Epidemiology of depression in older adults

Depression in older adults is one of the most common mental health conditions, although it is often underestimated.

Globally, it is estimated that between 4% and 35% of people over the age of 60 have depressive symptoms, depending on the socioeconomic context and the diagnostic method used. In Latin America, studies reflect a significant prevalence.

This is a worrying picture, as many older adults live with depressive symptoms that do not always receive adequate care, increasing the risk of functional decline, greater use of medical services, and, in the most serious cases, suicide. Up to 15% of older adults in nursing homes have clinically significant depressive symptoms, although many do not have a formal diagnosis.

Risk groups and key epidemiological factors

The onset of depression in this population is influenced by multiple factors. The main risk groups include women, people without pensions, individuals with low educational levels, people with chronic diseases such as hypertension, diabetes, or cardiovascular disease, and those who live alone or with a limited support network.

Other key factors are social isolation, loss of social roles (such as retirement), bereavement, and negative perceptions of one's own health. Physical inactivity and a lack of recreational or meaningful activities have also been identified as significantly increasing the risk of developing depression.

In addition, biological factors such as neurochemical changes associated with aging and brain diseases such as lacunar strokes may contribute to the onset or worsening of depressive symptoms.

Underdiagnosis and its clinical and social implications

One of the most important challenges in addressing depression in older adults is the high degree of underdiagnosis. It is estimated that between 50% and 67% of cases are not identified or treated appropriately.

This phenomenon is due to several factors: the social normalization of emotional suffering in old age, the tendency of older adults to express discomfort through somatic symptoms (such as body aches or fatigue), and the fear of stigma associated with mental disorders. Underdiagnosis has serious implications. Clinically, it delays the start of effective treatment, contributing to functional and cognitive decline.

Socially, it perpetuates the marginalization of older adults and increases the burden on health systems and caregivers. It is also associated with higher suicide rates, with older adults being one of the populations with the highest mortality rates in suicide attempts.

For all these reasons, it is essential to promote early recognition of symptoms, train health personnel in dealing with older adults with affective symptoms, and foster a culture of respect and care for this vulnerable population.