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Depression and the Elderly: United States and Abroad

Depression: Variable Statistics

Seligman (1975) pointed out over 20 years ago, that depression is akin to the common cold of psychopathology-at once familiar and mysterious. This certainly appears to be true (O’Rourke & Hadjistavropoulos,1997) among the elderly population. While there appears to be some divergence of statistics on its prevalence among the elderly population, most studies have found prevalence rates of depression of between 5% and 15%(Dunlop, Song, Lyons, Manheim & Chang, 2003; Hope, 2003; Unutzer, Patrick, Marmon, Simon, & Katon, 2002; Lai,2000; ) among seniors in the United States as well as various countries throughout the world. Much of the divergence in depression statistics seems to be explained by differences in the assessment methodologies used as well as the specific definition of depression utilized. Teresi, Abrams, Holmes Ramirez and Eimicke (2001) stated that “Studies using formal diagnostic criteria for assessing major depressive disorder versus one of its less severe variants yield lower ratios” (p.613). They then concluded that “While the point prevalence of major depression among community residents 65 years or older is 2%-4%, the estimates of the prevalence of less severe depression range from 5% - 44%, although more conservative estimates of depressive symptomatology range from 11% -16%” (p. 613).

 

Depression among the elderly: Prevalence in the U.S.

Unutzer and colleagues (2002) have concluded that the prevalence of major depressive disorder among healthy, non-institutionalize older adults in the United States to be only about 1%, but also found that as many as 15% of older adults also experience significant depression symptoms which were below the threshold of severity for a DSM-IV diagnosis of major depression. When controlled for ethnicity, some studies have even found higher levels of depression among elderly minorities in the United States.

Depression rates among minority elderly:

In a study published in the November online issue of the American Journal of Public Health (Dunlop et al., 2003) it was concluded that elderly Hispanics and African-Americans actually have higher rates of depression then their white counterparts, possibly due to greater health burdens and their lack of health insurance. In the study which included almost 7700 adults aged 54 to 65 for racial/ethnic differences in rates of depression, it was found that major depression was most prevalent among Hispanics (10.8%) followed by almost 9% in African-Americans, and approximately 8% in whites of the same age group.

Depression rates of the elderly throughout the world:

Similar levels of geriatric depression have been found in various parts of the world. Hope (2001)summarized the findings of the National Service Framework for older people, which was published by the Department of Health in Great Britain stating “The NSF for older people indicates that 10%-15% of people living in the community, over the age of 65, had depression severe enough to warrant clinical intervention” (p. 315)“. In referring to the same data, Baldwin (2000) commented that this is probably an underestimate owing to factors of presentation and recognition. The unique presentation of geriatric depression symptoms such as the high prevalence of somatic complaints have made diagnosis of depression among the elderly relatively difficult worldwide.

Even given problems in defining the unique presentation of depression among the elderly in a homogenous way, similar statistics have been found in various countries throughout the world. In a study (Bin Li, Yin Ho, Man Chan, Sang Ho, Pik Li, Leung & Hing Lam, 2004) of obesity and depressive symptoms among the Chinese elderly that included 18,750 men and 37,417 women, prevalence rates of depressive symptoms based upon the Geriatric Depression Scale were found to be 4.9% and 7.9% respectively. A Malaysian study (Mohd, Mohd & Mustaqim, 2003) of the elderly in a rural community setting, found the prevalence of depression to be 9% among individuals with chronic illness and 5.6% among those without chronic illness. Meanwhile, depression also has proven to be one of the most common emotional disorders among Canadian older adults, affecting almost 10% of the general elderly population of Canada (Lia, 2000).

Information and webpage by Paul Susic  Ph.D. Licensed Psychologist  (Health and Geriatric Psychologist   

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