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- Depression is a primary mood disorder characterized by a depressed mood and/or a markedly decreased interest or pleasure in normally enjoyable activities for at least 2 weeks and causing significant distress or impairment in daily functioning.
- It is not considered a part of normal aging.
Prevalence rates among the elderly vary, largely depending on the specific diagnostic instruments used and their current health and/or home environment:
- 1–3% of community-dwelling elderly
- 7.5% seen in primary care clinics
- 10–21% of hospitalized elderly patients
- 12–27% of nursing-home residents
- Chronic physical health condition(s)
- History of mental health problems
- Death of a loved one
- Social isolation
- Lack/Loss of social support
- Significant loss of independence
- Uncontrolled pain
- Insomnia/Sleep disturbance
- Prevalence of depression in medical illness:
- Stroke (22–50%)
- Cancer (18–50%)
- Myocardial infarction (15–45%)
- Parkinson disease (10–39%)
- Rheumatoid arthritis (13%)
- Diabetes mellitus (5–11%)
- Alzheimer dementia (5–15%)
- Suicide is the 11th leading cause of death in the US for all ages.
- Suicide rates are higher for Americans age >65 compared with the general population (∼15/100,000 people).
- Suicide rates are highest for males aged >75 (rate 38.5/100,000).
- Significant gaps exist in the understanding of the underlying pathophysiology.
- Ongoing research has identified several possible mechanisms, including:
- Monoamine transmission and associated transcriptional and translational activity
- Epigenetic mechanisms and resilience factors
- Neurotrophins, neurogenesis, neuroimmune systems, and neuroendocrine systems
Depression appears to be a complex interaction between heritable and environmental factors.