Despite depression being one of the most common emotional challenges for older adults, it is not a normal part of aging. Rather it presents within the context of events and conditions that increase the risk of depression, and these of course increase as we spend more time on this earth (i.e. as we get older). Given the global increase in the aging population in combination with limited resources, late-life depression is a global concern due to its consequences to the individual, their families, and society. These consequences include significant emotional suffering, suicide risk, increased risk of significant functional decline (physical, social) and resulting in decreased productivity and quality of life, and increased mortality.
While depression symptoms generally include depressed mood or loss of interest or pleasure, older adults might not endorse sadness per se, but rather present with somatic complaints such as body aches, pain, mental and physical fatigue, or sleep disturbance, all of which might signal depression or a physical health issue. Complicating its clinical presentation further, late-life depression may occur as a first depressive episode or as recurrence from early-onset depression. In other words, late-life depression is a complex challenge, and available treatments such as antidepressants are not as helpful nor safe for older adults as they are for younger adults.
Thus, psychological treatment can be considered the first choice to address the emotional challenges that arise from the conditions that precipitate depression in older adults, be those significant life events such as the loss of a loved one or dealing with disease or injury consequences. Accordingly, psychotherapeutic modalities to address late-life depression may include grief counselling, supportive therapy, problem-solving therapy, and cognitive behavioural therapy, based on the person’s immediate presenting issues. Importantly, while all these events (losses, disease, injury) are experienced by all of us, independent of age, treatment is often more challenging when addressing depression in an older person, simply due to the increased complexity of the older adult and their challenges.
Depression is closely associated with brain aging. Therefore, brain health is intricately intertwined with healthy aging. For example, brain-pathological processes lead to cognitive decline and dementia which can drive the development of late-life depression while, at the same time, late-life depression is a putative etiological factor in the development of dementia (i.e. it’s a two-way street).
Thus, priorities to address vulnerabilities in the context of aging processes include minimizing the impact of sources of vulnerabilities while maximizing people’s resilience to support healthy aging trajectories. In short, given that prevention is generally less invasive to a person’s daily routine, and more efficient than treatment, supporting one’s brain health is of vital importance. The 5 domains that any person can engage in to promote your own brain health and mental well-being include a) healthy diet, b) mental/ cognitive stimulation, c) physical exercise, d) social/ interpersonal engagement, and d) stress reduction (e.g. constructive coping mechanisms, sleep hygiene, self-care activities, relaxation/ tension reduction). And help in how to best implement strategies to promote your brain health is always available, one-step-at-a-time.