Recognizing Depression in the Elderly

As seniors advance in age, they face major life changes. Many of these changes can be extremely difficult to cope with; the deaths of close friends and/or spouses, health problems, and overall changes in lifestyle all have the potential to cause significant amounts of stress and anxiety. If not handled properly, the stress of these events can often manifest into clinical depression. Not only can depression cause a decline in quality of life, but it can also wreak havoc on a person’s health. It is extremely important to recognize the signs of depression in older adults before it can get out of hand. If a person has the knowledge of the signs to be looking for, a watchful eye should have no problem spotting the symptoms and recognizing depression in an elderly patient.

Among the outwardly recognizable symptoms of depression, caregivers must be able to identify abnormal thoughts about death, excessive guilt, plans for suicide or attempts to commit suicide, and other extreme changes in mood. These traits are usually easily identifiable in extreme cases of depression and must be addressed in order to restore a patient’s quality of life. However, elderly patients experiencing depression often have more subtle symptoms of depression that may be confused with pathologies such as Alzheimer’s disease, Cancer, Dementia, heart disease, Parkinson’s disease, thyroid disorders, and other scenarios that may mask the true underlying problem. It is for this reason that depression among the elderly is frequently undiagnosed and untreated. Patients who are experiencing a change in appetite, aches or pains, weight changes, difficulties with concentration, fatigue, memory loss, sleep abnormalities, and even irresponsible behavior. These sorts of symptoms do not often point medical logic directly in the direction of clinical depression and, therefore, can be misleading to caregivers. The truth remains, however, that if someone experiences these symptoms daily for a period of more than two weeks, they are likely depressed.

It has been estimated that around 15% of Americans 65 and older have experienced depression at some point in their later years. Nearly 20% of residents in nursing homes are clinically depressed. The most important facet to remember when dealing with depression in the elderly is that their quality of life for what remaining time they have left is of utmost importance.


"Depression - Elderly: MedlinePlus Medical Encyclopedia." National Library of Medicine - National Institutes of Health. Web. 11 Apr. 2010. .

Seniors With Diabetes

As our elderly population grows, so does the issue of the incidence of Type II diabetes. According to the American Diabetes Association, 18.3% of the population age 60 and over has been diagnosed, which translated into nearly nine million seniors with the disease. For seniors with diabetes, there are many unique complications that must be dealt with accordingly.

The diagnosis and monitoring of Type II diabetes can be problematic in seniors because many age-related changes in health can mask common warning signs. Often, elderly patients will not present with classic symptoms, raising the risk of a delayed or wrong diagnosis. Seniors often come to the doctor with multiple complaints, many of which can be wrongly attributed to simple aging. Elderly patients are also usually on many more medications than younger people, so separating side effects from symptoms may be more difficult.

Some elderly patients may have cognitive impairments that affect the way their diabetes could be recognized or should be managed. Cognitive impairments could cause a patient to forget about or discount symptoms of diabetes. Once diagnosed, these patients may not recognize important symptoms that manifest from poor glucose control, and will most likely be slower to respond to them. Severe cognitive impairments, such as dementia or Alzheimer’s disease, require simplified diabetes care and a higher level of supervision.

Many seniors develop conditions that may keep them from regularly exercising or take away their ability to be independently mobile. Immobility can have some severe health repercussions for all aging individuals, but especially for seniors with diabetes. A sedentary lifestyle, obesity, and hypertension are risk factors for macrovascular disease, which makes up 75% of the mortality rate of people with Type II diabetes. Also, diabetic neuropathy affects over half of patients who have been diagnosed with Type II diabetes for over 15 years, but can be avoided by strict glycemic control. The best way to control a patient’s glycemic index, and therefore his/her risk of developing these complications, is through proper diet and exercise. Even people with limited mobility can adequately exercise, and experience the benefits of stabilized blood sugar, increased insulin sensitivity, and lowered blood pressure. The American Diabetes Association recommends low impact, non-weight-bearing activities such as water aerobics, swimming, chair exercises, yoga, bicycling, and tai-chi.



Wallace, Jeffery I. "Management of Diabetes in the Elderly." Diabetes Journal. American Diabetes Association. Web.

Elder Drivers

Though there are perhaps many competent drivers over the age of 65, it is certainly in the best interest of the greater public to institute testing for these drivers. Currently, automobile accidents are the leading cause of death for drivers between the ages of 65 and 74. Because of this rapidly increasing population, especially in Florida, an adoption of such testing procedure will prove crucial in the reversal of this trend. Most other states already have their own testing for elderly drivers in place and are seeing positive results from it.

Of the thirty-three states that do already have testing requirements in place, Florida has some of the most relaxed guidelines. We require that all drivers renew every six years with a clean record, or four years otherwise. When drivers reach 80, they must pass a vision test. Obviously, all of the faculties needed for competent driving are not going to be assessed in a simple vision test. Other states, such Arizona and Kansas, have full-course testing in place for drivers when they reach 65 and require renewal every four to six years. A continuous renewal process for folks as they reach a certain age point would objectively ensure that drivers with reduced capacity for safe driving will certainly protect both the general public and the drivers themselves.

The main idea of stricter guidelines on motor vehicle drivers’ tests is not to take away the freedom of the elderly. The main objective of the licensure procedure itself is to ensure the safety of all drivers on the road. Because of the objectivity of driver testing, the dynamics of the competency of an aging driver must be taken into account. Reflexes, hand-eye coordination, muscular dexterity, and peripheral vision are all faculties necessary to operate a vehicle safely that are not being evaluated by the single vision exam when you reach 80 years old. In a recent article by the Boston Globe, elderly drivers were asked how they felt about that testing to which they responded positively in favor. Though most were confident that they could pass with ease, they did concede that it would filter out the weaker drivers that were giving them a bad a reputation. It is all too common for anyone to think that they themselves are a fine driver because no one would necessarily want to admit that they are losing their ability to perform normal tasks competently. Of course, the main objective is not to take away the independence or freedom of the elderly but to protect the safety of everyone on the road.

"Renewals and restrictions, state-by-state - USATODAY.com." News, Travel, Weather, Entertainment, Sports, Technology, U.S. & World - USATODAY.com. Web. 18 Feb. 2010. .
Schworm, Peter. "Elderly say they would ace mandatory driving tests - The Boston Globe." Boston.com. Web. 18 Feb. 2010. .

Aging Stereotypes

Everyone grows older in his or her own way. Some stay active while others slow way down. Some people gain wisdom as others become more forgetful as time goes on. Because of the very nature of the mechanism of aging, there are noticeable similarities among populations of elderly. From these similarities, which are not always positive or attractive, stem multitudes of stereotypes.
For instance, a common stereotype of the elderly is the idea that they are less than adequate drivers. When you think of the origins of this belief, there could be some validity. Eyesight, coordination, reaction time, and muscular dexterity all diminish with age. Since all these competencies are needed for good driving, it would be easy to immediately cast off elderly folks as unable to drive as well after a certain statistically determined age. But what if someone started with exceptional abilities in these areas and maintained them well into their later years? Can we standardize the stereotype after comparing this individual to someone much younger with inherently poor eyesight and equally bad reflexes?
Another stereotype among the elderly is that they are all riddled with health problems and are a drain on Medicare. Again, the very mechanism of aging itself is based on the fact that systems are breaking down. It is safe to say that a great deal of medical attention goes to the elderly population because their bodies have lowered immune systems, reduced capacity to heal, and a greater tendency toward more frequent and/or more serious medical pathologies. With this taken into account, it is still not fair to say that becoming elderly is analogous to becoming extremely ill. I am very sure that there are plenty of people in the world considered to be elderly that could run circles around me. However, since the statistical norm of the situation is that the elderly are the ones occupying the majority of the hospital, the observation becomes the stereotype and the general consensus. With all things considered, this observation could be taken more as an over-generalization than a stereotype.
The fact that these stereotypes are so prevalent in our society could be interpreted as proof that there is some truth to some of these stereotypes. However, they could also be taken as indicators of topics to address when considering the needs of the elderly. Currently, there is much debate over how to handle senior citizens who can no longer command full control of their vehicle but have no other means of transportation to accomplish daily tasks outside home. The issue was brought to attention due to a stereotype but must be handled in way that will not perpetuate it.
As for the stereotype of elderly comprising the majority of the sick population, we must take it as an indicator of the result of health practices already in place. The status of the health of our elderly population must be realized as the end products of the habits formed in earlier years of life. If we make notes and changes of our elderly population of today, we can begin a better system to promote the health of future elderly populations by changing the habits of today.