Clinical: Older Adults & Depression

What Doctor's Don't Tell Older Adults About Depression

Whiteman, K. (2014). Social Work Helper.

Depression is a serious and debilitating condition for older adults aged 65 years and older. Depression not only exacerbates physical health conditions, but it also reduces quality of life and is a risk factor for suicide and other behavioral health problems such as substance use. There are many evidence-based treatment approaches to treat depression in older adults; however, the one of the most common forms of treatment in primary care settings and nursing homes is psychotropic medication. Psychotropic medication has been show to reduce depression symptoms in older adults, but these medications also have some potentially serious and life threatening side effects that older adults are more vulnerable to than younger age groups.

Why are older adults being prescribed medication as the first response to depression when alternative therapies such as physical activity have also been show to reduce depression symptoms in older adults? Is depression treatment really as simple as exercising and encouraging active older adults to maintain current levels of activity?

Physical activity such as yoga, strength training, swimming, and tai chi have consistently been shown to lower depression severity in older adults, not to mention improve cardio-respiratory and muscular fitness, bone and functional health, reduce the risk of chronic diseases, and cognitive decline.

The Center for Disease Control and Prevention made the following exercise recommendations for adults aged 65 years or older, who are fit, and have no limiting health conditions. The following are three weekly exercise options for older adults aged 65 years and older.

• 2 hours and 30 minutes (150 minutes) of moderate-intensity aerobic activity (i.e., brisk walking) every week and muscle-strengthening activities on 2 or more days a week that work all major muscle groups (legs, hips, back, abdomen, chest, shoulders, and arms).
• 1 hour and 15 minutes (75 minutes) of vigorous-intensity aerobic activity (i.e., jogging or running) every week and muscle-strengthening activities on 2 or more days a week that work all major muscle groups (legs, hips, back, abdomen, chest, shoulders, and arms).
• An equivalent mix of moderate- and vigorous-intensity aerobic activity and muscle-strengthening activities on 2 or more days a week that work all major muscle groups (legs, hips, back, abdomen, chest, shoulders, and arms).

Social workers and other health care professionals such as primary care physicians, nurses, or physical therapists who work with older adults first need to know the signs of depression, and if they detect depression symptoms, include physical activity in their treatment plan as a preventative or early intervention.

If we move away from relying on psychotropic medication as the main option for treating depression in older adults, we can encourage alternative treatments that don’t have potentially serious and life threatening side effects but have also been shown to be effective.

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