The Prevalence Of Depression In Older People

Depression is generally considered to be the most common psychiatric disorder among older adults (Ames & Allen, 1991; Blazer, 1994), although recent evidence suggests that anxiety disorders may actually be more common (Blazer, 1997). Data from the Epidemiological Catchment Area Study (Regier et al., 1988) suggest that rates of major depressive disorder among older adults are lower than rates for younger adults (for review, see Futterman et al., 1995). A recent systematic review of community-based studies assessing the prevalence of late-life depression carried out by Beekman et al. (1999) calculated an average prevalence rate of 13.5% for clinically relevant depression symptoms. Data from the UK suggest that major depressive disorder affects only a minority of older people, Livingston et al. (1990) identifying an overall prevalence rate of 16% for depression symptoms in their inner-London sample. Consistent with other prevalence studies of depression in older adults, Livingston et al. (1990) found that depressed older adults were more likely to be living alone and to have been in recent contact with GPs and hospital services. Lindesay et al. (1989) report similar rates of depression in older adults living in the community, with 13.5% of their sample identified with mild to moderate depressive symptoms and 4.3% identified with severe depressive symptoms.

Katona et al. (1997) note that, in younger people, the comorbidity of depression with other psychiatric conditions has received much attention, yet depression comorbidity in older adults has received relatively little attention. This would appear to be surprising, as Katona et al. (1997) found very high rates of comorbid generalised anxiety in older adults diagnosed with depression. The association between depression and heightened levels of generalised anxiety was so great in their sample that they suggest depression should be looked for whenever anxiety is present in older people. These findings correspond to reports by Flint (1999) that late-life generalised anxiety disorder is usually associated with depression. Lenze et al. (2001) comment that older adults with depression and comorbid anxiety are more likely to present with greater severity levels and are more likely to experience poorer treatment response.

Rates of depression in older people vary depending upon the sample considered. For example, Katz et al. (1989) identified a prevalence rate of major depressive disorder among nursing home residents of 18-20%, and up to 27-44% overall for other dysphoric mood states. Likewise, Abrams et al. (1992) describe depression as being widespread in nursing-home residents. Unfortunately, although nurses are good at detecting depression in nursing-home residents, levels of treatment are low (Katz et al., 1989).

Levels of depression in community samples are much higher when disability is present; for example, in Parkinson's disease, prevalence rates of depression have been reported in up to 40-50% of people diagnosed with Parkinson's disease (Zesiewicz et al., 1999).

However, although there is an association between physical illness and depression, it is important to remember that the majority of older people with physical illness do not meet criteria for major depression (Zeiss et al., 1996), and it is the extent and personal importance of limitations imposed on an individual that is more important for determining disability (Zeiss et al., 1996). Koenig et al. (1992) demonstrate that the presence of a medical condition reduces the rate of detection and treatment of depression in older adults.

Free Yourself from Panic Attacks

Free Yourself from Panic Attacks

With all the stresses and strains of modern living, panic attacks are become a common problem for many people. Panic attacks occur when the pressure we are living under starts to creep up and overwhelm us. Often it's a result of running on the treadmill of life and forgetting to watch the signs and symptoms of the effects of excessive stress on our bodies. Thankfully panic attacks are very treatable. Often it is just a matter of learning to recognize the symptoms and learn simple but effective techniques that help you release yourself from the crippling effects a panic attack can bring.

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