enough information to help decide if you should seek medical help for depression:
- “Do you often feel sad or depressed?”
- “During the past month, have you often been bothered by feeling down, depressed, or hopeless?”
If the answer to one of those questions is yes, I would recommend going to your family doctor to find out if treatment or appropriate referral to a specialist is necessary. Remember, the earlier these impairments are identified, the sooner they can be improved.
