Insufficient Treatment For Older Patients With Depression

One in four older Americans experiences some mental disorder including depression, anxiety disorders, and dementia, according to the National Council on Aging. NCOA does not expect the situation to improve any time soon. “This number is expected to double to 15 million by 2030.”

Depression alone affects seven million older Americans, but many do not receive treatment. This was recently confirmed by a study published in the International Journal of Geriatric Psychiatry. “Depression treatment in older adults is frequently insufficient; it appears to depend on diagnosis as well as the patients' motivation to seek help. Education regarding the diagnosis of depression in the elderly as well as guidelines for appropriate treatment is needed,” concluded Friederike Boehlen et al.

In a follow-up to the ESTHER study, the researchers investigated pharmacological and psychological depression treatment, as well as prescribed antidepressants and their dosages, for older adults in a community dwelling.

Of the 3117 participants, 163 (5.2 percent) fulfilled the criteria for major depression. “Underuse of antidepressants was present in 126 depressed participants (77.3 percent). Persons who were motivated to seek help, who had an established depression diagnosis, or who were taking more than five different medications had lower odds of underuse. Anxiety was associated with higher odds for underuse. Overuse of antidepressants (prescription without clinical indication) was found in 96 cases (41.7 percent) of all antidepressant prescriptions.”

The results show that underdiagnosis and inadequate treatment of older adults with depression is common, while at the same time, there is also a high proportion of antidepressant overuse.

Contrary to what many people think, depression is not a “normal” part of the aging process. It is a medical problem that affects many older adults and can often be successfully treated. Since depression in older adults is often under-recognized and under-treated, many patients suffer needlessly.

Without treatment, depression can impair an older adult’s ability to function and enjoy life. It can also contribute to poorer overall health. Compared to older adults without depression, people with depression often need more help with activities of daily living, and often recover more slowly from physical problems. With adequate treatment these situations can mitigated.

The Pavilion at Williamsburg Place offers a geriatric program specifically designed specifically for adults ages 55 and over. Patients may present with symptoms including behavioral disturbances, severe depression with suicidal thoughts, anxiety, hallucinations, and delusions. Common admission diagnoses include dementia, depression, anxiety, mood and behavior changes, and even substance misuse.

As the aging process progresses, it is often necessary for patients to adjust to a “new normal.” They need to learn how to deal with new difficulties and adjust to the limitations that may be imposed by their declining health. A comprehensive discharge plan is designed to ensure that each individual has access to the required services and support. Whenever possible, we help our patients to return to their regular lives and home environment.