This document discusses depression as a developmental crisis in aging. It provides statistics showing that major depressive disorder affects 1-4% of older adults aged 65+, while subsyndromal depression affects 10-15% of this population. Depression is more prevalent among older women. Common symptoms and risk factors for depression are described, including biological, psychological, and social factors. Tools for screening and assessing depression in older adults include the Geriatric Depression Scale, Mini International Neuropsychiatric Interview-Depression, and Center for Epidemiologic Studies Depression Scale. The significance for health professionals is that research, practice/teaching, and policy need to consider gender-specific causes and interventions for late-life depression.

1. Developmental Crisis in Aging:
Depression
KarenWhiteman,PhD
June30,2014
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2. Population65 Years and Older by Size and
Percentof Total Population:1900to 2010
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(U.S. Census Bureau, 2010)

3. Prevalenceof DepressionAmong Older Adults
in the U.S.
Depression is one of the most common mental illnesses
suffered by older adults (Kessler, 2003).
• Major depressive disorder affects between 1 and 4% of
adult aged 65 years, and subsyndromal depression
affects between 10 and 15% of adults aged 65 years
and older (Blazer, 2009; Thomas & O’Brien, 2006).
• Burt and Stein (2002) found that “females have a
lifetime rate of major depressive disorder 1.7 to 2.7
times greater than men” (p. 258).
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4. Depression Video
http://youtu.be/h-lsyKBzuZo
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5. Small Group Discussion
• What does depression look like in older adults (men vs
women)?
• What are the social risk factors for depression in older
adults (men vs women)?
• What tools do you use to screen and assess for
depression in older adults (men vs women)?
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6. What does depression look like
in older adults?
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Common Symptoms:
Memory complaints, anhedonia, somatic complaints,
anxiety, lack of interest in personal care, sleep disturbance,
tiredness, loss of interest in life, hopelessness, slowed
movement, and agitation
Gender-specific (women):
Appetite problems, vegetative symptoms, and cognitive
dysfunction

7. Common Biological Risk Factors for
Depression in Older Adults
• Biological: Genetics and heredity; Vascular depression;
Alzheimer’s disease; Medical issues including myocardial
infarction and other heart conditions, diabetes, hip
fracture, stroke, functional impairment, and Parkinson's
disease
• Gender-specific (women): Biological effects of substance
use, including prescription drug use and alcohol use;
Neurotransmitter dysfunction; Endocrine changes;
Insomnia; multiple chronic physical conditions including
diabetes, cardiovascular disease, and obesity.
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8. Common Psychological Risk Factors
for Depression in Older Adults
• Psychological: Neuroticism; Cognitive distortions;
Emotional control; Avoidant coping style
• Gender-specific (women): None found specific for older
women
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9. What are the social risk factors for
depression in older adults?
• Social: Death of a close family member, friend, or
spouse; Personal illness; Change in sleeping habits; Social
isolation; Relationship problems
• Gender-specific (women): Bereavement; Change in
financial situation; Change in the health of a family
member (caregiving); Change in living
condition/residence; Personal injury (older adult
mistreatment/abuse)
*Death of a close family member or friend spouse
*Personal illness
*Personal injury
*Change in sleeping habits 9

10. What tools do you use to
screen and assess for
depression in older adults?
• The Geriatric Depression Scale
• The Mini International Neuropsychiatric Interview-Depression
• Center for Epidemiologic Studies Depression Scale
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11. Theoretical Model: An Integrated Life
Span Risk and Resilience Perspective
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• The life span perspective suggests that development
occurs throughout a lifetime.
• Risk and resilience perspective suggests that problems
can be prevented or at least reduced by identifying the
factors that increase the risk of having these problems
and then eliminating them or reducing their effects.

12. Significance for Health Professionals
• Research
• Research has focused primarily on reducing the symptoms of
depression for the general aging population, not the root causes
of depression.
• Researchers need to develop gender-specific interventions, and
screening and assessment tools.
• Apps
• Social media (facebook, twitter, google +)
• Skype (Reminiscence therapy)
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13. Significance for Health
Professionals
• Practice and Teaching
• Health care providers must be knowledgeable about
depression in older adults and men’s and women’s experience
of life stress related to depression.
• Change Agents!
• Workbooks (HHS, SAMHSA, and AHRQ)
• Curricula (National university accreditation)
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14. Significance for Health
Professionals
• Policy
• Policies need to support looking at the individual more
holistically.
• Promote health through considering contextual factors associated
with the development of depression.
• Engage policy stakeholders and partners to support research
to design gender-based screening and early and preventative
interventions and advance educational curriculum.
• Policymakers need to consider this study’s findings as they
develop and support existing health policy.
• Integrated care and enhanced specialty referral 14

15. Thank you
Contact Information:
karen@researchgerontology.com
www.karenwhiteman.com
@karenwhiteman 15