Occasional feelings of sadness are normal, but persistent feelings lasting weeks or months may indicate depression. Elderly individuals are particularly vulnerable to depression for various reasons. Studies show that about one-third of the global elderly population suffers from depression for differing causes.

Reasons for sadness in senior citizens can be physical. Health issues due to chronic diseases can cause depression. Lack of physical or outdoor activities makes one feel dull and sad. Mental health issues, including depression, occur at this stage of life for multiple reasons. When an individual reaches this age, their children or young close ones are busy and do not find enough time to spend with them, resulting in loneliness and depression.

Losing a spouse at this stage can be isolating, and distance from family due to work can worsen feelings of loneliness and anxiety. Mental stress and anxiety due to financial insecurity or chronic diseases result in stress-related problems like dryness of the mouth, palpitations, insomnia, etc.

Urinary incontinence, if present, can lead to embarrassment and anxiety in elderly individuals, increasing their isolation and contributing to loneliness and depression. Additionally, insomnia often affects older adults, causing physical and mental stress that may also result in depression.

Some medical conditions can cause depression without any other symptoms. Issues like reduced blood supply to the brain from thickened blood vessels, minor deep brain infarcts, brain tumours, and brain infections may present depression as the only sign.

Depression can be linked to electrolyte imbalance, particularly in individuals with inadequate food intake, kidney failure, or those undergoing treatment to eliminate excess salt and water from the body. Alcohol and tobacco use also cause depression. Many times, the diagnosis of these curable conditions is missed, as there is no other symptom except depression. Genetic factors also play a role.

Depression in the elderly may have different symptoms compared to that in youngsters. Instead of sadness, they could just feel numb or apathetic to everything around them. There may be vague headache and body ache. They may just complain of fatigue or difficulty in concentration or remembering. Suicidal thoughts may be present in extreme depression.

People should know the features of depression and detect it in a close one early. It is important to seek a doctor’s advice and let underlying medical causes for depression be excluded by clinical examination and suitable investigations, before diagnosing depression in an older person. A medical issue, if left untreated, can increase and cause serious health issues.

Many causes of depression in the elderly cannot be avoided. But a healthy lifestyle can help much in preventing depression or minimising its severity. One should take a healthy, nutritious diet, which should be high in fibre and nutrients. White sugar and excess salt are harmful and need to be avoided. Those suffering from chronic problems like hypertension and or diabetes should follow the diet as advised by a doctor or dietitian.

Regular physical activity is helpful in making one feel fresh and cheerful, including the elderly. It is also important to avoid age-related stiffness of joints or minimising it. One should be cautious to see that physical activity should be done within the physical ability of a person. Keeping oneself mentally occupied by indulging in a favourite hobby or creative past time keeps the mind cheerful.

At this age, one can pass on their skills and knowledge to the younger generation for further benefit of society as well. Family members should take care to see that an older member of their family does not feel lonely or isolated.

In spite of the above measures, if one has persistent depression, it is advisable to consult a mental health expert and start anti-depressant drugs.

Dr Rachna Pande is a specialist in internal medicine.