Skip to main content
SpringerLink
Log in

Depression in Elderly Women: Clinical Challenges

  • Chapter
  • First Online:
Older Women and Well-Being

  • 500 Accesses

Abstract

Geriatric depression is one of the commonest problems seen in the elderly populations. Men and women are equally inflicted with the disorder. This disorder aims to look at the unique clinical challenges posited by women that suffer from depression. There are unique socio-demographic variables and environmental factors that contribute to depression in women. Multiple factors like hormonal factors and menopause play a role in the genesis of depression in elderly women. This is coupled with factors like death of a spouse, loneliness, and the empty nest syndrome. There are also challenges in the accurate detection and management of depression as well as the long-term management of the disorder. It is also important to look at the overlap and differences between depression and dementia in women. The chapter highlights specific clinical aspects of depression in elderly women and highlights future research needs for the same.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 109.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 139.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 139.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Adli, M., Bauer, M., & Rush, A. J. (2006). Algorithms and collaborative-care systems for depression: Are they effective and why? A systematic review. Biological Psychiatry, 59(11), 1029–1038.

    Article  PubMed  Google Scholar 

  • Alexopoulos, G. S. (2005). Depression in the elderly. Lancet, 365(9475), 1961–1970.

    Article  PubMed  Google Scholar 

  • Alexopoulos, G. S., & Kelly, R. E., Jr. (2009). Research advances in geriatric depression. World Psychiatry, 8(3), 140–149.

    Article  PubMed  PubMed Central  Google Scholar 

  • Alexopoulos, G. S., Raue, P. J., Sirey, J. A., & Arean, P. A. (2008). Developing an intervention for depressed, chronically medically ill elders: A model from COPD. International Journal of Geriatric Psychiatry, 23(5), 447–453.

    Article  PubMed  Google Scholar 

  • Alexopoulos, G. S., Schultz, S. K., & Lebowitz, B. D. (2005). Late-life depression: A model for medical classification. Biological Psychiatry, 58(4), 283–289.

    Article  PubMed  PubMed Central  Google Scholar 

  • Alpass, F. M., & Neville, S. (2003). Loneliness, health and depression in older males. Aging & Mental Health, 7(3), 212–216.

    Article  Google Scholar 

  • Ayalon, L., Areán, P. A., & Alvidrez, J. (2005). Adherence to antidepressant medications in black and Latino elderly patients. The American Journal of Geriatric Psychiatry, 13(7), 572–580.

    Article  PubMed  Google Scholar 

  • Aylaz, R., Aktürk, Ü., Erci, B., Öztürk, H., & Aslan, H. (2012). Relationship between depression and loneliness in elderly and examination of influential factors. Archives of Gerontology and Geriatrics, 55(3), 548–554.

    Article  PubMed  Google Scholar 

  • Bartels, S. J., Dums, A. R., Oxman, T. E., Schneider, L. S., Arean, P. A., Alexopoulos, G. S., & Jeste, D. V. (2004). Evidence-based practices in geriatric mental health care. Focus, 53(2), 1419–1481.

    Google Scholar 

  • Bartels, S. J., & Naslund, J. A. (2013). The underside of the silver tsunami—older adults and mental health care. New Engl J Med, 368(6), 493–496.

    Article  PubMed  Google Scholar 

  • Birrer, R. B., & Vemuri, S. P. (2004). Depression in later life: A diagnostic and therapeutic challenge. American Family Physician, 69(10), 2375–2382.

    PubMed  Google Scholar 

  • Catalano, G. (2005). Bereavement, depression, and our growing geriatric population. Southern Medical Journal, 98(1), 3–5.

    Article  PubMed  Google Scholar 

  • Chang-Quan, H., Bi-Rong, D., Zhen-Chan, L., Yuan, Z., Yu-Sheng, P., & Qing-Xiu, L. (2009). Collaborative care interventions for depression in the elderly: A systematic review of randomized controlled trials. Journal of Investigative Medicine, 57(2), 446–455.

    Article  PubMed  Google Scholar 

  • Chopra, M. P., Zubritsky, C., Knott, K., Ten Have, T., Hadley, T., Coyne, J. C., & Oslin, D. W. (2005). Importance of subsyndromal symptoms of depression in elderly patients. The American Journal of Geriatric Psychiatry, 13(7), 597–606.

    Article  PubMed  Google Scholar 

  • Cole, M. G. (2005). Evidence-based review of risk factors for geriatric depression and brief preventive interventions. Psychiatria Clinica, 28(4), 785–803.

    Google Scholar 

  • Covinsky, K. E., Newcomer, R., Fox, P., Wood, J., Sands, L., Dane, K., & Yaffe, K. (2003). Patient and caregiver characteristics associated with depression in caregivers of patients with dementia. Journal of General Internal Medicine, 18(12), 1006–1014.

    Article  PubMed  PubMed Central  Google Scholar 

  • Crystal, S., Sambamoorthi, U., Walkup, J. T., & Akıncıgil, A. (2003). Diagnosis and treatment of depression in the elderly medicare population: Predictors, disparities, and trends. Journal of the American Geriatrics Society, 51(12), 1718–1728.

    Article  PubMed  PubMed Central  Google Scholar 

  • Djernes, J. K. (2006). Prevalence and predictors of depression in populations of elderly: A review. Acta Psychiatrica Scand., 113(5), 372–387.

    Article  Google Scholar 

  • Drayer, R. A., Mulsant, B. H., Lenze, E. J., Rollman, B. L., Dew, M. A., Kelleher, K., Karp, J. F., Begley, A., Schulberg, H. C., & Reynolds, C. F., III. (2005). Somatic symptoms of depression in elderly patients with medical comorbidities. International Journal of Geriatric Psychiatry, 20(10), 973–982.

    Article  PubMed  Google Scholar 

  • Epstein-Lubow, G., Davis, J. D., Miller, I. W., & Tremont, G. (2008). Persisting burden predicts depressive symptoms in dementia caregivers. J Geriatr Psychiatr Neurol, 21(3), 198–203.

    Article  Google Scholar 

  • Forlani, C., Morri, M., Ferrari, B., Dalmonte, E., Menchetti, M., De Ronchi, D., & Atti, A. R. (2014). Prevalence and gender differences in late-life depression: A population-based study. The American Journal of Geriatric Psychiatry, 22(4), 370–380.

    Article  PubMed  Google Scholar 

  • Fountoulakis, K. N., O’Hara, R., Iacovides, A., Camilleri, C. P., Kaprinis, S., Kaprinis, G., & Yesavage, J. (2003). Unipolar late-onset depression: A comprehensive review. Annals of General Hospital Psychiatry, 2(1), 11.

    Article  PubMed  PubMed Central  Google Scholar 

  • Galatzer-Levy, I. R., & Bonanno, G. A. (2012). Beyond normality in the study of bereavement: Heterogeneity in depression outcomes following loss in older adults. Social Science and Medicine, 74(12), 1987–1994.

    Article  PubMed  Google Scholar 

  • Ganguli, M., Du, Y., Dodge, H. H., Ratcliff, G. G., & Chang, C. C. (2006). Depressive symptoms and cognitive decline in late life: A prospective epidemiological study. Archives of General Psychiatry, 63(2), 153–160.

    Article  PubMed  Google Scholar 

  • Hegeman, J. M., Kok, R. M., Van der Mast, R. C., & Giltay, E. J. (2012). Phenomenology of depression in older compared with younger adults: Meta-analysis. British Journal of Psychiatry, 200(4), 275–281.

    Article  Google Scholar 

  • Heok, K. E., & Ho, R. (2008). The many faces of geriatric depression. Current Opinion in Psychiatry, 21(6), 540–545.

    Article  PubMed  Google Scholar 

  • Himelhoch, S., Weller, W. E., Wu, A. W., Anderson, G. F., & Cooper, L. A. (2004). Chronic medical illness, depression, and use of acute medical services among Medicare beneficiaries. Medical Care, 512–521.

    Google Scholar 

  • Horowitz, A., Reinhardt, J. P., Boerner, K., & Travis, L. A. (2003). The influence of health, social support quality and rehabilitation on depression among disabled elders. Aging & Mental Health, 7(5), 342–350.

    Article  Google Scholar 

  • Jain, R. K., & Aras, R. Y. (2007). Depression in geriatric population in urban slums of Mumbai. Indian Journal of Public Health, 51(2), 112–113.

    PubMed  Google Scholar 

  • Lapid, M. I., & Rummans, T. A. (2003). Evaluation and management of geriatric depression in primary care. Mayo Clinic Proceedings, 78(11), 1423–1429.

    Article  PubMed  Google Scholar 

  • Lawrence, V., Murray, J., Banerjee, S., Turner, S., Sangha, K., Byng, R., Bhugra, D., Huxley, P., Tylee, A., & Macdonald, A. (2006). Concepts and causation of depression: A cross-cultural study of the beliefs of older adults. The Gerontologist, 46(1), 23–32.

    Article  PubMed  Google Scholar 

  • Lenze, E. J. (2003). Comorbidity of depression and anxiety in the elderly. Current Psychiatry Reports, 5(1), 62–67.

    Article  PubMed  Google Scholar 

  • Lépine, J. P., & Briley, M. (2011). The increasing burden of depression. Neuropsychiatric Disease and Treatment, 7(Suppl 1), 3–7.

    PubMed  PubMed Central  Google Scholar 

  • Leyhe, T., Reynolds, C. F., III., Melcher, T., Linnemann, C., Klöppel, S., Blennow, K., Zetterberg, H., Dubois, B., Lista, S., & Hampel, H. (2017). A common challenge in older adults: Classification, overlap, and therapy of depression and dementia. Alzheim Dementia, 13(1), 59–71.

    Article  Google Scholar 

  • Lodha, P., & De Sousa, A. (2018). Geriatric mental health: The challenges for India. Journal of Geriatric Mental Health, 5(1), 16–29.

    Article  Google Scholar 

  • Löwe, B., Unützer, J., Callahan, C. M., Perkins, A. J., & Kroenke, K. (2004). Monitoring depression treatment outcomes with the patient health questionnaire-9. Medical Care, 1, 1194–201.

    Google Scholar 

  • Lyness, J. M., Niculescu, A., Tu, X., Reynolds, C. F., III., & Caine, E. D. (2006). The relationship of medical comorbidity and depression in older, primary care patients. Psychosomatics, 47(5), 435–439.

    Article  PubMed  Google Scholar 

  • Mackin, R. S., & Arean, P. A. (2005). Evidence-based psychotherapeutic interventions for geriatric depression. Psychiatria Clinica, 28(4), 805–820.

    Google Scholar 

  • Marty, M. A., Segal, D. L., & Coolidge, F. L. (2010). Relationships among dispositional coping strategies, suicidal ideation, and protective factors against suicide in older adults. Aging & Mental Health, 14(8), 1015–1023.

    Article  Google Scholar 

  • Mast, B. T. (2005). Impact of cognitive impairment on the phenomenology of geriatric depression. The American Journal of Geriatric Psychiatry, 13(8), 694–700.

    Article  PubMed  Google Scholar 

  • Maurer, D. M. (2012). Screening for depression. American Family Physician, 85(2), 139–144.

    PubMed  Google Scholar 

  • Meeks, T. W., Vahia, I. V., Lavretsky, H., Kulkarni, G., & Jeste, D. V. (2011). A tune in “a minor” can “b major”: A review of epidemiology, illness course, and public health implications of subthreshold depression in older adults. Journal of Affective Disorders, 129(1–3), 126–142.

    Article  PubMed  PubMed Central  Google Scholar 

  • Niti, M., Ng, T. P., Kua, E. H., Ho, R. C., & Tan, C. H. (2007). Depression and chronic medical illnesses in Asian older adults: The role of subjective health and functional status. International Journal of Geriatric Psychiatry, 22(11), 1087–1094.

    Article  PubMed  Google Scholar 

  • Papadopoulos, F. C., Petridou, E., Argyropoulou, S., Kontaxakis, V., Dessypris, N., Anastasiou, A., Katsiardani, K. P., Trichopoulos, D., & Lyketsos, C. (2005). Prevalence and correlates of depression in late life: A population based study from a rural Greek town. International Journal of Geriatric Psychiatry, 20(4), 350–357.

    Article  PubMed  Google Scholar 

  • Park, M., & Unützer, J. (2011). Geriatric depression in primary care. Psychiatria Clinica, 34(2), 469–487.

    Google Scholar 

  • Pattanayak, R. D., & Sagar, R. (2011). Depression in dementia patients: Issues and challenges for a physician. Journal of the Association of Physicians of India, 59, 647–652.

    Google Scholar 

  • Prakash, O., & Kukreti, P. (2013). State of geriatric mental health in India. Current Translational Geriatrics and Experimental Gerontology Reports, 2(1), 1–6.

    Article  Google Scholar 

  • Rajkumar, A. P., Thangadurai, P., Senthilkumar, P., Gayathri, K., Prince, M., & Jacob, K. S. (2009). Nature, prevalence and factors associated with depression among the elderly in a rural south Indian community. International Psychogeriatrics, 21(2), 372–378.

    Article  PubMed  PubMed Central  Google Scholar 

  • Roh, S., Burnette, C. E., Lee, K. H., Lee, Y. S., Easton, S. D., & Lawler, M. J. (2015). Risk and protective factors for depressive symptoms among American Indian older adults: Adverse childhood experiences and social support. Aging & Mental Health, 19(4), 371–380.

    Article  Google Scholar 

  • Routasalo, P., Arve, S., & Lauri, S. (2004). Geriatric rehabilitation nursing: Developing a model. International Journal of Nursing Practice, 10(5), 207–215.

    Article  PubMed  Google Scholar 

  • Sanders, S., & Adams, K. B. (2005). Grief reactions and depression in caregivers of individuals with Alzheimer’s disease: Results from a pilot study in an urban setting. Health and Social Work, 30(4), 287–295.

    Article  PubMed  Google Scholar 

  • Sarkisian, C. A., Lee-Henderson, M. H., & Mangione, C. M. (2003). Do depressed older adults who attribute depression to “old age” believe it is important to seek care? Journal of General Internal Medicine, 18(12), 1001–1005.

    Article  PubMed  PubMed Central  Google Scholar 

  • Schulz, R., Martire, L. M., & Klinger, J. N. (2005). Evidence-based caregiver interventions in geriatric psychiatry. Psychiatria Clinica, 28(4), 1007–1038.

    Google Scholar 

  • Seitz, D., Purandare, N., & Conn, D. (2010). Prevalence of psychiatric disorders among older adults in long-term care homes: A systematic review. International Psychogeriatrics, 22(7), 1025–1039.

    Article  PubMed  Google Scholar 

  • Sikorski, C., Luppa, M., Heser, K., Ernst, A., Lange, C., Werle, J., Bickel, H., Mösch, E., Wiese, B., Prokein, J., & Fuchs, A. (2014). The role of spousal loss in the development of depressive symptoms in the elderly—implications for diagnostic systems. Journal of Affective Disorders, 161, 97–103.

    Article  PubMed  Google Scholar 

  • Sözeri-Varma, G. (2012). Depression in the elderly: Clinical features and risk factors. Aging & Disease, 3(6), 465–471.

    Google Scholar 

  • Tagariello, P., Girardi, P., & Amore, M. (2009). Depression and apathy in dementia: Same syndrome or different constructs? A Critical Review. Archives of Gerontology and Geriatrics, 49(2), 246–249.

    Article  PubMed  Google Scholar 

  • Taqui, A. M., Itrat, A., Qidwai, W., & Qadri, Z. (2007). Depression in the elderly: Does family system play a role? A cross-sectional study. BMC Psychiatry, 7(1), 57.

    Article  PubMed  PubMed Central  Google Scholar 

  • VanItallie, T. B. (2005). Subsyndromal depression in the elderly: Underdiagnosed and undertreated. Metabolism, 54(5), 39–44.

    Article  PubMed  Google Scholar 

  • Wancata, J., Alexandrowicz, R., Marquart, B., Weiss, M., & Friedrich, F. (2006). The criterion validity of the Geriatric Depression Scale: A systematic review. Acta Psychiatrica Scandinavica, 114(6), 398–410.

    Article  PubMed  Google Scholar 

  • Wang, Y. P., & Gorenstein, C. (2013). Psychometric properties of the Beck Depression Inventory-II: A comprehensive review. Brazilian Journal of Psychiatry, 35(4), 416–431.

    Article  PubMed  Google Scholar 

  • Watson, L. C., & Pignone, M. P. (2003). Screening accuracy for late-life depression in primary care: A systematic review. Journal of Family Practice, 52(12), 956–964.

    PubMed  Google Scholar 

  • Wetherell, J. L., & Unützer, J. (2003). Adherence to treatment for geriatric depression and anxiety. CNS Spectrums, 8(S3), 48–59.

    Article  PubMed  Google Scholar 

  • Weyerer, S., Eifflaender-Gorfer, S., Köhler, L., Jessen, F., Maier, W., Fuchs, A., Pentzek, M., Kaduszkiewicz, H., Bachmann, C., Angermeyer, M. C., & Luppa, M. (2008). Prevalence and risk factors for depression in non-demented primary care attenders aged 75 years and older. Journal of Affective Disorders, 111(2–3), 153–163.

    Article  PubMed  Google Scholar 

  • Wilkins, V. M., Kiosses, D., & Ravdin, L. D. (2010). Late-life depression with comorbid cognitive impairment and disability: Nonpharmacological interventions. Clinical Interventions in Aging, 5, 323–331.

    PubMed  PubMed Central  Google Scholar 

  • Williams, J. R., Jr. (2005). Depression as a mediator between spousal bereavement and mortality from cardiovascular disease: Appreciating and managing the adverse health consequences of depression in an elderly surviving spouse. Southern Medical Journal, 98(1), 90–96.

    Article  PubMed  Google Scholar 

  • Wuthrich, V. M., & Frei, J. (2015). Barriers to treatment for older adults seeking psychological therapy. International Psychogeriatrics, 27(7), 1227–1236.

    Article  PubMed  Google Scholar 

  • Yaka, E., Keskinoglu, P., Ucku, R., Yener, G. G., & Tunca, Z. (2014). Prevalence and risk factors of depression among community dwelling elderly. Archives of Gerontology and Geriatrics, 59(1), 150–154.

    Article  PubMed  Google Scholar 

  • Yates, W. R., Mitchell, J., Rush, A. J., Trivedi, M. H., Wisniewski, S. R., Warden, D., Hauger, R. B., Fava, M., Gaynes, B. N., Husain, M. M., & Bryan, C. (2004). Clinical features of depressed outpatients with and without co-occurring general medical conditions in STAR* D. General Hospital Psychiatry, 26(6), 421–429.

    Article  PubMed  Google Scholar 

  • Zivin, K., & Kales, H. C. (2008). Adherence to depression treatment in older adults. Drugs and Aging, 25(7), 559–571.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Desousa Foundation, Consultant Psychiatrist and Founder Trustee, 18, St. Francis Road, Off SV Road, Santacruz West, Mumbai, 400054, India

    Avinash De Sousa

Authors
  1. Avinash De Sousa
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Independent International Consultant, New Delhi, Delhi, India

    Mala Kapur Shankardass

Rights and permissions

Reprints and permissions

Copyright information

© 2021 The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

De Sousa, A. (2021). Depression in Elderly Women: Clinical Challenges. In: Shankardass, M.K. (eds) Older Women and Well-Being. Springer, Singapore. https://doi.org/10.1007/978-981-16-4605-8_6

Download citation

Publish with us

Policies and ethics

Search

Navigation