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Division of Aging and
Adult Services
PO Box 1437
Slot S-530
Little Rock AR 72203

By Herb Sanderson, Director
Division of Aging & Adult Services

This column appears in the January 2008 edition of Aging Arkansas,
a publication of the Arkansas Aging Foundation.

This is Not Normal Aging

There is a common perception that suicide rates are highest among the young.  However, it is the elderly, particularly older white males that have the highest rates.  In fact, 73% of all suicides are committed by white men.ood information is the best medicine for older adults,” says Donald A.B. Lindberg, M.D, Director, National Library of Medicine.

Among white males 65 and older, risk goes up with age.  White men 85 and older have a suicide rate that is six times that of the overall national rate.  Some older persons are less likely to survive attempts because they are less likely to recuperate.  Over 70 percent of older suicide victims have been to their primary care physician within the month of their death, many did not tell their doctors they were depressed nor did the doctor detect it according to the National Institute of Mental Health (NIMH)

Older individuals may experience a heightened sense of depression during this time of year.  Although depression is NOT a normal part of aging, "During the holidays, older adults may feel more acutely the passing of time, the absence of parents, siblings and friends who have died, and the distance of loved ones who have moved away," according to the American Association for Geriatric Psychiatry.  A limited budget may also contribute to the holiday blues.

While clinical depression is not a natural consequence of aging, it is commonly encountered among older adults.  Between 8 and 20 percent of older adults in the community and up to 37 percent in primary care settings suffer from depressive symptoms.  In contrast to the normal emotional experiences of sadness, grief, loss, or passing mood states, they tend to be persistent and to interfere significantly with an individual's ability to function.  Depression often co-occurs with other serious illnesses such as heart disease, diabetes, or cancer.  Because of these co-occurring conditions health care professionals may mistakenly conclude that depression is a normal consequence of these problems — an attitude often shared by patients themselves.  The Centers for Disease Control state these factors contribute to the underdiagnosis and undertreatment of depressive disorders in older people.

"Late-life depression that is untreated can last for years," says Jurgen Unutzer, MD.  He states is associated with a poor quality of life, difficulty with social and physical functioning, poor adherence to treatment, worsening of chronic medical problems, and increased occurrence of disease and death.  He says recognizing and treating depression and reducing access to firearms may be the most important things primary care providers can do to reduce the risk of suicide.

A person may be depressed if they feel:  nervous or "empty;" guilty or worthless; very tired or slowed down; you don't enjoy things the way you used to; restless and irritable; like no one loves you; like life is not worth living.  Or they are: sleeping more or less than usual; eating more or less than usual; having persistent headaches, stomach aches, or chronic pain.

Depression is treatable, but your doctor can only help you if you say how you are really feeling. As a caregiver, family member and/or friend of a depressed older adult, you can help by looking for the above signs of depression.  Keep in mind that signs may be different for older adults; taking the older adult to a medical professional; and being patient and understanding.  Talk with the older adult and support the prescribed treatment for depression.

Clinical, or major, depression is rapidly becoming a major chronic disease in the world.  The World Health Organization predicts that, as it already is in the United States, major depression will be surpassed only by heart disease as the leading cause of disability and premature death in developed countries by 2020.  Undiagnosed and undertreated, they account for increased health care spending and repeated office visits often for associated physical complaints.

Depression can and should be treated when it occurs and many effective therapies are available.

Remember, depression is not a normal part of aging.

Division of Aging and Adult Services
Herb Sanderson, Director
PO Box 1437 - Slot S-530
Little Rock AR 72203-1437
Telephone: (501) 682-2441
Fax: (501) 682-8155