Depression in older adults“Everyone feels sad or blue sometimes. It is a natural part of life. But when the sadness persists and interferes with everyday life, it may be depression. Depression is not a normal part of growing older. It is a treatable medical illness, much like heart disease or diabetes.”— Geriatric Mental Health Foundation

To recognize National Mental Illness Awareness Week and National Depression Screening Day in October, I want to share more recent, action-oriented information, tools and resources for older adults who are living with depression and the family/professional caregivers who support them. The quote above from the Geriatric Mental Health Foundation captures the stigma related to mental health issues in older adults such as depression and the importance of treatment. Sadly, there is still a common misperception that mental health conditions such as depression are a normal part of the aging process. We assume that mounting losses that come with aging are the sole driver for depression in older adults. I believe that this has created complacency towards early and effective dialogue, screening, diagnosis and treatment of mental health conditions in older adults.

Our Challenge

From 2009 to 2012, The Center for Disease Control and Prevention (CDCP) has published a number of great resources which capture the “state of mental health and aging in America.”;; Through these reports, we have learned that…

  • About 20% of people age 55 years or older are living with mental health issues
  • The most common mental health conditions for older adults are:
    • Mood disorders
    • Anxiety
    • Severe cognitive impairment
  • Depression is the most common mental health condition among older adults
  • Older adults with untreated depression…
    • Visit the doctor and emergency room more often
    • Use more medicine
    • Incur higher outpatient charges
    • Have longer hospital stays and increased readmission rates
    • Are at highest risk for suicide as compared to other age groups
  • Untreated depression in older adults has also been connected with chronic conditions such as:
    • Heart disease
    • Diabetes
    • Stroke
    • Increased health care costs
    • Inability to function
    • Disability 

Older Adult Barriers to Diagnosis and Treatment

The most common older adult barriers to early, accurate mental health screening, diagnosis and treatment include:

  • Having a stoic attitude towards physical and emotional pain
  • Preferring not to “complain”
  • Reluctant to discuss mental health issues due to generational stigma
  • Isolated from family, friends and providers due to…
    • Medical issues and decreased mobility
    • Lack of transportation
    • Lack of comfort with and access to online resources

It is important to note that family caregivers often live with depression as well. Click here to learn more about this challenge and how to cope.

DID YOU KNOW… that NIH has created a website specially designed for older adults about mental health care? Check it out –

Provider Barriers to Diagnosis and Treatment

Healthcare providers work very hard to recognize and treat mental health conditions in older adults, but there is still room for improvement. Common provider barriers include:

  • Inadequate vigilance and screening for mental health conditions
  • Time constraints during office visits
  • Misperception that mental health issues are a normal part of aging, which leads to inadequate treatment 
  • Poor or decreased access to older adults due to mobility issues and low adoption of online tools such as email/texting/e-portals

Notice, Discuss and Diagnose Depression

Here is a list of the most common symptoms of depression in older adults. Place a check next to any symptoms that you or someone you care about may have. Share this list with your healthcare provider and ask if treatment can help. [ ]

 Memory problems 


 Social withdrawal 

 Feeling worthless

 Loss of appetite 

 Weight loss 

 Vague complaints of pain 

 Inability to sleep

 Feeling anxious or irritable 

 Delusions (thinking things that are not based in reality) 

 Hallucinations (seeing, hearing or feeling things that are not reality-based)

A diagnosis of depression should include…

  • A physical exam 
  • A review of medications 
  • A clinical and psychiatric interview 
  • Speaking with family members or close friends
  • Blood tests and lab studies
  • Imaging studies

Treating Depression in Older Adults

“For older adults (age 60+), the top recommended treatment is home or
clinic-based depression care management (DCM).”  Task Force on Community Preventive Services

The quote above calls out the importance of home-based depression care, mental health care, mental health help, education, support and treatment. The most effective treatments for depression can include:

DID YOU KNOW… that a Geriatric Psychiatrist can play a key role in assessing the need for medicine and deciding which medicine/s and dose are best? Older adults can be sensitive to medicine, but with proper vigilance medicine can play a key role in the treatment of mental health issues like depression. Click here to find a Geriatric Psychiatrist now –

Innovative Solutions

Based on a review of recent research and social media, we can improve the timeliness of diagnosis and treatment by using the many innovative tools and solutions that have been developed by advocacy/government organizations and knowledge leaders. Read on and check our Mental Health and Aging Toolkit. These tools can drive…

  • Comfort with getting mental health help by discussing mental health issues with family and healthcare providers
  • Increased client and family caregiver access to education, support and resources
  • Early, accurate screening, diagnosis and treatment
  • Improved client/provider communication during office visits
  • Effective care coordination

DID YOU KNOW…that the Geriatric Mental Health Foundation has developed a “Guide to Mental Wellness in Older Age: Recognizing and Overcoming Depression –

Mental Health and Aging Toolkit

For Clients and Family Caregivers

For Family Caregivers and Friends

For Healthcare Providers

Practice Guidelines

Screening Tools

Related Tools and Research


The good news is that recent research has shown that the prevalence of depression in older adults has shown a gradual decrease. I hope that this blog plays a small role in supporting this trend. After reviewing our Toolkit, please share any other tools or resources that have been helpful for you. Thank you.