Depression and Suicide in Older Adults

The social issue of depression and suicide in older adulthood significantly impacts lifespan development. This essay aims to define and explore the extent of depression and suicide in older adults in America, highlighting the influence of cultural background, gender, and socioeconomic status on the prevalence of depression in the elderly. Using a biopsychosocial approach, this essay will examine these issues and their impact on individual development as people age. Additionally, it will discuss the implications for social work practice and social policy regarding depression and suicide in older populations.

Prevalence and Impact

Depression affects two million Americans aged sixty-five and older out of the thirty-five million in this age group. Alarmingly, only ten percent of these individuals seek help from medical professionals. The prevalence of late-life depression is increasing as the population of people over sixty-five grows, contradicting the misconception that depression is a normal part of aging. Studies conducted in 2010 estimated that thirty-five million Americans were aged sixty-five or older, with this number expected to double by 2030. This increase can be attributed to factors such as reduced infant mortality rates, the aging of the baby boomer generation, and declining birth rates.

The fastest-growing age group is those aged eighty-five and older, leading to a higher prevalence of variables that affect lifespan development, such as depression and suicide. Older adults account for at least twenty percent of suicides in America, with depression significantly increasing the risk of suicide. According to the American Psychiatric Association, depression is a major depressive disorder that adversely affects how a person feels, thinks, and acts. In older adults, depression is the most common form of impairment and disability, leading to increased health risks, loneliness, social deprivation, cognitive decline, and, most critically, suicide.

Context of Diversity

As the elderly population in America grows, it is crucial to consider depression among older adults in the context of diversity. Factors such as cultural background, gender, and socioeconomic status play significant roles in the prevalence and experience of depression in this demographic. Notably, there are gender differences in depression and suicide rates among older adults. For white males aged sixty-five and older, the suicide rate is six times the national average. The systematic review of social factors and suicidal behavior in older adulthood suggests that up to 75% of older adults in the U.S. die as a result of their first suicidal act, possibly due to increased planning, physical frailty, and method lethality as they age. Men are more likely to commit suicide but have lower depression rates compared to women.

The Cache County Study conducted in Utah revealed that the prevalence of major depression in elderly women was 4.4%, compared to 2.7% in men. Despite the higher suicide rate among white men, women aged sixty-five and older are twice as likely to experience depression, partly due to hormonal changes. A study on non-demented elderly women found that 3.6% exhibited six or more depressive symptoms, yet only a small fraction received treatment. Factors such as age, education level, marital status, and health significantly influence depression rates in older women, with widows facing a higher risk of depression.

Socioeconomic status also correlates with depression in older adults, with lower socioeconomic standing increasing the likelihood of depression. Approximately 14.7% of older adults live below the poverty line, limiting their financial resources and access to healthcare. Minority groups are disproportionately affected by poverty, with 19.2% of African American and 18.1% of Hispanic older adults living in poverty, compared to just 8.7% of whites.

Depression disproportionately affects minority groups, particularly African Americans and Latinos. Elderly African Americans experience higher rates of depression due to psychological stressors like poverty, racism, discrimination, and violence. A comprehensive review of late-life depression in older African Americans found significant correlations between socioeconomic status, educational attainment, and depression. In contrast, Latinos face unique challenges, including language barriers, cultural stigma, and limited access to healthcare. These factors contribute to elevated depression rates among older Latinos, impacting their lifespan development.

Biopsychosocial Approach

Depression and suicide are not inherent aspects of aging; rather, they result from complex interactions between biological, psychological, and social factors. The biopsychosocial approach offers a comprehensive framework for understanding these issues in older adults. Biological changes, such as physical deterioration and disability, can trigger psychological and social challenges, increasing the risk of depression.

Older adults with disabilities or chronic illnesses face higher depression risks due to reduced mobility, pain, and social isolation. Vision impairment, for example, affects 18.1% of individuals by age seventy and correlates with increased depressive symptoms. Chronic illness exacerbates these issues, with depressed patients experiencing longer illness durations and greater social isolation.

Protective factors can mitigate depression risk in older adults. Access to healthcare, strong social support, and positive self-identity are crucial protective factors. Encouraging elderly individuals to be open about mental health issues and maintaining independence can further reduce depression risk.

Social Work and Policy Implications

Addressing depression and suicide in older adults presents challenges for social work practice and policy. A significant barrier is the misconception that depression is a normal part of aging, which prevents many older adults from seeking help. Mental Health America reports that 58% of people aged sixty-five and older believe depression is a normal aspect of aging, and 68% know little about the condition.

Social workers can play a vital role in prevention and intervention by conducting workshops on late-life depression. These workshops can educate older adults about depression symptoms, protective factors, and resources for support. By reducing stigma and increasing awareness, social workers can empower older adults to seek help and improve their mental well-being.

Medicare is a critical resource for older adults, covering mental health care costs. However, financial constraints can limit access to necessary services. Medicare Part A covers inpatient mental health care, while Part B provides broader coverage, including psychotherapy and medication. Unfortunately, Part B requires a premium, making it inaccessible for some older adults with limited incomes.

In conclusion, depression and suicide in older adulthood are pressing social issues affecting lifespan development. Understanding the role of diversity, the biopsychosocial approach, and social work implications can inform strategies to address these challenges. By increasing awareness, reducing stigma, and improving access to care, society can enhance the well-being and quality of life for older adults.

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