VNS Health EasyCare: Depression Screening

The good news is that most older adults are not depressed, though they are at increased risk for it.  Depression is more than just feeling sad and experiencing natural emotions of grief or loss.  Depression is a true and treatable medical condition like any other and is not a normal part of aging. Less than 1% (460,000) to about 5% (2.3 million) of older people living in the community suffer from depression, which rises to 13.5% (6.21 million) in those who require home healthcare and 11.5% (5.29 million) in those who are hospitalized or in skilled care.

It’s important to remember that depression is no one’s fault.  Depression can occur no matter how much we love and support and provide for one another. Depression sets in due to a combination of factors like aging, chronic illness, declining mobility and function, loss of loved ones, loss of relationships, moving, isolation and loneliness, perception of being a burden to others, and lack of engagement in meaningful activities.  This triggers abnormalities in our brain chemistry, which is why we can’t “just snap out of it.”

Depression is often misdiagnosed and undertreated in the senior population.  Even older adults themselves mistake depression as a natural reaction to illness or life changes and don’t think of it as something to be treated.  They don’t seek help because they don’t understand that they could feel better with treatment.  In fact, many older adults adapt so well to being in a state of depression that they—and others—don’t recognize they have it and where it causes problems.  For example, it is well-known that depression delays healing (wounds, injuries, surgeries, even activity recovery), affects adherence to medications, and causes chronic conditions to worsen both short-term and long-term.

Considering attitudes and beliefs about what is “natural” with aging, and that 80% of older adults have at least one chronic health condition (50% have two or more), depression is likely more common than we know or have measured.  Depression can also take hold rather rapidly, within weeks or months, which is why it’s important that older adults are continuously being checked for depression.  The recommendation is annual, with or without symptoms.

Note that depression questionnaires widely available online may be helpful in detecting a problem, though they are not adequate or accurate in determining the presence and severity of depression.  Depression has specific criteria that such free questionnaires do not capture, and those questionnaires have no explanations for their results.  Only a healthcare professional should make the diagnosis and develop a care plan to address it.

If you or someone you know is struggling or in crisis, call or text 988, the free and confidential Suicide & Crisis Lifeline. Trained crisis counselors are available 24 hours a day, 7 days a week. Counselors can also be contacted through web chat at 988lifeline.org.