Monday, October 16, 2006 Depression among senior citizens under-recognized, expert warns
CONTRARY to common belief, depression is avoidable among the elderly.
But changes in their physical and mental capacity, aggravated by a lot of factors, make depression more common among the old than the youth.
Dr. Glenda Ilano, of the Philippine Psychiatric Association, said depression today is “under-recognized, under-diagnosed, and under-treated.”
“It is more common among the old than it is in the general public. The prevalence rate is 25 to 50 percent,” she told a senior citizens’ gathering last Friday.
She said it is under-recognized because doctors have the tendency to attend first to the bodily symptoms like headache and low appetite.
“Some clinicians (also) accept that when you get old, you become depressed, which is not necessarily true,” Ilano said.
Economic status
Consequently, diagnosis does not dwell on depression, which would likely be under-treated.
Depression among older people is often due to low economic status, concurrent physical illness, social isolation and loss of independence.
Loss of spouse is also a factor, which may explain why spouses or husbands die just months after their partners’ demise.
Among the signs of depression is insomnia, agitation, less expressed suicidal thoughts, concentration or memory problem. Feeling of hopelessness and helplessness adds to the problem.
Ilano said that despite the situation, referrals of depressed patients to psychiatrists are low.
“(They) feel that psychiatrists have nothing to do with what the pediatricians do,” she said.
Other doctors also believe psychiatric illness is not important, and that psychiatric intervention would just increase length of stay in the hospital.
Effective
They feel intervention is unlikely to be effective.
“Medical illness tends to worsen depression in old age. And co-existence of depression and physical morbidity worsens prognosis of both,” Ilano said.
Often, it is difficult to distinguish if the physical problem is an offshoot of depression or that physical illness led to the patient’s depressed state, she said.
Most of the time, depressed patients are referred to psychiatrists when they are already worse off and in need of anti-depressant medications, she added.
She advised routine screening for the elderly, saying it “offers improvement.” (RHM)
