Older Adults: Depression And Suicide Facts ?

Q: Major depression, a significant predictor of suicide in older adults,1 is a widely underrecognized and undertreated medical illness. In fact, several studies have found that many older adults who commit suicide have visited a primary care physician very close to the time of the suicide:

A:Older Americans are disproportionately likely to commit suicide. Comprising only 13 percent of the U.S. population, individuals ages 65 and older accounted for 19 percent of all suicide deaths in 1997. The highest rate is for white men ages 85 and older: 64.9 deaths per 100,000 persons in 1997, about 6 times the national U.S. rate of 10.6 per 100,000.3 Depression often co-occurs with other medical illnesses such as cardiovascular disease, stroke, diabetes, and cancer.6 Because many older adults face such physical illnesses as well as various social and economic difficulties, individual health care professionals often mistakenly conclude that depression is a normal consequence of these problems—an attitude often shared by patients themselves.7 These factors conspire to make the illness underdiagnosed and undertreated. Both doctors and patients may have difficulty identifying the signs of depression. NIMH-funded researchers are currently investigating the effectiveness of a depression education intervention delivered in

primary care clinics for improving recognition and treatment of depression and suicidal symptoms in elderly patients. In addition, NIMH has developed this cue card for older adults. Studies are in progress on the efficacy of SSRIs and short-term specific psychotherapies for depression in older persons. Findings from these studies will provide important data regarding the clinical course and treatment of late-life depression. Further research will be needed to determine the role of hormonal factors in the development of depression, and to find out whether hormone replacement therapy with estrogens or androgens is of benefit in the treatment of depression in the elderly.