Depression in Older Adults

Depression in older adults is a significant public health concern. Approximately 14% of older adults cope with depression. Older adults have the highest rate of suicide. Factors such as poverty, poor housing, social isolation, chronic illnesses and functional limitations contribute to depression in older adults.

Depression can cause confusion and forgetfulness and is frequently, incorrectly, assumed to be a sign of dementia. It is important that a qualified professional evaluate depressive symptoms to ensure effective treatment for depression is implemented to prevent worsening of the depression and its consequences. Additionally, dementia symptoms require medical evaluation to ensure a correct diagnosis is made and an appropriate treatment plan is developed.

There are many factors that are associated with the high rate of depression in older populations. They can be placed in 3 categories: physical, psychological and social. No one factor results in depression, but a combination of several factors is often an indicator that the older adult is at risk for depression.

There are many physical factors in the aging process that are linked to the development of depression. Research on chronic illnesses such as heart disease, stroke, lung disease and cancer has identified a significant correlation between these illnesses and depression symptoms. Cognitive decline occurring in older adults increases the likelihood of depression. Older adults, in general, report changes in sleep patterns and for some people sleep disturbance is linked to depression. Lastly, age-related changes to brain structure appear to be a factor in depression for some older adults.

One of the most common psychological factors in older adults is grief associated with loss. Grief is the usual response to loss, but it can turn into clinical depression, particularly when it interferes with activities of daily life. Older adults often face considerable loss: career, siblings, spouses, friends, physical independence, homes. A combination of several types of loss can result in depression. Often when these losses occur, one of the impacts is the development of social isolation. The older adult may not intentionally withdraw from social interaction, rather, they may have lost the companions with whom (s)he interacted at work, in family life, at home, and in the community. Negative thinking can reinforce feelings of sadness, worthlessness and hopelessness. Prolonged experience of these feelings can lead to depression.

Social factors that can lead to feelings of depression may include: change in living arrangements, financial problems, access to social support, and access to health care. Upon retirement or the death of a spouse many older adults change their living arrangements. The process of leaving a home in which many decades of life were spent is overwhelming. Even though the new living arrangement may be “better” than the old home, leaving the old home is often associated with sadness. For many it is the first time in decades they had to make new acquaintances, learn new routines and develop a new pattern of life.

Older adults who live in poverty have fewer options about social factors in their life. Traveling, theater trips, dining out with friends isn’t in the budget. Scrimping to pay for food is common. Making choices between medication co-pays and food for a pet is a common situation. Many older adults lack the financial means to maintain a vehicle and stop driving. Others have physical challenges that cause them to surrender their license.

If you or your older loved one is exhibiting signs of depression, seek out a professional evaluation of the symptoms. Many older adults report difficulty in accessing mental health services. Cost of care is one frequently identified factor. In 2025, Medicare responded to this need by expanding coverage for mental health care. Older adults now have access to a more comprehensive range of services from family therapists, marriage counselors, and licensed social workers. This increased Medicare access will enable more older adults to receive the care they need. If you need more information about Medicare coverage and mental health services, call the CHOICES program at the Agency on Aging 1-800-994-9422.